Therapeutic Horseback Riding in Children with Autism Spectrum Disorders

Background: Therapeutic horseback riding (THR) has been used to enhance functioning in many individuals with disabilities in Canada and the U.S. for over 40 years, but few studies have evaluated such interventions scientifically. Children diagnosed with an autism spectrum disorder (ASD) have social, communication, behavior, emotional, and dependency issues and caregivers struggle to find helpful interventions for these children.

Objectives: Evaluate effects of 10 one-hour weekly lessons of standardized THR treatment in three core areas: 1) Self-regulation behaviors, 2) adaptive daily living skills, and 3) motor coordination, organization and planning. Compare changes made following THR intervention with changes made during a ten-week waitlist control period, occurring immediately before THR.

 Methods: Forty-one subjects (35 male, 6 female) between the ages of 6 – 16 years (mean age: 8.7 years) with an ASD received pre- and post-intervention evaluations including the Aberrant Behavior Checklist-Community (ABC-C), Vineland Adaptive Behavior Scales-II (VABS-II), Bruininks-Oseretsky Test of Motor Proficiency (BOT-II) and Sensory Integration and Praxis Test (SIPT) within one month prior to and following engagement in 10 weeks of THR lessons. Caregivers completed ratings (ABC-C) of the child’s behaviors on a weekly basis. Sixteen subjects also participated in a wait-list control group before THR.

Results: Subjects from the THR group demonstrated significant improvements on the Irritability, Lethargy, Stereotypic Behavior, Hyperactivity and Inappropriate Speech subscales of the ABC-C; Short Form of the BOT-2; SIPT Verbal Praxis and Communication raw score and Adaptive Total score of the VABS-II. For the Irritability, Lethargy, Stereotypic Behavior and Hypersensitivity subscales of the ABC-C, significant improvement was noticed as early as the third week of THR. The expressive and receptive language subdomain raw scores of the VABS-II Communication domain were examined and subjects displayed significant improvement on the measure of expressive language, but there was a trend towards improvement on receptive language.

The waitlist control group enabled further analysis of the data to determine if the improvements were due to THR or if they might be due to a different, unidentified factor. ANCOVA analyses were performed to compare the change from pre-test to post-test. Significant improvements were found in subjects who participated in THR vs. waitlist period on the Irritability, Lethargy, Stereotypic Behavior and Hyperactivity subscales of the ABC-C.

Conclusions: The presence of a significant difference on the ANCOVA analysis suggests that the degree of change from the pre-test to the post-test differs significantly between the waitlist and the THR conditions and, therefore, may be due to the treatment itself. Lack of significant results on this ANCOVA analysis could mean that any differences observed on the t-tests described above may be due to developmental changes, lack of statistical power to identify a significant difference using the ANCOVA analysis or other factors that cause fluctuations between testing sessions.