Table 2.
Study characteristics.
| Basic Article Information | Sample Characteristics | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sample Demographics | Diagnoses and Measures | ||||||||||
| First Author, Year, Journal |
Type of Trial | Reported Inclusion/ Exclusion of Participants (Y/N) |
Final Sample of Participants (E, C) |
Age (Range, Mean, SD) |
Gender (Male/Female) |
IQ (SD) | Participant Eligibility Criteria | Past/Recent EAI Experience |
Screening Instrument for Participants | Diagnoses | Diagnostic Measure |
| Peters, B. C., 2022, [43], J Autism Dev Disord |
RCTs | Y |
n = 21 E(OTEE): 12 C: 9 |
6–13 THR: (-), 8.68 ± 2.09 RA: (-), 9.45 ± 1.62 |
Male: 16 Female: 5 THR: 10/2 CT: 6/3 |
NVIQ ≥ 55 | (1) Aged 6–13 years old; (2) SCQ score ≥ 15; (3) Meets clinical cutoffs for ASD on ADOS, ADOS-2, or SRS-2; (4) Leiter-3 score ≥ 55; (5) Combined irritability and hyperactivity score ≥ 25 |
No EAA experience during previous 6 months. | SCQ ADOS-2 Leiter-3 |
ASD | HCC ABC-C SRS-2 GAS PEDI-CAT ASD |
| Zoccante, L., 2021, [25], J Clin Med |
Pre–post design | Y |
n = 15 Level 1: 7 Level 2: 6 Level 3: 2 |
7–15, 9.8 ± 2.2 | Male: 13 Female: 2 |
(-) | ASD participants without: (1) Critical medical illness; (2) Previous experience with horses; (3) Distressed behavior. |
N | ADOS-2 DSM-5 |
ASD ADHD: 9 |
VABS-2 DCDQ’07 PSI-SF IEMS |
| Zhao, M., 2021, [40], Int J Environ Res Public Health |
RCTs | Y |
n = 61 E(THR): 31 C(RA): 30 |
6–12; THR: (-), 7.06 ± 1.50 RA: (-), 7.13 ± 1.36 |
Male: 44 Female: 17 THR: 21/10 RA: 23/7 |
(-) | Children diagnosed with ASD, aged 6–12 years old. | (-) | DSM-5 | ASD | SSIS-RS; ABLLS-R |
| Peters, B. C., 2020, [28], OTJR (Thorofare N J) |
SCED | Y | n = 6 | 6–13 | (-) | NVIQ ≥ 55 on Leiter-3 | (1) Aged 6–13 years old; (2) Diagnosed with ASD on SCQ (≥15); (3) NVIQ ≥ 55 on Leiter-3; (4) Combined score ≥ 11 on irritability and hyperactivity subscales of ABC-C; (5) Meets physical, mental, and emotional standards set forth by PATH Intl. |
No THR experience during previous 6 months | SCQ ADOS Leiter-3 |
ASD | VAS |
| Kalmbach, D., 2020, [53], Occup Ther Health Care |
Explanatory sequential design | (-) | n = 4 | 8–13 | Male: 4 Female: 0 |
NVIQ (M: 100, SD: 15) | (-) | (-) | ABAS | ASD | Semistructured interviews |
| Ozyurt, Gonca., 2020, [54], Montenegrin Journal of Sports Science and Medicine |
RCTs | (-) |
n = 24 E(EAA): 12 C: 12 |
4–12, 6.77 ± 1.3 EAA: 6.75 ± 0.7 C: 6.7 ± 0.64 |
Male: 17 Female: 7 EAA: 8/4 C: 9/3 |
(-) | (-) | No previous experience with equine-assisted activities. | (-) | ASD | CGAS FAD SCQ |
| Kwon, S., 2019, [55], Ann Rehabil Med |
More group control | Y |
n = 29 E(THR): 18 C(CT): 11 |
6–11 THR: 8.2 ± 1.7 CT: 7.5 ± 1.1 |
Male: 16 Female: 13 THR: 11/7 CT: 5/6 |
(-) | (1) Diagnosis of ASD or ID; (2) Aged 6–13 years old; (3) Body weight < 35 kg; height < 150 cm; (4) Understanding of simple instructions; (5) Appropriate physical development for rehabilitative horseback riding; (6) Informed consent from legal guardian. |
N | (-) | ASD: 19 ID: 10 |
