Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder - 16/06/15
, Zhaoxing Pan, PhD a, Briar Dechant, BS a, John A. Agnew, PhD b, Natalie Brim, BA b, Gary Mesibov, PhD cAbstract |
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; clinicaltrials.gov; NCT02301195.
Le texte complet de cet article est disponible en PDF.Key Words : autism spectrum disorder, equine-assisted activities and therapies, human-animal interaction, therapeutic horseback riding, social-communication functioning
Plan
| This article is discussed in an editorial by Dr. L. Eugene Arnold on page 535. |
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| An interview with the author is available by podcast at www.jaacap.org or by scanning the QR code to the right. |
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| This study was supported by grant R01NR012736 from the National Institute of Nursing Research (R.L.G.). |
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| Dr. Pan served as the statistical expert for this research. |
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| The authors gratefully acknowledge the children and families who participated in this study, those who assisted with this project from Children's Hospital Colorado (Laurie Burnside, MSM, CCRC, Tina Farrell, CCC-SLP, Syd Martin, MS, OTR, Shana Holderness, MA, Oren Gordon, BA, and Jessie Lucas, student research assistant), and personnel from the Colorado Therapeutic Riding Center (Amy Shoffner, MSW, PATH International Advanced instructor, Jody Howard, PATH International Advanced Instructor and Registered Evaluator, and Penelope Powell, BA, PATH International Advanced Instructor and Registered Evaluator). The authors also thank PATH International and its former CEO, Kay Green, BA, for disseminating information about this study along with Luitpold Pharmaceuticals and Allen Mann, Director, Luitpold Animal Health, for donating Adequan for study horses. The authors are grateful to Carol Beresford, MD, and Doug Novins, MD, University of Colorado Anschutz Medical Campus, for assistance with manuscript preparation. |
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| Disclosure: Dr. Gabriels is a co-author of the book Growing Up With Autism: Working With School-Age Children and Adolescents (Guilford Press), and the book Autism—From Research to Individualized Practice (Jessica Kingsley Publishers), from which she has received royalties. She has received grant funding from the Simons Foundation, Nancy Lurie Marks Family Foundation, MARS/WALTHAM, and the Human–Animal Bond Research Institute (HABRI) Foundation. She has served on the Medical Advisory Board of Professional Association of Therapeutic Horsemanship International and has received honoraria from Spring Harbor Hospital, Portland, ME, Indiana University Neuroscience Center, Indianapolis, IN, and Routledge/Taylor and Francis Group. Dr. Mesibov is the co-author of the book The TEACCH Approach to Autism Spectrum Disorders (Springer Press), from which he has received royalties. Drs. Pan and Agnew, Ms. Dechant, and Ms. Brim report no biomedical financial interests or potential conflicts of interest. |
Vol 54 - N° 7
P. 541-549 - juillet 2015 Retour au numéro
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