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Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: a Systematic Review

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Abstract

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 remediate 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 and to some extent on social communication skills in ASD. The evidence for positive effects of equine therapy on perceptuo-motor, cognitive, and functional skills is currently limited.

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References

  • Ajzenman, H. F., Standeven, J. W., & Shurtleff, T. L. (2013). Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study. American Journal of Occupational Therapy, 67(6), 653–663. https://doi.org/10.5014/ajot.2013.008383.

    Article  PubMed  Google Scholar 

  • American Hippotherapy Association. Hippotherapy as a treatment. Available at: http://www.americanhippotherapy association.org/hippotherapy/hippotherapy-as-a-treatment-strategy/. Accessed June 16, 2017.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

    Book  Google Scholar 

  • Anderson, S., & Meints, K. (2016). Brief report: the effects of equine-assisted activities on the social functioning in children and adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(10), 3344–3352. https://doi.org/10.1007/s10803-016-2869-3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bass, M. M., Duchowny, C. A., & Llabre, M. M. (2009). The effect of therapeutic horseback riding on social functioning in children with autism. Journal of Autism and Developmental Disorders, 39(9), 1261–1267. https://doi.org/10.1007/s10803-009-0734-3.

    Article  PubMed  Google Scholar 

  • Baranek, G., Parham, L., & Bodfish, J. (2005). Sensory and motor features in autism: assessment and intervention. In F. P. R. Volkmar, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (pp. 831–857). Hoboken: Wiley.

    Google Scholar 

  • Bedford, R., Pickles, A., & Lord, C. (2016). Early gross motor skills predict the subsequent development of language in children with autism spectrum disorder. Autism Research, 9(9), 993–1001. https://doi.org/10.1002/aur.1587.

    Article  PubMed  Google Scholar 

  • Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S. A., Engel-Yeger, B., & Gal, E. (2009). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 1–11. https://doi.org/10.1007/s10803-008-0593-3.

    Article  PubMed  Google Scholar 

  • Bhat, A., Landa, R., & Galloway, J. C. (2011). Perspectives on motor problems in infants, children, and adults with autism spectrum disorders. Physical Therapy, 91(7), 1116–1129. https://doi.org/10.2522/ptj.20100294.

    Article  PubMed  Google Scholar 

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243. https://doi.org/10.1023/A:1005596502855.

    Article  PubMed  Google Scholar 

  • Bondy, A., & Frost, A. (2003). Communication strategies for visual learners. In O. I. Lovaas (Ed.), Teaching individuals with developmental delays: basic intervention techniques (pp. 291–304). Austin: Pro-Ed.

    Google Scholar 

  • Borgi, M., Loliva, D., Cerino, S., Chiarotti, F., Venerosi, A., Bramini, M., .. Cirulli, F. (2016). Effectiveness of a standardized equine-assisted therapy program for children with autism spectrum disorder. Journal of Autism and Developmental Disorders 46(1):1–9. doi: https://doi.org/10.1007/s10803-015-2530-6

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.).

    Google Scholar 

  • Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., & Liaw, J. (2004). Early social attention impairments in autism: social orienting, joint attention, and attention to distress. Developmental Psychology, 40(2), 271–283. https://doi.org/10.1037/0012-1649.40.2.271.

    Article  PubMed  Google Scholar 

  • Dewey, D., Cantell, M., & Crawford, S. G. (2007). Motor and gestural performance in children with autism spectrum disorders, developmental coordination disorder, and or attention deficit hyperactivity disorder. Journal of the International Neuropsychological Society, 13, 246–256. https://doi.org/10.1017/S1355617707070270.

    Article  PubMed  Google Scholar 

  • Dziuk, M. A., Gidley Larson, J. C., Apostu, A., Mahone, E. M., Denckla, M., & Mostofsky, S. H. (2007). Dyspraxia in autism: association with motor, social, and communicative deficits. Developmental Medicine and Child Neurology, 49, 734–739. https://doi.org/10.1111/j.1469-8749.2007.00734.x.

    Article  PubMed  Google Scholar 

  • Fournier, K. A., Hass, C. J., Naik, S. K., Lodha, N., & Cauraugh, J. H. (2010). Motor coordination in autism spectrum disorders: a synthesis and meta-analysis. Journal of Autism and Developmental Disorders, 40, 1227–1240. https://doi.org/10.1007/s10803-010-0981-3.

    Article  PubMed  Google Scholar 

  • Gabriels, R. L., Agnew, J. A., Holt, K. D., Shoffner, A., Zhaoxing, P., Ruzzano, S., et al. (2012). Pilot study measuring the effects of therapeutic horseback riding on school-age children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(2), 578–588.

