Equine-Assisted Occupational Therapy: Increasing Engagement for Children With Autism Spectrum Disorder.
Llambias Cecilia,Magill-Evans Joyce,Smith Veronica,Warren Sharon
The American journal of occupational therapy : official publication of the American Occupational Therapy Association
Engagement in meaningful activities is essential to development and is often reduced in children with autism spectrum disorder (ASD) who have limited engagement in activities or relationships. A multiple-baseline design was used with 7 children with ASD ages 4-8 yr to assess the effect of including a horse in occupational therapy intervention on task engagement. The children showed improvements in engagement. Including horses in occupational therapy sessions may be a valuable addition to conventional treatments to increase task engagement of children with ASD. Factors related to the environment, therapeutic strategies, and individual participation need to be considered in understanding why this intervention may be effective and developing a theoretical basis for implementation.
10.5014/ajot.2016.020701
Replication Pilot Trial of Therapeutic Horseback Riding and Cortisol Collection With Children on the Autism Spectrum.
Frontiers in veterinary science
We aimed to determine whether results of our prior randomized control trial [RCT; NCT02301195, (1)] of Therapeutic Horseback Riding (THR) for children and adolescents with autism spectrum disorder (ASD) could be at a different riding center and if treatment effects also included differences in the expression of associations between problem behavior and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants with ASD ( = 16) ages 6-16 years were randomized by nonverbal intelligence quotient to either a 10-week THR group ( = 8) or no horse interaction barn activity (BA) control group ( = 8). Outcome measures were a standard speech-language sample and caregiver-report of aberrant and social behaviors. Participants' saliva was sampled weekly at a consistent afternoon time immediately pre- and 20 min' post-condition (later assayed for cortisol). Intent-to-treat analysis revealed that compared to controls, THR participants had significant improvements in hyperactivity, and social awareness, and significant improvements at the 0.1 significance level in irritability and social communication behaviors. There were no significant improvements in number of words or new words spoken during the standard language sample. Linear mixed effects model analysis indicated that greater weekly pre-lesson irritability levels were associated with smaller post-lesson reduction in salivary cortisol levels, and greater weekly pre-lesson hyperactivity levels were associated with smaller cortisol reduction in the THR group, but not in the BA control group. The findings represent a partial replication of prior results (1), extend prior observations to include THR effects on biobehavioral relationships and suggest that cortisol could be a target mediator for THR effects on irritability and hyperactivity behaviors in youth with ASD. Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov, identifier: NCT02301195.
10.3389/fvets.2018.00312
The effect of therapeutic horseback riding on social functioning in children with autism.
Bass Margaret M,Duchowny Catherine A,Llabre Maria M
Journal of autism and developmental disorders
This study evaluated the effects of therapeutic horseback riding on social functioning in children with autism. We hypothesized that participants in the experimental condition (n = 19), compared to those on the wait-list control (n = 15), would demonstrate significant improvement in social functioning following a 12-weeks horseback riding intervention. Autistic children exposed to therapeutic horseback riding exhibited greater sensory seeking, sensory sensitivity, social motivation, and less inattention, distractibility, and sedentary behaviors. The results provide evidence that therapeutic horseback riding may be a viable therapeutic option in treating children with autism spectrum disorders.
10.1007/s10803-009-0734-3
Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: A Systematic Review.
Srinivasan Sudha M,Cavagnino David T,Bhat Anjana N
Review journal of autism and developmental disorders
Literature on effects of equine therapy in individuals with autism spectrum disorder (ASD) has grown in recent times. Equine therapy is an alternative multimodal intervention that involves utilizing a horse to enhance core impairments in ASD. Recent systematic reviews in this area have several limitations including inclusion of populations other than ASD, assessment of a variety of animal-assisted interventions other than equine therapy, and a failure to conduct quantitative analyses to provide accurate effect size estimates. We conducted a focused systematic review to address these limitations. Our review suggested that equine therapy has beneficial effects on behavioral skills and to some extent on social communication in ASD. The evidence for positive effects of equine therapy on perceptuo-motor, cognitive, and functional skills is currently limited.
