Horse-Centered Occupational Therapy for Autism

Overseen By Brittany C Peters, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Colorado State University

Must not be taking: Steroids

Disqualifiers: Smoking, Horseback riding, Animal abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 10 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether occupational therapy that includes horse interaction (referred to as OTEE HORS) can improve self-regulation in autistic youth. Researchers aim to determine if spending time with horses differs from traditional clinic-based therapy. Participants will undergo 10 weeks of therapy and provide saliva samples to measure stress-related changes. Ideal candidates are autistic youth who can ride a horse for 10 minutes, follow safety rules, and provide saliva samples. As an unphased trial, this study offers a unique opportunity to explore innovative therapy methods that could enhance well-being.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this occupational therapy integrating horses is safe for autistic youth?

Research has shown that using horses in therapy is generally safe for young people with autism. Studies found no serious problems during these therapy sessions. Therapists adhered to the guidelines 91% of the time, indicating a high level of safety and organization.

While this therapy method remains under study, previous research has not identified any major safety issues. Participants can feel assured about the focus on safety and the positive environment this therapy aims to create. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about horse-centered occupational therapy for autism because it offers a unique, dynamic approach by incorporating horse riding into therapeutic sessions. Unlike traditional therapy that takes place in a clinic, this method uses the natural movement of horses to help individuals with autism develop self-regulation skills. The interaction with horses is believed to enhance emotional connections and sensory experiences, potentially leading to improved outcomes in a shorter time. This innovative therapy could provide a more engaging and effective alternative to conventional methods.

What evidence suggests that occupational therapy integrating horses is effective for autism?

Research has shown that using horses in therapy, known as equine therapy, could benefit young people with autism. In this trial, participants will receive either Occupational Therapy Integrating Horses or Occupational Therapy in a Clinic. Studies have found that equine therapy is easy to set up and generally well-received by participants. Early results suggest it might offer more social benefits than traditional therapies. Participants have reported satisfaction with the therapy, and evidence indicates it may help improve their ability to manage emotions and behavior. While more research is needed, these early findings suggest equine therapy could effectively help autistic youth. ^{3 4 5 6 7}

Who Is on the Research Team?

Brittany C Peters, PhD

Principal Investigator

Colorado State University

Are You a Good Fit for This Trial?

This trial is for autistic youth who meet specific criteria on the Autism Diagnostic Observation Schedule and Social Communication Questionnaire, have a nonverbal IQ of 65 or higher, can speak fluently, show certain levels of irritability, are able to wear a helmet and ride a horse safely for at least 10 minutes, and can provide saliva samples.

Inclusion Criteria

I can wear a helmet and safely ride a horse for 10 minutes.

Meet clinical cut-offs for ASD on the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and Social Communication Questionnaire (≥ 11)

Nonverbal IQ ≥ 65 on Leiter International Performance Scale Third Edition (Leiter-3)

Exclusion Criteria

I am currently receiving occupational therapy as an outpatient.

History of animal abuse or phobia of horses

Weigh more than 200 pounds

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 10 weeks of occupational therapy integrating horses or in a clinic, focusing on self-regulation skills

10 weeks

10 visits (in-person, weekly)

Follow-up

Participants are monitored for changes in self-regulation and physiological measures after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• OTEE HORS

Trial Overview The study compares two types of occupational therapy: one that includes interaction with horses (OTEE HORS) and traditional clinic-based therapy (OT Clinic). The aim is to see if therapy with horses improves self-regulation in autistic youth better than standard therapy.

How Is the Trial Designed?

Group I: Occupational Therapy Integrating Horses Experimental Treatment 1 Intervention

10 weeks of occupational therapy focused on self-regulation skills, provided while participants are riding horses

Group II: Occupational Therapy in a Clinic Active Control 1 Intervention

10 weeks of occupational therapy focused on self-regulation skills, provided in a traditional clinic environment

Who Is Running the Clinical Trial?

Colorado State University

Lead Sponsor

Trials

138

Recruited

38,200+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

In a study involving 24 youth with autism spectrum disorder (ASD), those who participated in 10 weeks of occupational therapy in an equine environment (OTee HORSPLAY) showed significant improvements in goal attainment, social motivation, and reduced irritability compared to a waitlist control group.

The findings suggest that integrating horses into occupational therapy can effectively enhance social and behavioral outcomes for youth with ASD, indicating a promising therapeutic approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary Efficacy of Occupational Therapy in an Equine Environment for Youth with Autism Spectrum Disorder. Peters, BC., Wood, W., Hepburn, S., et al.[2022]

Equine therapy shows beneficial effects on behavioral skills and some improvement in social communication for individuals with autism spectrum disorder (ASD), based on a focused systematic review.

