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Autism : the international journal of research and practice2022; 26(6); 1320-1340; doi: 10.1177/13623613221085338

Calm with horses? A systematic review of animal-assisted interventions for improving social functioning in children with autism.

Abstract: Children with autism typically experience difficulties interacting socially with others when compared to their non-autistic peers. Establishing how effective interventions are for improving social functioning is important to help inform what should be offered to children with autism. This study reviewed how effective interventions that involved interaction with a live animal, known as animal-assisted interventions, are in improving social functioning in children with autism. A systematic search of the evidence on this topic found nine studies, which were explored for the effectiveness of animal-assisted interventions and the quality of methods used. Overall, these studies showed improvements in social functioning following equine-assisted or therapeutic horse-riding interventions, with initial evidence showing improvements are sustained in the short and medium term. However, several issues were identified, which limit the strength of any conclusions that can be drawn from this evidence. For example, in many studies people assessing the children were aware that they received the intervention or were in a control group. There was also not enough evidence available to draw conclusions on the effectiveness of other animal-assisted interventions. Future research should address the limitations that were common in the designs of these studies and investigate the potential benefit of other animal populations, such as dogs and cats.
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Publication Date: 2022-04-11 PubMed ID: 35403450PubMed Central: PMC9344573DOI: 10.1177/13623613221085338Google Scholar: Lookup
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  • Journal Article
  • Systematic Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article investigates the impact of animal-assisted interventions, particularly equine-assisted activities or therapeutic horse-riding, on the social functioning of children with autism. Although the results generally indicate improvement, there were challenges in the studies that limit conclusive results, suggesting the need for further in-depth research.

Overview and Method of Systematic Review

  • The study starts by acknowledging the social interaction difficulties that children with autism face compared to their non-autistic counterparts.
  • It emphasizes the necessity to assess the effectiveness of various interventions aimed at improving social functioning in such children.
  • This specific review is focused on animal-assisted interventions – activities involving interaction with live animals.
  • The authors performed a systematic search to gather relevant studies that had examined this topic, resulting in a selection of nine studies for further exploration.
  • Both the effectiveness of the animal-assisted interventions to improve social functioning and the quality of methodological procedures used in the studies were evaluated.

Findings from the Systematic Review

  • It was generally observed that equine-assisted activities such as therapeutic horse-riding facilitated improvements in social functioning for children with autism.
  • In addition, there was some evidence suggesting these improvements persisted at least in the short to medium term.

Limitations of the Reviewed Studies

  • Although the systematic review yielded promising results, the authors also highlighted several limitations that affect the drawing of concrete conclusions from these findings.
  • A common issue across many of the studies was that the assessors evaluating the children’s progress were cognizant of whether the kids were part of the intervention group or a control group, which could potentially introduce assessment bias.
  • There was insufficient data available to evaluate the effectiveness of animal-assisted interventions involving other species, aside from horses.

Directions for Future Research

  • Going forward, researchers are encouraged to address the recurring design flaws in previous studies related to assessment biases.
  • Additionally, investigations should also expand to include consideration of other animal species, such as dogs and cats, to determine their potential benefits in social functioning interventions for children with autism.

Cite This Article

APA
Sissons JH, Blakemore E, Shafi H, Skotny N, Lloyd DM. (2022). Calm with horses? A systematic review of animal-assisted interventions for improving social functioning in children with autism. Autism, 26(6), 1320-1340. https://doi.org/10.1177/13623613221085338

Publication

Autism : the international journal of research and practice
ISSN: 1461-7005
NlmUniqueID: 9713494
Country: England
Language: English
Volume: 26
Issue: 6
Pages: 1320-1340

Researcher Affiliations

Sissons, Jon H
  • University of Leeds, UK.
Blakemore, Elise
  • University of Leeds, UK.
Shafi, Hannah
  • University of Leeds, UK.
Skotny, Naomi
  • University of Leeds, UK.
Lloyd, Donna M
  • University of Leeds, UK.
  • University of Manchester, UK.