    Article  Google Scholar 

  • Gabriels, R. L., Pan, Z., Dechant, B., Agnew, J. A., Brim, N., & Mesibov, G. (2015). Randomized controlled trial of therapeutic horseback riding in children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 541–549. https://doi.org/10.1016/j.jaac.2015.04.007.

    Article  PubMed  PubMed Central  Google Scholar 

  • Garcia-Gomez, A., Risco, M. L., Rubio, J. C., & Garcia-Pena, I. M. (2014). Effects of a program of adaptive therapeutic horse-riding in a group of ASD children. Electronic Journal of Research in Educational Psychology, 12(1), 107–128.

    Google Scholar 

  • Green, D., Charman, T., Pickles, A., Chandler, S., Loucas, T., Simonoff, E., & Baird, G. (2009). Impairment in movement skills of children with autistic spectrum disorders. Developmental Medicine and Child Neurology, 51(4), 311–316. https://doi.org/10.1111/j.1469-8749.2008.03242.x.

    Article  PubMed  Google Scholar 

  • Greenspan, S. I., & Wieder, S. (1997). Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A chart review of 200 cases of children with autistic spectrum diagnoses. Journal of Developmental and Learning Disorders, 1, 87–142.

    Google Scholar 

  • Hallett, M., Lebiedowska, M. K., Thomas, S. L., Stanhope, S. J., Denckla, M. B., & Rumsey, J. (1993). Locomotion of autistic adults. Archives of Neurology, 50(12), 1304–1308.

    Article  PubMed  Google Scholar 

  • Hedges, L. V. (1981). Distribution theory for Glass’s estimator of effect size and related estimators. Journal of Educational Statistics, 6(2), 107–128.

    Article  Google Scholar 

  • Huedo-Medina, T. B., & Johnson, B. T. (2011). Estimating the standardized mean difference effect size and its variance from different data sources: a spreadsheet. Storrs: Authors.

    Google Scholar 

  • Jansiewicz, E. M., Goldberg, M. C., Newschaffer, C. J., Denckla, M. B., Landa, R., & Mostofsky, S. H. (2006). Motor signs distinguish children with high functioning autism and Asperger’s syndrome from controls. Journal of Autism and Developmental Disorders, 36(5), 613–621. https://doi.org/10.1007/s10803-006-0109-y.

    Article  PubMed  Google Scholar 

  • Jenkins, S. R., & Reed, F. D. D. (2013). An experimental analysis of the effects of therapeutic horseback riding on the behavior of children with autism. Research in Autism Spectrum Disorders, 7(6), 721–740.

    Article  Google Scholar 

  • Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008). Language outcome in autism: randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76(1), 125–137. https://doi.org/10.1037/0022-006X.76.1.125.

    Article  PubMed  Google Scholar 

  • Kern, J. K., Fletcher, C. R., Garver, C. R., Mehta, J. A., Grannemann, B. D., Knox, K. R., & Trivedi, M. H. (2011). Prospective trial of equine-assisted activities in autism spectrum disorder. Alternative Therapies, 17(3), 14–20 http://www.ncbi. nlm.nih.gov/pubmed/22164808.

    Google Scholar 

  • Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore, MD: Paul H Brookes Publishing.

    Google Scholar 

  • Landa, R. J., Holman, K. C., O’neill, A. H., & Stuart, E. A. (2011). Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 52(1), 13–21.

    Article  PubMed  Google Scholar 

  • Lanning, B. A., Baier, M. E., Ivey-Hatz, J., Krenek, N., & Tubbs, J. D. (2014). Effects of equine assisted activities on autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(8), 1897–1907. https://doi.org/10.1007/s10803-014-2062-5.

    Article  PubMed  Google Scholar 

  • Llambias, C., Magill-Evans, J., Smith, V., & Warren, S. (2016). Equine-assisted occupational therapy: increasing engagement for children with autism spectrum disorder. American Journal of Occupational Therapy, 70(6), 7006220040p1–7006220040p9. https://doi.org/10.5014/ajot.2016.020701.

    Article  PubMed  Google Scholar 

  • Leary, M. R., & Hill, D. A. (1996). Moving on: autism and movement disturbance. Mental Retardation, 34, 39–53.

    PubMed  Google Scholar 

  • Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive developmental disorders: relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, (8), 1101–1114. https://doi.org/10.1007/s10803-006-0147-5.

  • Lentini, J. A., & Knox, M. S. (2015). Equine-facilitated psychotherapy with children and adolescents: an update and literature review. Journal of Creativity in Mental Health, 10, 278–305. https://doi.org/10.1080/15401383.2015.1023916.

