Horse-Centered Occupational Therapy for Autism

Overseen by Brittany C Peters, PhD

Age: < 18

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Colorado State University

Must not be taking: Steroids

Disqualifiers: Smoking, Horseback riding, Animal abuse, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to learn about occupational therapy integrating horses for autistic youth. The main questions it aims to answer are: * Does occupational therapy integrating horses improve self-regulation in autistic youth * Does occupational therapy integrating horses affect salivary cortisol and alpha-amylase Participants will receive 10 weeks of occupational therapy, and will be asked to provide saliva samples each week. Researchers will compare occupational therapy integrating horses to occupational therapy in a clinic to see if integrating horses affects self-regulation.

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 data supports the effectiveness of the treatment Horse-Centered Occupational Therapy for Autism?

Research shows that incorporating horses into occupational therapy for children with autism can improve social motivation, goal attainment, and task engagement, while also reducing irritability. Studies have demonstrated that children participating in such therapies show greater language use and social interaction compared to standard occupational therapy. ^{1 2 3 4 5}

Is horse-centered occupational therapy safe for humans?

Research shows that horse-centered occupational therapy, also known as hippotherapy, is generally safe when recommended safety practices are followed. Safety incidents are rare, with only 0.05% of sessions requiring basic first aid and 0.01% needing off-site care. ^{1 4 5 6 7}

How is the treatment Horse-Centered Occupational Therapy for Autism different from other treatments for autism?

This treatment is unique because it incorporates horses into occupational therapy sessions, which has been shown to improve social motivation, task engagement, and reduce irritability in children with autism. Unlike traditional therapies, this approach uses the equine environment to enhance social and behavioral outcomes. ^{1 3 4 5 8}

Research Team

Brittany C Peters, PhD

Principal Investigator

Colorado State University

Eligibility Criteria

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)

Verbally fluent defined by meeting standard administration criteria for ADOS-2 module 3

Exclusion Criteria

I am currently receiving occupational therapy as an outpatient.

Weigh more than 200 pounds

I have ridden a horse for more than 10 hours in the last 6 months.

Trial Timeline

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

Treatment Details

Interventions

• OTEE HORS (Behavioural Intervention)

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.

Participant Groups

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+

Dr. Mark Brown

Colorado State University

Chief Medical Officer

MD from Georgetown University School of Medicine

John Wyckoff

Colorado State University

Chief Executive Officer since 2017

Ph.D. in Veterinary Parasitology and Immunology from the University of Florida

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Aviva Abosch

University of Colorado, Denver

Chief Medical Officer since 2019

MD

Uday B. Kompella

University of Colorado, Denver

Chief Executive Officer since 2015

PhD in Pharmaceutical Sciences

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

Collaborator

Trials

2,103

Recruited

2,760,000+

Dr. Diana W. Bianchi

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

Chief Executive Officer since 2016

MD from Stanford University

Dr. Alison Cernich

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

Chief Medical Officer since 2020

PhD in Clinical Psychology from University of Maryland

Findings from Research

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Preliminary Efficacy of Occupational Therapy in an Equine Environment for Youth with Autism Spectrum Disorder. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Occupational therapy incorporating animals for children with autism: A pilot investigation. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of simulated developmental horse-riding program in children with autism. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Equine-Assisted Occupational Therapy: Increasing Engagement for Children With Autism Spectrum Disorder. [2017]

5. United States pubmed.ncbi.nlm.nih.gov

Pilot Study: Occupational Therapy in an Equine Environment for Youth With Autism. [2021]

6. England 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. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Hippotherapy Practice and Safety Patterns in the United States: A Descriptive Survey Study. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: A Systematic Review. [2020]