MeSH Terms

  • Animal Assisted Therapy
  • Animals
  • Autistic Disorder / psychology
  • Autistic Disorder / therapy
  • Child
  • Horses
  • Humans
  • Social Interaction

Conflict of Interest Statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

References

This article includes 53 references
  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, text revision (DSM IV – TR). .
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). .
  3. Avcil S, Baykara B, Baydur H, Münir KM, İnal Emiroğlu N. [The validity and reliability of the Social Communication Questionnaire- Turkish form in autistics aged 4-18 years].. Turk Psikiyatri Derg 2015 Spring;26(1):56-64.
    pmc: PMC4820243pubmed: 25742038
  4. Baron-Cohen S. Editorial Perspective: Neurodiversity - a revolutionary concept for autism and psychiatry.. J Child Psychol Psychiatry 2017 Jun;58(6):744-747.
    doi: 10.1111/jcpp.12703pubmed: 28524462google scholar: lookup
  5. Bass MM, Duchowny CA, Llabre MM. The effect of therapeutic horseback riding on social functioning in children with autism.. J Autism Dev Disord 2009 Sep;39(9):1261-7.
    doi: 10.1007/s10803-009-0734-3pubmed: 19350376google scholar: lookup
  6. Benevides TW, Shore SM, Palmer K, Duncan P, Plank A, Andresen ML, Caplan R, Cook B, Gassner D, Hector BL, Morgan L, Nebeker L, Purkis Y, Rankowski B, Wittig K, Coughlin SS. Listening to the autistic voice: Mental health priorities to guide research and practice in autism from a stakeholder-driven project.. Autism 2020 May;24(4):822-833.
    doi: 10.1177/1362361320908410pmc: PMC7787673pubmed: 32429818google scholar: lookup
  7. Borgi M, Loliva D, Cerino S, Chiarotti F, Venerosi A, Bramini M, Nonnis E, Marcelli M, Vinti C, De Santis C, Bisacco F, Fagerlie M, Frascarelli M, Cirulli F. Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder.. J Autism Dev Disord 2016 Jan;46(1):1-9.
    doi: 10.1007/s10803-015-2530-6pubmed: 26210515google scholar: lookup
  8. Brookman-Frazee L, Stadnick N, Chlebowski C, Baker-Ericzén M, Ganger W. Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services.. Autism 2018 Nov;22(8):938-952.
    doi: 10.1177/1362361317712650pmc: PMC6491206pubmed: 28914082google scholar: lookup
  9. Coman D. C., Bass M. P., Alessandri M., Ghilain C. S., Llabre M. M.. Effect of equine-assisted activities on social and sensory functioning of children with autism. Society & Animals: Journal of Human-Animal Studies 2018;26(6):551–575.
    doi: 10.1163/15685306-12341479google scholar: lookup
  10. Constantino JN, Davis SA, Todd RD, Schindler MK, Gross MM, Brophy SL, Metzger LM, Shoushtari CS, Splinter R, Reich W. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised.. J Autism Dev Disord 2003 Aug;33(4):427-33.
    doi: 10.1023/a:1025014929212pubmed: 12959421google scholar: lookup
  11. Corbett BA, Schupp CW, Simon D, Ryan N, Mendoza S. Elevated cortisol during play is associated with age and social engagement in children with autism.. Mol Autism 2010 Sep 27;1(1):13.
    doi: 10.1186/2040-2392-1-13pmc: PMC2955575pubmed: 20875126google scholar: lookup
  12. Crossman MK, Kazdin AE, Matijczak A, Kitt ER, Santos LR. The Influence of Interactions with Dogs on Affect, Anxiety, and Arousal in Children.. J Clin Child Adolesc Psychol 2020 Jul-Aug;49(4):535-548.
    doi: 10.1080/15374416.2018.1520119pubmed: 30376648google scholar: lookup
  13. den Houting J. Neurodiversity: An insider's perspective.. Autism 2019 Feb;23(2):271-273.
    doi: 10.1177/1362361318820762pubmed: 30556743google scholar: lookup
  14. Eaton-Stull Y., Beall M., Hutchins D., Marino S., Zinn H.. An exploratory study of Animal-Assisted Interventions (AAI) in social service agencies. Journal of Social Service Research 2020;46(6):756–769.
    doi: 10.1080/01488376.2019.1658028google scholar: lookup
  15. Gabriels RL, Pan Z, Dechant B, Agnew JA, Brim N, Mesibov G. Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder.. J Am Acad Child Adolesc Psychiatry 2015 Jul;54(7):541-9.
    doi: 10.1016/j.jaac.2015.04.007pmc: PMC4475278pubmed: 26088658google scholar: lookup
  16. Gabriels RL, Pan Z, Guérin NA, Dechant B, Mesibov G. Long-Term Effect of Therapeutic Horseback Riding in Youth With Autism Spectrum Disorder: A Randomized Trial.. Front Vet Sci 2018;5:156.
    doi: 10.3389/fvets.2018.00156pmc: PMC6054954pubmed: 30062099google scholar: lookup