10.1007/s40489-018-0130-z
Therapeutic horseback riding outcomes of parent-identified goals for children with autism spectrum disorder: an ABA' multiple case design examining dosing and generalization to the home and community.
Holm Margo B,Baird Joanne M,Kim Young Joo,Rajora Kuwar B,D'Silva Delma,Podolinsky Lin,Mazefsky Carla,Minshew Nancy
Journal of autism and developmental disorders
We examined whether different doses of therapeutic riding influenced parent-nominated target behaviors of children with autism spectrum disorder (ASD) (a) during the session (b) at home, and (c) in the community. We used a single subject multiple Baseline, multiple case design, with dosing of 1, 3, and 5 times/week. Three boys with ASD, 6-8 years of age participated, and counts of target behaviors were collected in each setting and phase of the study. Compared to Baseline, 70% of the target behaviors were better during Intervention and improvement was retained in 63% of the behaviors during Withdrawal. Increased doses of therapeutic riding were significant for magnitude of change, and the effect of the therapeutic riding sessions generalized to home and community.
10.1007/s10803-013-1949-x
Animal-assisted intervention for autism spectrum disorder: a systematic literature review.
O'Haire Marguerite E
Journal of autism and developmental disorders
The inclusion of animals in therapeutic activities, known as animal-assisted intervention (AAI), has been suggested as a treatment practice for autism spectrum disorder (ASD). This paper presents a systematic review of the empirical research on AAI for ASD. Fourteen studies published in peer-reviewed journals qualified for inclusion. The presentation of AAI was highly variable across the studies. Reported outcomes included improvements for multiple areas of functioning known to be impaired in ASD, namely increased social interaction and communication as well as decreased problem behaviors, autistic severity, and stress. Yet despite unanimously positive outcomes, most studies were limited by many methodological weaknesses. This review demonstrates that there is preliminary "proof of concept" of AAI for ASD and highlights the need for further, more rigorous research.
10.1007/s10803-012-1707-5
The effectiveness of simulated developmental horse-riding program in children with autism.
Wuang Yee-Pay,Wang Chih-Chung,Huang Mao-Hsiung,Su Chwen-Yng
Adapted physical activity quarterly : APAQ
This study investigated the effectiveness of a 20-week Simulated Developmental Horse-Riding Program (SDHRP) by using an innovative exercise equipment (Joba) on the motor proficiency and sensory integrative functions in 60 children with autism (age: 6 years, 5 months to 8 years, 9 months). In the first phase of 20 weeks, 30 children received the SDHRP in addition to their regular occupational therapy while another 30 children received regular occupational therapy only. The arrangement was reversed in the second phase of another 20 weeks. Children with autism in this study showed improved motor proficiency and sensory integrative functions after 20-week SDHRP (p < .01). In addition, the therapeutic effect appeared to be sustained for at least 24 weeks (6 months).
10.1123/apaq.27.2.113
Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder.
Gabriels Robin L,Pan Zhaoxing,Dechant Briar,Agnew John A,Brim Natalie,Mesibov Gary
Journal of the American Academy of Child and Adolescent Psychiatry
OBJECTIVE:This study expands previous equine-assisted intervention research by evaluating the effectiveness of therapeutic horseback riding (THR) on self-regulation, socialization, communication, adaptive, and motor behaviors in children with autism spectrum disorder (ASD). METHOD:Participants with ASD (aged 6-16 years; N = 127) were stratified by nonverbal IQ standard scores (≤85 or >85) and randomized to 1 of 2 groups for 10 weeks: THR intervention or a barn activity (BA) control group without horses that used similar methods. The fidelity of the THR intervention was monitored. Participants were evaluated within 1 month pre- and postintervention by raters blinded to intervention conditions and unblinded caregiver questionnaires. During the intervention, caregivers rated participants' behaviors weekly. RESULTS:Intent-to-treat analysis conducted on the 116 participants who completed a baseline assessment (THR n = 58; BA control n = 58) revealed significant improvements in the THR group compared to the control on measures of irritability (primary outcome) (p = .02; effect size [ES] = 0.50) and hyperactivity (p = .01; ES = 0.53), beginning by week 5 of the intervention. Significant improvements in the THR group were also observed on a measure of social cognition (p = .05; ES = 0.41) and social communication (p = .003; ES = 0.63), along with the total number of words (p = .01; ES = 0.54) and new words (p = .01; ES = 0.54) spoken during a standardized language sample. Sensitivity analyses adjusting for age, IQ, and per protocol analyses produced consistent results. CONCLUSION:This is the first large-scale, randomized, controlled trial demonstrating efficacy of THR for the ASD population, and findings are consistent with previous equine-assisted intervention studies. CLINICAL TRIAL REGISTRATION INFORMATION:Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195.