    Article  Google Scholar 

  • Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Loh, A., Soman, T., Brian, J., Bryson, S. E., Roberts, W., Szatmari, P., Smith, I. M., & Zwaigenbaum, L. (2007). Stereotyped motor behaviors associated with autism in high-risk infants: a pilot videotape analysis of a sibling sample. Journal of Autism and Developmental Disorders, 37(1), 25–36. https://doi.org/10.1007/s10803-006-0333-5.

    Article  PubMed  Google Scholar 

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.

    Article  PubMed  Google Scholar 

  • MacDonald, M., Lord, C., & Ulrich, D. A. (2014). Motor skills and calibrated autism severity in young children with autism spectrum disorder. Adapted Physical Activity Quarterly, 31(2), 95–105. https://doi.org/10.1123/apaq.2013-0068.

    Article  PubMed  Google Scholar 

  • McDaniel, P., & Wood, W. (2017). Autism and equine-assisted interventions: a systematic mapping review. Journal of Autism and Developmental Disorders, 47(10), 3220–3242. https://doi.org/10.1007/s10803-017-3219-9.

    Article  Google Scholar 

  • Moseley, A. M., Herbert, R. D., Sherrington, C., & Maher, C. G. (2002). Evidence for physiotherapy practice: a survey of the Physiotehrapy Evidence Database (PEDro). The Australian Journal of Physiotherapy, 48, 43–49.

    Article  PubMed  Google Scholar 

  • Mazefsky, C. A., Pelphrey, K. A., & Dahl, R. E. (2012). The need for a broader approach to emotion regulation research in autism. Child Development Perspectives, 6, 92–97. https://doi.org/10.1111/j.1750-8606.2011.00229.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mesibov, G. B., Shea, V., & Schopler, E. (2005). The TEACCH approach to autism spectrum disorders. Springer Science & Business Media.

  • Minshew, N. J., Sung, K. B., Jones, B. L., & Furman, J. M. (2004). Underdevelopment of the postural control system in autism. Neurology, 63(11), 2056–2061. https://doi.org/10.1212/01.WNL.0000145771.98657.62.

    Article  PubMed  Google Scholar 

  • Mostofsky, S. H., Dubey, P., Jerath, V. K., Jansiewicz, E. M., Goldberg, M. C., & Denckla, M. B. (2006). Developmental dyspraxia is not limited to imitation in children with autism spectrum disorders. Journal of the International Neuropsychological Society, 12(3), 314–326. https://doi.org/10.1017/S1355617706060437.

    Article  PubMed  Google Scholar 

  • Mundy, P., & Newell, L. (2007). Attention, joint attention, and social cognition. Current Directions in Psychological Science, 16, 269–274. https://doi.org/10.1111/j.1467-8721.2007.00518.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • O’Haire, M. E. (2013). Animal-assisted intervention for autism spectrum disorder: a systematic literature review. Journal of Autism and Developmental Disorders, 43(7), 1606–1622. https://doi.org/10.1007/s10803-012-1707-5.

    Article  PubMed  Google Scholar 

  • O’Haire, M. E. (2017). Research on animal-assisted intervention and autism spectrum disorder, 2012–2015. Applied Developmental Science, 21(3), 200–216.

    Article  Google Scholar 

  • Ozonoff, S., Pennington, B. F., & Rogers, S. J. (2006). Executive function deficits in high-functioning autistic individuals: relationship to theory of mind. Journal of Child Psychology and Psychiatry, 32(7), 1081–1105. https://doi.org/10.1111/j.1469-7610.1991.tb00351.x.

    Article  Google Scholar 

  • PATH International. PATH International home page. 2011. Available at: http://www.pathintl.org/. 2017. Accessed June 16, 2017.

  • Prizant, B. M. (2006). The SCERTS model: A comprehensive educational approach for children with autism Spectrum disorders volume II Program Planning & Intervention. Baltimore: Paul H. Brookes Publishing Company.

    Google Scholar 

  • Rogers, S. J., & Dawson, G. (2009). Play and engagement in early autism: The early start Denver model. New York: Guilford.

    Google Scholar 

  • Sackett, D., Rosenberg, J., Muir, G., Haynes, B., & Richardson, W. (1996). Evidence based medicine: what it is and what it isn’t. British Medical Journal, 312, 71–72. https://doi.org/10.1136/bmj.312.7023.71.