  17. Handlin L., Hydbring-Sandberg E., Nilsson A., Ejdebäck M., Jansson A., Uvnäs-Moberg K.. Short-term interaction between dogs and their owners: Effects on oxytocin, cortisol, insulin and heart rate – An exploratory study. Anthrozoös 2011;24(3):301–315.
    doi: 10.2752/175303711x13045914865385google scholar: lookup
  18. Hernández-Espeso N., Martinez E. R., Sevilla D. G., Mas L. A.. Effects of dolphin-assisted therapy on the social and communication skills of children with autism spectrum disorder. Anthrozoos 2021;34(2):251–266.
    doi: 10.1080/08927936.2021.1885140google scholar: lookup
  19. Huang SW, Chi WC, Yen CF, Chang KH, Liao HF, Escorpizo R, Chang FH, Liou TH. Does more education mean less disability in people with dementia? A large cross-sectional study in Taiwan.. BMJ Open 2017 May 4;7(4):e013841.
    pmc: PMC5566594pubmed: 28473510doi: 10.1136/bmjopen-2016-013841google scholar: lookup
  20. Isaacson R.. The horse boy. .
  21. Jobin A. Varied treatment response in young children with autism: A relative comparison of structured and naturalistic behavioral approaches.. Autism 2020 Feb;24(2):338-351.
    doi: 10.1177/1362361319859726pmc: PMC6962565pubmed: 31311289google scholar: lookup
  22. Jones RM, Carberry C, Hamo A, Lord C. Placebo-like response in absence of treatment in children with Autism.. Autism Res 2017 Sep;10(9):1567-1572.
    doi: 10.1002/aur.1798pubmed: 28401674google scholar: lookup
  23. London MD, Mackenzie L, Lovarini M, Dickson C, Alvarez-Campos A. Animal Assisted Therapy for Children and Adolescents with Autism Spectrum Disorder: Parent perspectives.. J Autism Dev Disord 2020 Dec;50(12):4492-4503.
    doi: 10.1007/s10803-020-04512-5pubmed: 32333302google scholar: lookup
  24. Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis.. J Am Acad Child Adolesc Psychiatry 2017 Jun;56(6):466-474.
    doi: 10.1016/j.jaac.2017.03.013pubmed: 28545751google scholar: lookup
  25. Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism.. Lancet 2022 Jan 15;399(10321):271-334.
    doi: 10.1016/S0140-6736(21)01541-5pubmed: 34883054google scholar: lookup
  26. Lord C., Rutter M., DiLavore P., Risi S., Gotham K., Bishop S.. Autism Diagnostic Observation Schedule–2nd Edition (ADOS-2). .
  27. Malcolm R, Ecks S, Pickersgill M. 'It just opens up their world': autism, empathy, and the therapeutic effects of equine interactions.. Anthropol Med 2018 Aug;25(2):220-234.
    doi: 10.1080/13648470.2017.1291115pmc: PMC6199690pubmed: 28513182google scholar: lookup
  28. Marcheselli F., McManus S., Sadler K., Vizard T., Ford T., Goodman A., Goodman R.. Mental health of children and young people in England, 2017. 2018.
  29. Martin F, Farnum J. Animal-assisted therapy for children with pervasive developmental disorders.. West J Nurs Res 2002 Oct;24(6):657-70.
    pubmed: 12365766doi: 10.1177/019394502320555403google scholar: lookup
  30. Michopoulos I, Furukawa TA, Noma H, Kishimoto S, Onishi A, Ostinelli EG, Ciharova M, Miguel C, Karyotaki E, Cuijpers P. Different control conditions can produce different effect estimates in psychotherapy trials for depression.. J Clin Epidemiol 2021 Apr;132:59-70.
    doi: 10.1016/j.jclinepi.2020.12.012pubmed: 33338564google scholar: lookup
  31. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.. PLoS Med 2009 Jul 21;6(7):e1000097.
    doi: 10.1371/journal.pmed.1000097pmc: PMC2707599pubmed: 19621072google scholar: lookup
  32. National Institute for Health and Care Excellence. Autism spectrum disorder in under 19s: Support and management (Clinical Guideline). 2013.
    pubmed: 34283415
  33. O'Haire M. Research on animal-assisted intervention and autism spectrum disorder, 2012-2015.. Appl Dev Sci 2017;21(3):200-216.
    doi: 10.1080/10888691.2016.1243988pmc: PMC6510492pubmed: 31080343google scholar: lookup
  34. O'Haire ME, McKenzie SJ, Beck AM, Slaughter V. Social behaviors increase in children with autism in the presence of animals compared to toys.. PLoS One 2013;8(2):e57010.
    doi: 10.1371/journal.pone.0057010pmc: PMC3584132pubmed: 23468902google scholar: lookup
  35. Ozyurt G., Ozcan K., Elikucuk C. D., Odek U., Akpinar S.. Equine assisted activities have positive effects on children with autism spectrum disorder and family functioning. Montenegrin Journal of Sports Science and Medicine 2020;9(2):51–58.