10.1016/j.jaac.2015.04.007
The association between therapeutic horseback riding and the social communication and sensory reactions of children with autism.
Ward Sandra C,Whalon Kelly,Rusnak Katrina,Wendell Kimberly,Paschall Nancy
Journal of autism and developmental disorders
This study investigated the association between therapeutic riding (TR) and the social communication and sensory processing skills of 21 elementary students with autism attending TR as part of a school group. An interrupted treatment design was employed to determine whether children were able to maintain treatment effects following the removal of TR. Teacher ratings indicated that participating children with autism significantly increased their social interaction, improved their sensory processing, and decreased the severity of symptoms associated with autism spectrum disorders following TR. Gains were not maintained consistently after two 6-week breaks from TR, but were recovered once TR was reinstated. Potential explanations regarding the benefits of TR are discussed, and suggestions for future research provided.
10.1007/s10803-013-1773-3
What is hippotherapy? The indications and effectiveness of hippotherapy.
Koca Tuba Tulay,Ataseven Hilmi
Northern clinics of Istanbul
Hippotherapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse to provide carefully graded motor and sensory input. A foundation is established to improve neurological function and sensory processing, which can be generalized to a wide range of daily activities. Unlike therapeutic horseback riding (where specific riding skills are taught), the movement of the horse is a means to a treatment goal when utilizing hippotherapy as a treatment strategy. Hippotherapy has been used to treat patients with neurological or other disabilities, such as autism, cerebral palsy, arthritis, multiple sclerosis, head injury, stroke, spinal cord injury, behavioral disorders and psychiatric disorders. The effectiveness of hippotherapy for many of these indications is unclear, and more research has been needed. Here, we purpose to give information about hippotherapy which is not known adequately by many clinicians and health workers.
10.14744/nci.2016.71601
Effects of equine assisted activities on autism spectrum disorder.
Lanning Beth A,Baier Margaret E Matyastik,Ivey-Hatz Julie,Krenek Nancy,Tubbs Jack D
Journal of autism and developmental disorders
Quality of life assessments were used in this study to determine the behavioral changes of children diagnosed with autism spectrum disorder (ASD) who participated in equine assisted activities. Behavioral changes of children with ASD participating in 9 weeks of equines assisted activities (EAA) (N = 10) were compared to behavioral changes of children who participated in a non-equine intervention (N = 8). Parents noted significant improvements in their child's physical, emotional and social functioning following the first 6 weeks of EAA. The children participating in the non-equine program also demonstrated improvement in behavior, but to a lesser degree. The favorable outcome of this study lends support for continuation of programs utilizing EAA in the treatment of children with ASD.
10.1007/s10803-014-2062-5
Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis.
Trzmiel Tomasz,Purandare Barbara,Michalak Michał,Zasadzka Ewa,Pawlaczyk Mariola
Complementary therapies in medicine
INTRODUCTION:The multifactorial nature of Autism Spectrum Disorder (ASD) is the reason why complementary and alternative methods of treatment are sought in order to support the classic approach. OBJECTIVES:The aim of the study was to assess the effectiveness of Equine-Assisted Activities and Therapies (EAAT) in ASD patients based on a review of the literature. METHODS:A review of the literature and a meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PUBMED, Cochrane Library, Web of Science, ClinicalTrials.gov and PEDro databases were searched until July 20, 2017. Only articles published in English, in a journal with a review process, after 1999, with a control group or presentation of comparative pre-/post-therapy results in ASD patients, and clear inclusion/exclusion criteria were considered. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS).The meta-analysis of three studies was conducted. RESULTS:A total of 15 studies with 390 participants (aged: 3-16 years) were included. The interaction between psychosocial functioning and EAAT was investigated in most studies. Improvement was reported in the following domains: socialization, engagement, maladaptive behaviors, and shorter reaction time in problem-solving situations after EAAT. The meta-analysis revealed no statistically significant differences for the investigated effects. CONCLUSIONS:Despite the need for further, more standardized research, the results of the studies included in this review allow us to conclude that EAAT may be a useful form of therapy in children with ASD.