    Article  PubMed  PubMed Central  Google Scholar 

  • Srinivasan, S., Kaur, M., Park, I., Gifford, T., Marsh, K., & Bhat, A. (2015). The effects of rhythm and robotic interventions on the imitation/praxis, interpersonal synchrony, and motor performance of children with autism spectrum disorder (ASD): a pilot randomized controlled trial. Autism Research and Treatment, 2015, 736516, 18 pages. https://doi.org/10.1155/2015/736516.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steiner, H., & Kertesz, Z. (2015). Effects of therapeutic horse riding on gait cycle parameters and some aspects of behavior of children with autism. Acta Physiologica Hungarica, 102(3), 324–335. https://doi.org/10.1556/036.102.2015.3.10.

    Article  PubMed  Google Scholar 

  • Sullivan, G. M., & Feinn, R. (2012). Using effect size—Or why the P value is not enough. Journal of Graduate Medical Education, 4(3), 279–282.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabares, C., Vicente, F., Sanchez, S., Aparicioc, S., Alejoc, S., & Cuberob, J. (2012). Quantification of hormonal changes by effects of hippotherapy in the autistic population. Clinical Neurochemistry Neurochemical Journal, 6(4), 311–316.

    Article  Google Scholar 

  • Tager-Flusberg, H. (1999). A psychological approach to understanding the social and language impairments in autism. International Review of Psychiatry, 11(4), 325–334.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: a comparative study using the short sensory profile. The American Journal of Occupational Therapy, 61(2), 190–200.

    Article  PubMed  Google Scholar 

  • Vilensky, J. A., Damasio, A. R., & Maurer, R. G. (1981). Gait disturbances in patients with autistic behavior: a preliminary study. Archives of Neurology, 38(10), 646–649.

    Article  PubMed  Google Scholar 

  • Ward, S. C., Whalon, K., Rusnak, K., Wendell, K., & Paschall, N. (2013). The association between therapeutic horseback riding and the social communication and sensory reactions of children with autism. Journal of Autism and Developmental Disorders, 43(9), 2190–2198. https://doi.org/10.1007/s10803-013-1773-3.

    Article  PubMed  Google Scholar 

  • Weise, C., Simpson, R., & Kumar, S. (2016). The effectiveness of equine-based therapy in the treatment of social and behavioural aspects of children with autism Spectrum disorder: a systematic review. Internet Journal of Allied Health Sciences and Practice, 14(3), 12.

    Google Scholar 

  • Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425–435.

    Article  PubMed  Google Scholar 

  • Williams, D. L., Goldstein, G., & Minshew, N. J. (2006). The profile of memory function in children with autism. Neuropsychology, 20(1), 21–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wuang, Y. P., Wang, C. C., Huang, M. H., & Su, C. Y. (2010). The effectiveness of simulated developmental horse-riding program in children with autism. Adapted Physical Activity Quarterly, 27(2), 113–126.

    Article  PubMed  Google Scholar 

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Funding

DC and AB’s work on this manuscript was supported by the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) grant from the Maternal & Child Health Bureau (MCHB) of the Health Resources and Service Administration (HRSA) under grant number T73MC30116 (PI: Beth Mineo and Co-I: Brian Freedman). AB’s work on this manuscript was also supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number U54-GM104941 (PI: Binder-Macleod).

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Authors and Affiliations

  1. IDC School of Design, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, 400076, India

    Sudha M. Srinivasan

  2. Department of Physical Therapy, University of Delaware, 540 S College Ave., Newark, DE, 19713, USA

    David T. Cavagnino & Anjana N. Bhat

  3. Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, 19713, USA

    Anjana N. Bhat

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  1. Sudha M. Srinivasan
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  2. David T. Cavagnino
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Correspondence to Anjana N. Bhat.

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Appendices

Appendix 1: Search Terms for Databases

(“hippotherapy” OR “horse-riding” OR “therapeutic horseback riding” OR “horseback riding” OR “therapeutic riding” OR “equine therapy” OR “pet therapy” OR “animal-assisted” OR “equine-assisted” OR “horse therapy” OR “equine movement” OR “equine facilitated therapy” OR “equine-assisted therapy”[MeSH Terms] OR “animal-assisted therapy”[MeSH Terms])

AND (“Autistic Disorder”[MeSH Terms] OR “autism” OR “autistic” OR “autism spectrum disorder” OR “ASD” OR “ASDs”)

Appendix 2: Final Coding Sheet per Study

Coding Form: Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: A Systematic Review.

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Srinivasan, S.M., Cavagnino, D.T. & Bhat, A.N. Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: a Systematic Review. Rev J Autism Dev Disord 5, 156–175 (2018). https://doi.org/10.1007/s40489-018-0130-z

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