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Randomized Controlled Trial
. 2015 Jul;54(7):541-9.
doi: 10.1016/j.jaac.2015.04.007. Epub 2015 May 5.

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

Free PMC article
Randomized Controlled Trial

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

Robin L Gabriels et al. J Am Acad Child Adolesc Psychiatry. .
Free PMC article


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;; NCT02301195.

Keywords: autism spectrum disorder; equine-assisted activities and therapies; human-animal interaction; social-communication functioning; therapeutic horseback riding.


Figure 1
Figure 1
Therapeutic horseback riding (THR) and autism spectrum disorder (ASD): participant flowchart. Note: ADOS = Autism Diagnostic Observation Schedule; BA = barn activity; ITT = intent to treat. a Eligible for ITT analysis; b Eligible for per protocol analysis.
Figure 2
Figure 2
Time course of Aberrant Behavior Checklist-Community (ABC-C) subscale scores during the course of the 10-week therapeutic horseback riding (THR) intervention. Note: SEM = standard error of the mean.

Comment in

  • The Alone Rangers and Silver.
    Arnold LE. Arnold LE. J Am Acad Child Adolesc Psychiatry. 2015 Jul;54(7):535-6. doi: 10.1016/j.jaac.2015.04.010. J Am Acad Child Adolesc Psychiatry. 2015. PMID: 26088655 No abstract available.

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