REVT PRES K-ABC-2 BSID-2 Luria Model |
| Pan, Z., 2018, [56], Front Vet Sci |
RCTs | Y |
n = 16 E(THR): 8 C(BA): 8 |
6–16 THR: 11.88 ± 2.45 BA: 9.80 ± 2.82 |
Male: 13 Female: 3 THR: 6/2 BA: 7/1 |
THR: 102.88 ± 16.28 BA: 100.25 ± 29.26 |
(1) Aged 6–16 years; diagnosis of ASD; (2) Combined total score of > 11 on irritability and stereotype subscales of ABC-C; (3) NVIQ score of ≥ 40 by Leiter-3. |
(-) | SCQ ADOS-2 ABC-C Leiter-3 |
ASD CPD: 12 PM: 9 PD: 1 MD: 3 AD: 8 ADHD: 7 LD: 1 |
SALT SRS ABC-C Saliva cortisol |
| Gabriels, R. L., 2018, [57], Front Vet Sci |
RCTs | Y |
n = 64 E(THR): 36 C(BA): 28 |
6–16 | (-) | NVIQ 85 or > 85 | 6 months | (-) | ASD | ABC-C SRS SALT |
|
| Tan, V. X., 2018, [58], J Autism Dev Disord |
Case design | (-) | n = 6 | 3–14 | Male: 1 Female: 5 |
NVIQ: 40 and 56 | (-) | 8 months–5 years | (-) | ASD | IPA |
| Harris, A., 2017, [59], Int J Environ Res Public Health |
More group control | Y |
n = 26 E(HR): 12 C: 14 |
6.08–9.33, 7.5 ± 10.57 HR: 8.2 ± 10.56 C: 7 ± 3.95 |
Male: 22 Female: 4 |
(-) | Excluded: (1) Not wearing helmet; (2) Known history of treating animals; (3) Fear or dislike of animals. |
Four children in intervention group had more than 2–3 years. |
Test in Social Communication Clinic | ASD | CARS2 ABC-C MOPI |
| Anderson, S., 2016, [60], J Autism Dev Disord |
Case–control | Y | n = 15 | 5–16, 10 [3.8] | Male: 11 Female: 4 |
(-) | (1) Diagnosis of ASD; (2) No previous experience with horses. |
N | DSM | ASD (27%) ADHD (20%) HSID (53%) |
VABS ASQ EQ/SQ |
| Borgi, M., 2016, [61], J Autism Dev Disord |
RCTs | Y |
n = 28: E(EAT): 15 C: 13 |
6–12, 8.6 ± 1.7 EAT: 9.2 ± 1.8 CG: 8.0 ± 1.5 |
(-) | IQ > 70 EAT: 98.3 ± 16.2 CG: 92.8 ± 19.9 |
(1) Diagnosis of ASD, aged 6–12 years; (2) IQ > 70 on WISC-III; (3) Lack of previous THR experience. |
Lack of previous therapeutic riding experience. | (-) | ASD | VABS TOL |
| Gabriels, R. L., 2015, [30], J Am Acad Child Adolesc Psychiatry |
RCTs | Y |
n = 116 E(THR): 58 C(BA): 58 |
6–16; THR: (-), 10.5 ± 3.2 BA: (-), 10.0 ± 2.7 |
Male: 101 Female: 15 THR: 49/9 BA: 52/6 |
NVIQ: THR: 86.7 [25.5] BA: 86.1 [22.7] |
Leiter-R nonverbal IQ cutoff ≥ 40; SCQ-ASD screening cutoff ≥ 15; ABC-C score ≥ 11. |
No more than two hours of EAAT within past six months. | SCQ ADOS-2 ABC-C Leiter-3 |
ASD MD AD ADHD, LD SD |
PPVT-4 SALT SRS BOT-2 SIPT VABS ABC-C |
| Steiner, H., 2015, [62], Acta Physiol Hung |
Control design | (-) |
n = 26 E(THR): 13 C(PT): 13 |
10–13 | Male: 12 Female: 14 THR: 6/7 PT: 6/7 |
(-) | (-) | (-) | (-) | ASD | APAS PAC-test |
| Holm, M. B., 2014, [63], J Autism Dev Disord |
Single-case–control | Y | n = 3 | 6–8 | Male: 3 Female: 0 |
(-) | (1) Diagnosis of ASD; (2) Aged 5–13 years old; (3) Available to participant in intervention; (4) Parental agreement. |
Approximately one year. | (-) | ASD | KTEA-2 ABC-C CARS SRS SP-CQ |
| Lanning, B. A., 2014, [42], J Autism Dev Disord |
Control design | Y |
n = 18 * E(EAA): 10 C(SC): 8 |
4–15 EAA: 4–15, 7.5 ± 3.2 C: 5–14, 9.8 ± 3.2 |
Male: 21 Female: 4 EAA: 9/4 C: 12 |