10.1016/j.ctim.2018.11.004
Prospective trial of equine-assisted activities in autism spectrum disorder.
Kern Janet K,Fletcher Charles L,Garver Carolyn R,Mehta Jyutika A,Grannemann Bruce D,Knox Kandice R,Richardson Theresia A,Trivedi Madhukar H
Alternative therapies in health and medicine
BACKGROUND:Anecdotal reports and some studies suggest that equine-assisted activities may be beneficial in autism spectrum disorders (ASD). OBJECTIVE:To examine the effects ofequine-assisted activities on overall severity of autism symptoms using the Childhood Autism Rating Scale (CARS) and the quality ofparent-child interactions using the Timberlawn Parent-Child Interaction Scale. In addition, this study examined changes in sensory processing, quality of life, and parental treatment satisfaction. DESIGN AND PARTICIPANTS:Children with ASD were evaluated at four time points: (1) before beginning a 3-to-6 month waiting period, (2) before starting the riding treatment, and (3) after 3 months and (4) 6 months of riding. Twenty-four participants completed the waiting list period and began the riding program, and 20 participants completed the entire 6 months of riding. Pretreatment was compared to posttreatment with each child acting as his or her own control. RESULTS:A reduction in the severity of autism symptoms occurred with the therapeutic riding treatment. There was no change in CARS scores during the pretreatment baseline period; however, there was a significant decrease after treatment at 3 months and 6 months of riding. The Timberlawn Parent-Child Interaction Scale showed a significant improvement in Mood and Tone at 3 months and 6 months of riding and a marginal improvement in the reduction of Negative Regard at 6 months of riding. The parent-rated quality of life measure showed improvement, including the pretreatment waiting period. All of the ratings in the Treatment Satisfaction Survey were between good and very good. CONCLUSION:These results suggest that children with ASD benefit from equine-assisted activities.
Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study.
Ajzenman Heather F,Standeven John W,Shurtleff Tim L
The American journal of occupational therapy : official publication of the American Occupational Therapy Association
OBJECTIVE:The purpose of this investigation was to determine whether hippotherapy increased function and participation in children with autism spectrum disorder (ASD). We hypothesized improvements in motor control, which might increase adaptive behaviors and participation in daily activities. METHOD:Six children with ASD ages 5-12 participated in 12 weekly 45-min hippotherapy sessions. Measures pre- and post-hippotherapy included the Vineland Adaptive Behavior Scales-II and the Child Activity Card Sort. Motor control was measured preintervention and postintervention using a video motion capture system and force plates. RESULTS:Postural sway significantly decreased postintervention. Significant increases were observed in overall adaptive behaviors (receptive communication and coping) and in participation in self-care, low-demand leisure, and social interactions. CONCLUSION:These results suggest that hippotherapy has a positive influence on children with ASD and can be a useful treatment tool for this population.
10.5014/ajot.2013.008383
Effects of therapeutic horse riding on gait cycle parameters and some aspects of behavior of children with autism.
Steiner H,Kertesz Zs
Acta physiologica Hungarica
We studied effects of therapeutic riding on the development of children with autism. Experiments in walking is appropriate for assessing the coordination of movement and for following the changes. We found that therapeutic riding should be considered as a new form of rehabilitation. Twenty-six pupils (12 boys and 14 girls) of a special needs school participated in therapeutic riding. We analyzed walking twice during a school-term: full body analyses each time before and after one-month therapy. The research included a non-riding control group. All together 104 analyses were performed. We measured mental skills using Pedagogical Analysis and Curriculum (PAC) test consisting of four parts being communication, self care, motor skills and socialization. The Gait Cycle Analysis consists of the time-series analysis, the analysis of part of the gait cycle and the measurement of joint angles in each plane. We found significant differences between before and after the therapy in the length of the gait cycle that became more stable in the sagital plane and concluded that our results proved that horse therapy may be successfully used as an additional therapy for children with autism, and it may be a form of rehabilitation in cases when other therapies are not successful.