    doi: 10.26773/mjssm.200909google scholar: lookup
  36. Pan Z, Granger DA, Guérin NA, Shoffner A, Gabriels RL. Replication Pilot Trial of Therapeutic Horseback Riding and Cortisol Collection With Children on the Autism Spectrum.. Front Vet Sci 2018;5:312.
    doi: 10.3389/fvets.2018.00312pmc: PMC6339889pubmed: 30693284google scholar: lookup
  37. Park EY, Kim J. Factor structure of the Childhood Autism Rating Scale as per DSM-5.. Pediatr Int 2016 Feb;58(2):139-45.
    doi: 10.1111/ped.12770pubmed: 26256774google scholar: lookup
  38. Park I, Gong J, Lyons GL, Hirota T, Takahashi M, Kim B, Lee SY, Kim YS, Lee J, Leventhal BL. Prevalence of and Factors Associated with School Bullying in Students with Autism Spectrum Disorder: A Cross-Cultural Meta-Analysis.. Yonsei Med J 2020 Nov;61(11):909-922.
    doi: 10.3349/ymj.2020.61.11.909pmc: PMC7593096pubmed: 33107234google scholar: lookup
  39. Pellicano L, Bölte S, Stahmer A. The current illusion of educational inclusion.. Autism 2018 May;22(4):386-387.
    doi: 10.1177/1362361318766166pubmed: 29600722google scholar: lookup
  40. Peters BC, Wood W, Hepburn S, Moody EJ. Preliminary Efficacy of Occupational Therapy in an Equine Environment for Youth with Autism Spectrum Disorder.. J Autism Dev Disord 2022 Sep;52(9):4114-4128.
    doi: 10.1007/s10803-021-05278-0pubmed: 34557985google scholar: lookup
  41. Rowland N.. Calm with Horses. 2020.
  42. Russell G, Rodgers LR, Ukoumunne OC, Ford T. Prevalence of parent-reported ASD and ADHD in the UK: findings from the Millennium Cohort Study.. J Autism Dev Disord 2014 Jan;44(1):31-40.
    doi: 10.1007/s10803-013-1849-0pubmed: 23719853google scholar: lookup
  43. Sandbank M, Bottema-Beutel K, Crowley S, Cassidy M, Dunham K, Feldman JI, Crank J, Albarran SA, Raj S, Mahbub P, Woynaroski TG. Project AIM: Autism intervention meta-analysis for studies of young children.. Psychol Bull 2020 Jan;146(1):1-29.
    doi: 10.1037/bul0000215pmc: PMC8783568pubmed: 31763860google scholar: lookup
  44. Silva K, Correia R, Lima M, Magalhães A, de Sousa L. Can dogs prime autistic children for therapy? Evidence from a single case study.. J Altern Complement Med 2011 Jul;17(7):655-9.
    doi: 10.1089/acm.2010.0436pubmed: 21689015google scholar: lookup
  45. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample.. J Am Acad Child Adolesc Psychiatry 2008 Aug;47(8):921-9.
    doi: 10.1097/CHI.0b013e318179964fpubmed: 18645422google scholar: lookup
  46. Souza-Santos C., Dos Santos J. F., Azevedo-Santos I., Teixeira-Machado L.. Dance and equine-assisted therapy in autism spectrum disorder: Crossover randomized clinical trial. Clinical Neuropsychiatry 2018;15(5):284–290.
  47. Sparrow S., Balla D., Cicchetti D.. The Vineland Adaptive Behavior Scales: Interview edition, survey form manual. .
  48. Spence SJ, Schneider MT. The role of epilepsy and epileptiform EEGs in autism spectrum disorders.. Pediatr Res 2009 Jun;65(6):599-606.
    doi: 10.1203/PDR.0b013e31819e7168pmc: PMC2692092pubmed: 19454962google scholar: lookup
  49. Trzmiel T, Purandare B, Michalak M, Zasadzka E, Pawlaczyk M. Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis.. Complement Ther Med 2019 Feb;42:104-113.
    doi: 10.1016/j.ctim.2018.11.004pubmed: 30670226google scholar: lookup
  50. Uccheddu S, Albertini M, Pierantoni L, Fantino S, Pirrone F. The Impacts of a Reading-to-Dog Programme on Attending and Reading of Nine Children with Autism Spectrum Disorders.. Animals (Basel) 2019 Jul 26;9(8).
    doi: 10.3390/ani9080491pmc: PMC6721078pubmed: 31357456google scholar: lookup
  51. Wood W, Alm K, Benjamin J, Thomas L, Anderson D, Pohl L, Kane M. Optimal Terminology for Services in the United States That Incorporate Horses to Benefit People: A Consensus Document.. J Altern Complement Med 2021 Jan;27(1):88-95.
    doi: 10.1089/acm.2020.0415pubmed: 33252244google scholar: lookup
  52. World Health Organization. The ICD-10 classification of mental and behavioural disorders. 1993.
  53. Zhao M, Chen S, You Y, Wang Y, Zhang Y. Effects of a Therapeutic Horseback Riding Program on Social Interaction and Communication in Children with Autism.. Int J Environ Res Public Health 2021 Mar 6;18(5).
    doi: 10.3390/ijerph18052656pmc: PMC7967314pubmed: 33800787google scholar: lookup