(-) | (1) Diagnosis of ASD from physician or therapist; (2) Parental agreement; (3) No participation in EAA 6 months prior to start of study. |
No EAA experiences during previous 6 months. | (-) | ASD | PedsQL CHQ |
| Ward, S. C., 2013, [38], J Autism Dev Disord |
Quasi-experimental | Y | n = 21 | 8.1 | Male: 15 Female: 6 |
(-) | (1) Meeting criteria for autism according to DSM IV-TR; (2) Qualified for services in public school division. |
Thirteen participants with no TR experience. | DSM IV-TR CAB-T |
ASD | GARS-2 SPSC |
| Jenkins, Sarah R., 2013, [64], Research in Autism Spectrum Disorders |
Multiple baseline SCED | Y |
n = 7 THR: 4 C: 3 |
6–14, 9.5 | Male: 6 Female: 1 |
(-) | (1) No prior exposure to THR or hippotherapy; (2) Residing within 30 miles of primary research site. |
No THR or HIP experience. | VABS-2 | ASD TC Verbal and Motor Apraxia |
CBC BOT-2 |
| Ghorban, Hemati, 2013, [65], Journal of education and learning |
Pre–post design | Y | n = 6 | 6–12 | Male: 1 Female: 5 |
(-) | Meeting criteria for DSM-IV-TR. | (-) | (-) | ASD | TSSA |
| Gabriels, Robin L., 2012, [66], Research in Autism Spectrum Disorders |
Waitlist control and pre–post design | Y |
n = 42 THR: 26 C: 16 |
6–16, 8.7 E: 5–16, 8.6 C: 6–14, 8.8 |
Male: 36 Female: 6 E: 21/5 C: 15/1 |
NVIQ range of 44–139, Mean: 95.2 | (1) Chronological ages of 6–16 years; (2) Diagnosis of autistic or Asperger’s disorder; (3) Combined score of at least 11 on ABC-C. |
No THR experience within past three years. | ABC-C SCQ ADOS Leiter-R |
ASD Asperger’s disorder Seizures |
ABC-C BOT-2 SIPT VABS-2 |
| Tabares, C., 2012, [67], Neurochemical Journal |
Pre–post design | (-) | n = 8 | 8–16 | Male: 8 | (-) | (-) | (-) | (-) | ASD | ELISA |
| Janet K Kern., 2011, [68], Alternative Therapies in Health and Medicine |
Pre–post design | Y | n = 24 | 3–12, 7.8 ± 2.9 | Male: 18 Female: 6 |
(-) | (1) Between 3 and 12 years of age; (2) Primary diagnosis of ASD; (3) CARS score ≥ 30; (4) No previous participation in equine-assisted activities. |
No previous EAA participation. | CARS | ASD | CARS Timberlawn Parent–Child Interaction Scales SP QLES-Q TSS |
| Bass, M. M., 2009, [69], J Autism Dev Disord |
Case–control | Y |
n = 34 E: 19 C: 15 |
5–10 E: 6.95 ± 1.67 C: 7.73 ± 1.65 |
Male: 29 Female: 5 E: 17/2 C: 12/3 |
(-) | (1) Meeting criteria for DSM-IV-TR. | No EAA experience. | DSM-IV-TR SSSS |
ASD Asperger’s |
SRS SP |
| Taylor, Renee R., 2009, [70], Occupational Therapy in Mental Health |
SCED | (-) | n = 3 | 4–6 | (-) | (-) | (1) Aged 4–6 years; (2) No other medical or psychiatric diagnoses. |
(-) | (-) | ASD | PVQ |