10.1556/036.102.2015.3.10
'It just opens up their world': autism, empathy, and the therapeutic effects of equine interactions.
Malcolm Roslyn,Ecks Stefan,Pickersgill Martyn
Anthropology & medicine
Experiences of autism-spectrum disorder are now increasingly studied by social scientists. Human-animal relations have also become a major focus of social inquiry in recent years. Examining horse-assisted therapy for autistic spectrum disorders, this is the first paper that brings these fields together. Drawing on participant observation and interviews at a UK horse therapy Centre, this article examines how staff and the parents of riders account for the successes and limitations of equine therapy. To the respondents, horses 'open up' autistic children and make possible interactions that seemed impossible before. Horses were regarded as facilitating the emergence of apparently social behaviours, which included eye contact, pointing, and speech. Three key explanations emerged for therapeutic success: the sensorial, embodied experience of riding the horse; the specific movements and rhythms of the horse; and, the 'personality' of the horse. Equine therapy can be regarded as enabling a form of multispecies intersubjectivity, with the resonance between rider and horse seeming to make possible a new attunement between humans. Practices of equine therapy, and perceptions of its efficacy, serve in turn to attune social scientists to a version of empathy constituted through lively and sensorial interactions, as opposed to one that is restricted to particular kinds of humans.
10.1080/13648470.2017.1291115
Brief Report: The Effects of Equine-Assisted Activities on the Social Functioning in Children and Adolescents with Autism Spectrum Disorder.
Anderson Sophie,Meints Kerstin
Journal of autism and developmental disorders
Equine-assisted activities and therapies are increasing in popularity for treatment of ASD symptoms. This research evaluated effects of a 5-week programme of therapeutic riding on social functioning of children/adolescents (N = 15) with ASD. The effectiveness of the programme was evaluated using the autism spectrum quotient, the Vineland Adaptive Behaviour Scale and the empathising and systemising quotient. Results established that the TR intervention increased empathising and reduced maladaptive behaviours. The findings also indicated that specific adaptive behaviours like socialization and communication were not affected by the intervention. Thus, a complex picture of the effects of this intervention emerges: while TR does not change all of the child's behaviour, it can improve specific aspects of social functioning and also reduce maladaptive ASD traits.
10.1007/s10803-016-2869-3
Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder.
Tan Vanessa Xue-Ling,Simmonds Janette Graetz
Journal of autism and developmental disorders
This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using Interpretative phenomenological analysis. Four super-ordinate themes emerged from the analysis: (1) child's improved self-concept and enhanced emotional well-being, (2) child's improved self-regulatory ability, (3) social benefits for the child, and (4) unexpected outcomes. EAI was perceived by the parents as having several levels of psychosocial benefits for their children. These benefits may also extend to parents and family through ecopsychological and "flow on" effects associated with the children's involvement in EAI programs.
10.1007/s10803-017-3399-3
Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder.
Borgi Marta,Loliva Dafne,Cerino Stefania,Chiarotti Flavia,Venerosi Aldina,Bramini Maria,Nonnis Enrico,Marcelli Marco,Vinti Claudia,De Santis Chiara,Bisacco Francesca,Fagerlie Monica,Frascarelli Massimo,Cirulli Francesca
Journal of autism and developmental disorders
In this study the effectiveness of an equine-assisted therapy (EAT) in improving adaptive and executive functioning in children with autism spectrum disorder (ASD) was examined (children attending EAT, n = 15, control group n = 13; inclusion criteria: IQ > 70). Therapeutic sessions consisted in structured activities involving horses and included both work on the ground and riding. Results indicate an improvement in social functioning in the group attending EAT (compared to the control group) and a milder effect on motor abilities. Improved executive functioning was also observed (i.e. reduced planning time in a problem-solving task) at the end of the EAT program. Our findings provide further support for the use of animal-assisted intervention programs as complementary intervention strategies for children with ASD.
10.1007/s10803-015-2530-6