However, the evidence supporting equine therapy's impact on perceptuo-motor, cognitive, and functional skills in ASD remains limited, indicating that more research is needed in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: A Systematic Review. Srinivasan, SM., Cavagnino, DT., Bhat, AN.[2020]

A study involving 7 children with autism spectrum disorder (ASD) aged 4-8 years demonstrated that incorporating horses into occupational therapy significantly improved the children's engagement in tasks.

The findings suggest that using horses in therapy could be a beneficial addition to traditional treatments for children with ASD, highlighting the importance of environmental and individual factors in therapy effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Equine-Assisted Occupational Therapy: Increasing Engagement for Children With Autism Spectrum Disorder. Llambias, C., Magill-Evans, J., Smith, V., et al.[2017]

A pilot study involving six youth with autism showed that a 10-week occupational therapy intervention in an equine environment led to improvements in occupational performance goals, social motivation, and communication, with some participants also experiencing reduced irritability and hyperactivity.

The study successfully implemented a screening and evaluation protocol for this type of therapy, indicating potential benefits for youth with autism, and suggests further research is needed to confirm these findings through a randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pilot Study: Occupational Therapy in an Equine Environment for Youth With Autism. Peters, BC., Wood, W., Hepburn, S., et al.[2021]

The 20-week Simulated Developmental Horse-Riding Program (SDHRP) significantly improved motor proficiency and sensory integrative functions in 60 children with autism, compared to those receiving only regular occupational therapy.

The benefits of the SDHRP were not only immediate but also sustained for at least 24 weeks after the program ended, indicating lasting positive effects on the children's development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of simulated developmental horse-riding program in children with autism. Wuang, YP., Wang, CC., Huang, MH., et al.[2019]

The presence of a therapy dog in a student-led occupational therapy clinic significantly enhanced children's engagement during therapy sessions, as reported by both students and parents.

Participants identified that the relationship between the children and the therapy dog fostered a sense of safety, which in turn encouraged the children to participate more actively in their therapy activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Canine-Assisted Occupational Therapy for Children within a Student-Led University Clinic: The Influence on Child Engagement from the Perspectives of Student and Parent Participants. Hill, J., Mensforth, S., Waldby, L., et al.[2023]

Hippotherapy is primarily utilized by physical and occupational therapists for pediatric clients, with significant variations in practice patterns based on geographic location.

Safety practices in hippotherapy are effective, with very low rates of incidents requiring basic first aid (0.05% of sessions) or off-site care (0.01% of sessions), indicating that risks are well managed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hippotherapy Practice and Safety Patterns in the United States: A Descriptive Survey Study. Peters, BC., Fields, BE., Erdman, EA.[2021]

In a study involving 22 children with autism aged 7 to 13, those who participated in occupational therapy sessions that included animals showed significantly greater language use and social interaction compared to those receiving standard therapy techniques.

The results suggest that incorporating animals into therapy can enhance motivation and engagement in children with autism, potentially leading to better therapeutic outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Occupational therapy incorporating animals for children with autism: A pilot investigation. Sams, MJ., Fortney, EV., Willenbring, S.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11405308/

The feasibility of occupational therapy using Zones ... This study demonstrated that OT-ZOR Equine is feasible to implement, acceptable to recipients and providers, and may offer additive benefits in social ...

2. mdpi.com mdpi.com/2076-328X/15/4/495

The Acceptability of Occupational Therapy Using Zones ... We analyzed interview transcripts using directed content analysis. Autistic children found OT-ZOR-Equine to be generally acceptable. The children especially ...

3. researchgate.net researchgate.net/publication/380098459_Occupational_Therapy_Using_Zones_of_Regulation_Concepts_A_Feasibility_Study

(PDF) Occupational Therapy Using Zones of Regulation ... The purpose of this study was to identify appropriate outcome measures and assess preliminary efficacy of occupational therapy in an equine environment (OTee ...

4. cabidigitallibrary.org cabidigitallibrary.org/doi/full/10.1079/hai.2021.0033

A Transactional Analysis of Occupational Therapy in an ... The current study sought to support manualization of one approach to occupational therapy in an equine environment for youth with ASD (OT ee HORSPLAY).

5. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40282116/

The Acceptability of Occupational Therapy Using Zones ... We analyzed interview transcripts using directed content analysis. Autistic children found OT-ZOR-Equine to be generally acceptable. The ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12024242/

The Acceptability of Occupational Therapy Using Zones ... Occupational therapists support self-regulation in autistic children by helping them understand and learn strategies to modify their emotional state and degree ...

7. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1401222/full

The feasibility of occupational therapy using Zones ... Occupational therapists maintained 91% fidelity to the OT-ZOR Equine intervention protocol and there were no serious adverse events. All ...