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Child and adolescent psychiatry and mental health2025; 19(1); 131; doi: 10.1186/s13034-025-00990-6

Horses and ADHD: the ASTride intervention for cognitive and emotional growth.

Abstract: This study aimed to evaluate the efficacy of the Attention Skill Training (ASTride) protocol, an Equine-Assisted Occupational Therapy (EAOT) intervention, for children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) in enhancing and promoting cognitive and emotional aspects including executive functions, self-efficacy, anxiety and hope perception. Methods: A prospective cohort study with an Interrupted Time-Series design was conducted. Fifty participants (mean age = 9.51 years, SD = 1.52) were assessed at four time points: baseline, pre-test (following a 12-week waiting period), post-test (after 12 weeks of intervention), and after three-month follow-up. The intervention was administered by a licensed equine assisted occupational therapists, and assessments were conducted by a blinded occupational therapist. Measures included The Behavior Rating Inventory of Executive Function (BRIEF) for executive functions, and the Hope, Child Anxiety Related Emotional Disorders (SCARED), and The New General Self-Efficacy Scale (NGSE) questionnaires for emotional factors. Results: Significant improvements were found in executive functions, hope perception, and self-efficacy. Anxiety levels significantly decreased post-intervention. Conclusions: The ASTride intervention showed efficacy in improving executive functions, hope, and self-efficacy, while reducing anxiety in children with ADHD, supporting its potential as a comprehensive therapeutic approach. Trial registration The research is registered at Clinical Trials.gov, identifier number NCT05869253, first registration at 22/5/2023.
© 2025. The Author(s).
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Publication Date: 2025-11-21 PubMed ID: 41272733PubMed Central: PMC12639777DOI: 10.1186/s13034-025-00990-6Google Scholar: Lookup
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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.

Overview

  • This study evaluates the effectiveness of the ASTride protocol, an Equine-Assisted Occupational Therapy intervention, in improving cognitive and emotional functions in children with ADHD.
  • The intervention aims to enhance executive functions, self-efficacy, hope perception, and reduce anxiety among the participants.

Study Objective and Design

  • Objective: To assess the efficacy of the ASTride protocol in promoting cognitive and emotional improvements in children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD).
  • Study Design: A prospective cohort study utilizing an Interrupted Time-Series design.
  • Participants: 50 children with ADHD, average age approximately 9.5 years.
  • Assessment Time Points:
    • Baseline (initial measurement)
    • Pre-test (after a 12-week waiting period)
    • Post-test (after 12 weeks of intervention)
    • Three-month follow-up (to assess lasting effects)

Intervention Details

  • ASTride Protocol:
    • Delivered through Equine-Assisted Occupational Therapy (EAOT), which involves therapeutic activities with horses.
    • Administered by licensed equine-assisted occupational therapists.
    • Aimed at enhancing executive functions, emotional well-being, self-efficacy, hope, and reducing anxiety.
  • Assessment:
    • Conducted by a blinded occupational therapist to avoid bias.

Measures Used in the Study

  • Executive Functions: Measured by The Behavior Rating Inventory of Executive Function (BRIEF)
  • Emotional Factors:
    • Hope Perception: Assessed via the Hope Questionnaire
    • Anxiety Levels: Measured by the Child Anxiety Related Emotional Disorders (SCARED) scale
    • Self-Efficacy: Evaluated using The New General Self-Efficacy Scale (NGSE)

Key Findings

  • Significant improvements were observed in:
    • Executive functions (better cognitive control, attention, and task management)
    • Hope perception (increased positive outlook and goal-directed thinking)
    • Self-efficacy (enhanced belief in one’s ability to execute actions successfully)
  • Anxiety levels showed a statistically significant decrease after the intervention, indicating improved emotional regulation and reduced stress symptoms.
  • The improvements were sustained at the three-month follow-up, suggesting lasting benefits.

Conclusions and Implications

  • The ASTride intervention demonstrates efficacy as a comprehensive therapeutic approach for children with ADHD, addressing both cognitive and emotional domains.
  • Equine-Assisted Occupational Therapy can serve as a valuable complement or alternative to traditional ADHD interventions.
  • By enhancing executive function and emotional well-being, the intervention may contribute to improved daily functioning and quality of life for affected children.
  • The study supports further research and potential clinical adoption of this intervention model.

Additional Information

  • The research is registered with ClinicalTrials.gov under the identifier NCT05869253.
  • First registration date was May 22, 2023.

Cite This Article

APA
Helmer A, Delore E, Bart O. (2025). Horses and ADHD: the ASTride intervention for cognitive and emotional growth. Child Adolesc Psychiatry Ment Health, 19(1), 131. https://doi.org/10.1186/s13034-025-00990-6

Publication

Child and adolescent psychiatry and mental health
ISSN: 1753-2000
NlmUniqueID: 101297974
Country: England
Language: English
Volume: 19
Issue: 1
Pages: 131
PII: 131

Researcher Affiliations

Helmer, Anne
  • Department of Occupational Therapy, School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
  • Mount Judeah stable, Tzur Hadassah, Israel.
Delore, Elaina
  • Department of Occupational Therapy, School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
  • Elwyn Israel, Jerusalem, Israel.
Bart, Orit
  • Department of Occupational Therapy, School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel. oritbert@tauex.tau.ac.il.

Conflict of Interest Statement

Declarations. Ethics approval and consent to participate: Ethical approval was received from the Sackler Faculty of Medicine of Tel-Aviv University IRB No:0003949-2. All methods were approved and carried out in accordance with the IRB guidelines. Informed consent was obtained from Parents or Legally Authorized Representative of the child participants before conducting the study. Human or animal rights: The experiment with equines were approved by the Sackler Faculty of Medicine of Tel-Aviv University IRB No:0003949-2. All methods were approved and carried out in accordance with the IRB guidelines and ARRIVE guidelines for reporting research involving animals [35]. Competing interests: The authors declare no competing interests.

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