title: Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder.
abstract: 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195.
authors.affiliation: University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, CO. Electronic address: robin.gabriels@childrenscolorado.org.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Gabriels
authors.affiliation: University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, CO.
authors.forename: Zhaoxing
authors.initials: Z
authors.lastname: Pan
authors.affiliation: University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, CO.
authors.forename: Briar
authors.initials: B
authors.lastname: Dechant
authors.affiliation: University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado.
authors.forename: John A
authors.initials: JA
authors.lastname: Agnew
authors.affiliation: University of Colorado Anschutz Medical Campus and the Children's Hospital Colorado.
authors.forename: Natalie
authors.initials: N
authors.lastname: Brim
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Gary
authors.initials: G
authors.lastname: Mesibov
mesh_terms: D000293:Adolescent; D000818:Animals; D000067877:Autism Spectrum Disorder / Q000628:therapy*; D002648:Child; D056147:Equine-Assisted Therapy / Q000379:methods*; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D000068356:Self-Control; D016037:Single-Blind Method; D012919:Social Behavior; D016896:Treatment Outcome; D014481:United States
keywords: autism spectrum disorder; equine-assisted activities and therapies; human-animal interaction; social-communication functioning; therapeutic horseback riding