Horse therapy brought about improvements in key behavioural areas in 15 children affected by autism spectrum disorder, researchers report.
The study team from Italy reported on the effects of 20 weekly sessions of equine-assisted activities and therapy on the group of autistic boys, aged 7 to 15.
Leonardo Zoccante and his fellow researchers, writing in the Journal of Clinical Medicine, said autism was by nature a multifactorial disease, whose different features were probably caused by different genes, associated with different brain regions and related to different core cognitive impairments.
Complementary and alternative methods of treatment may support the classic medical approach.
“In fact, it is not uncommon in clinical practice that parents of children with autism spectrum disorder would ask for different treatments in addition to the pharmacological approach, including healthcare practices that traditionally have not been part of conventional medicine, especially when the child’s behavioral difficulties have not been adequately controlled,” they said.
Among the most implemented and effective types of complementary methods are swimming, art therapy, music therapy and horse-related therapy.
Over the last decade, therapies involving horses have gained interest in the treatment of autism in light of their potential benefits around social functioning and postural control, which remain mostly resistant to medication.
The study team enrolled the boys from the Veneto Autism Spectrum Disorder Regional Centre of the Integrated University Hospital of Verona, Italy.
The twenty weekly 45-minute horse-related therapy sessions took place in Verona, half of which were done one-on-one and the other half in pairs.
Upon arrival, each child engaged in horse grooming, then activities on the ground, followed by activities on the animal. In each session, different techniques and activities were proposed, with gradual increases in difficulty and complexity. The program was tailored to each child’s characteristics.
Before and after the 20-week program, each child’s psychosocial, neurocognitive and neuromotor abilities were assessed by a clinical psychologist using a range of recognised parent-report questionnaires.
The psychologist also examined the level of stress in the parent–child relationship.
The study team found that the horse-related program was associated with better coordination and greater adaptive behavior. Adaptive behaviors are age-appropriate behaviors that enable a person to get on effectively in their daily lives, with the least conflict with others.
The authors also reported progressive improvement in the children’s abilities to respond to the increasing complexity of positive behavioral support.
However, horse therapy did not prove effective in reducing parental stress.
The study team said the preliminary evidence presented in the study may have important public health implications. The findings, they said, give reason to hope that equine-assisted activities and therapy could be an effective option in autism, warranting further clinical trials to investigate its potential benefits.
“It gives reason to hope that complementary and alternative methods of treatment could possibly be effective in complex and multifactorial conditions such as autism spectrum disorder, in order to achieve the best possible lifetime outcome for individuals suffering from these conditions.”
However, the therapy provided in the study was a one-time, time-limited, preliminary intervention made possible thanks to the joint effort of a tertiary referral facility and an amateur sports association with more than 10 years of experience in equine therapy.
“Such intervention may be less feasible in the longer-term and in common clinical settings, due to infrastructure and resource costs,” they said
“Preliminary results from this study require replication in larger populations from different socioeconomic backgrounds, as well as before, during and after receiving other therapeutic interventions.”
Work is also warranted to investigate the potential presence of a differential response to the therapy in children with different degrees of autism, and whether the improvements seen in the study persisted.
The study team comprised Zoccante, Michele Marconi, Marco Luigi Ciceri, Silvia Gagliardoni, Luigi Alberto Gozzi, Sara Sabaini, Gianfranco Di Gennaro and Marco Colizzi, variously affiliated with the Integrated University Hospital of Verona, Corte Molon—ASD HorseValley, the University of Verona, and King’s College London.
Zoccante, L.; Marconi, M.; Ciceri, M.L.; Gagliardoni, S.; Gozzi, L.A.; Sabaini, S.; Di Gennaro, G.; Colizzi, M. Effectiveness of Equine-Assisted Activities and Therapies for Improving Adaptive Behavior and Motor Function in Autism Spectrum Disorder. J. Clin. Med. 2021, 10, 1726. https://doi.org/10.3390/jcm10081726