Table chronologically sorted and abbreviations alphabetically ordered as follows: (-): not reported; Y: yes; N: no; E: experimental group; C: control group; n/a: not applicable; n: number; BA: barn activity; Type of Trial: SCED: single-case experimental design; Final sample of participants: n = 18 *, initial sample = 25; BA: barn activities; CT: conventional therapy; EAAs: equine-assisted activities; EAT: equine-assisted therapy; HR: horseback riding; OTEE: occupational therapy in equine environment; PT: physical therapy; RA: regular activity; SC: social circle; THR: therapeutic horseback riding; Participant eligibility criteria: ABC-C: Aberrant Behavior Checklist—Community; NVIQ: nonverbal IQ; PATH Intl.: Professional Association of Therapeutic Horsemanship International; WISC-Ⅲ: Wechsler Intelligence Scale for Children III; Screening Instruments: ABAS: Adaptive Behavior Assessment System; ABC-C: Aberrant Behavior Checklist—Community; ADOS: Autism Diagnostic Observation Schedule; CAB-T: Clinical Assessment Battery Teacher Rating Form; CARS: Childhood Autism Rating Scale; DSM: Diagnostic and Statistical Manual of Mental Disorders; Leiter: Leiter International Performance Scale; SCQ: Social Communication Questionnaire; SSSS: Stone’s Social Skills Scale; VABS: Vineland Adaptive Behavior Scale; Diagnosis: AD: anxiety disorder; ADHD: attention-deficit/hyperactivity disorder; CPD: community psychiatric diagnoses; HSID: hypersensitivity and sensory integration disorder; ID: intellectual disability; LD: learning disability; MD: mood disorder; PD: psychotic disorder; SD: seizure disorder; TC: tuberous sclerosis; Diagnostic Measure: ABLLS-R: Assessment of Basic Language and Learning Skills—Revised; APAS: Ariel Performance Analysis System; BOT: Bruininks–Oseretsky Test of Motor Proficiency; BSID-2: Cognitive Domain of Bayley Scales of Infant Development 2; CBC: Child Behavior Checklist; CGAS: Children’s Global Assessment Scale; CHQ: Child Health Questionnaire; DCDQ’07: Developmental Coordination Disorder Questionnaire, as revised in 2007; ELISA: competitive enzyme immune essay method; EQ/SQ: empathizing quotient/systemizing quotient; FAD: McMaster Family Assessment Device; GARS-2: Gilliam Autism Rating Scale 2; GAS: Goal Attainment Scale; HCC: hair cortisol content; IEMS: interaction emotions motor skills; IPA: interpretive phenomenological analysis; K-ABC-2: Kaufman Assessment Battery for Children 2; KTEA-2: Kaufman Test of Educational Achievement—Second Edition; PAC-test: Pedagogical Analysis and Curriculum; PEDI-CAT ASD: Pediatric Evaluation of Disability Inventory Computer Adaptive Test, Autism Spectrum Disorder Module; MOPI: observational measure of child’s engagement; PedsQL: Pediatric Quality of Life 4.0 Generic Core Scales; PPVT-4: Peabody Picture Vocabulary Test, Fourth Edition; PRES: Preschool Receptive–Expressive Language Scale; PSI-SF: Parenting Stress Index—Short Form; PVQ: Pediatric Volitional Questionnaire; QLES-Q: Quality of Life Enjoyment and Satisfaction Questionnaire; REVT: Receptive and Expressive Vocabulary Test; SALT: Systematic Analysis of Language Transcripts; SIPT: Sensory Integration and Praxis Test; SP: Sensory Profile; SPSC: Sensory Profile School Companion; SRS: Social Responsiveness Scale; SSIS-RS: Social Skills Improvement System Rating Scale; TSIF: Test of Sensory Integration Function; TOL: Tower of London; TSS: Treatment Satisfaction Survey; TSSA: Triad Social Skills Assessment; VAS: Visual Analog Scale.