Citations

This article has been cited 6 times.
  1. González-Sala F, Llopiz-Guerra K, Ferri A, Martí-Vilar M. Parents' Perspectives on the Benefits of Animal-Assisted Intervention: A Systematic Review. Behav Sci (Basel) 2025 Dec 2;15(12).
    doi: 10.3390/bs15121663pubmed: 41464006google scholar: lookup
  2. Hai Y, Bai S, Qiao H, Li D, Wang D, Xia M. A Review of Therapeutic Approaches for Autism Spectrum Disorder. Brain Sci 2025 Nov 28;15(12).
    doi: 10.3390/brainsci15121280pubmed: 41440076google scholar: lookup
  3. Visser EK, Jens AL, Nieuwe Weme LE, Spaapen AA, Maarleveld KN, Enzerink KH, Tromp PN, Haven-Pross SC. Assessing Equine Behavioural Responses in Equine-Assisted Services: A Field Study Analysis. Animals (Basel) 2025 Feb 25;15(5).
    doi: 10.3390/ani15050671pubmed: 40075954google scholar: lookup
  4. Wang D, Zhao D, Wang W, Hu F, Cui M, Liu J, Meng F, Liu C, Qiu C, Liu D, Xu Z, Wang Y, Zhang Y, Li W, Li C. How do lateral septum projections to the ventral CA1 influence sociability?. Neural Regen Res 2024 Aug 1;19(8):1789-1801.
    doi: 10.4103/1673-5374.389304pubmed: 38103246google scholar: lookup
  5. Fan MSN, Li WHC, Ho LLK, Phiri L, Choi KC. Nature-Based Interventions for Autistic Children: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023 Dec 1;6(12):e2346715.
    doi: 10.1001/jamanetworkopen.2023.46715pubmed: 38060224google scholar: lookup
  6. Wallace-Watkin C, Sigafoos J, Woods L, Waddington H. Parent reported barriers and facilitators to support services for autistic children in Aotearoa New Zealand. Autism 2023 Apr 27;27(8):13623613231168240.
    doi: 10.1177/13623613231168240pubmed: 37129303google scholar: lookup
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