Background: Horses are frequently employed as a tool for engagement and developmental support for children and adolescents diagnosed with autism spectrum disorder. The equine species provides a distinctive opportunity for interaction, as the child or adolescent can physically mount and engage with the animal, thereby establishing a therapeutic experience that involves tactile contact distinct from that of other animal species. The advantages obtained from therapies that incorporate equines may encompass physical, social, behavioral, emotional, sensory, and cognitive dimensions. For children with more severe ASD, targeted interventions are required Objectives: We aimed to assess the acceptability and effectiveness of a standardized horseback-riding program in children with autism and intellectual disability of medium-severe degrees. Methods: A qualitative and quantitative study was conducted with six autistic children ages 4-14 years who received ten weeks of hippotherapy. A qualitative descriptive research study was conducted with observation of child reaction by expert therapists and with semi-structured interviews that used questions guided by the Theoretical Framework of Acceptability. The acceptability was quantified through an 18-item scale exploring behaviors and attitudes inherent to interactions with the Equestrian Center environment and with horses. The effectiveness was assessed through standard functional scales focusing on specific individual needs like emotional autoregulation and self-esteem, socialization, muscle relaxation, and communication skills. Results: Children showed a positive response to the program in terms of happiness and enthusiasm. A progressive increase in the acceptability total score was observed in all participants, going from a baseline average score of 11.6 to an average final score of 20.5 (76.5% increase). During treatment, therapists observed a reduced psychomotor agitation, reduced motor and vocal stereotypies, reduced problem behaviors, increased spontaneous functional and contextual communicative gestures, greater seeking and interaction with operators and with the animal, and greater attention to requests made by adults. The changes also persisted in the medium term. Conclusions: We found evidence to support the efficacy of standardized horseback-riding programs applied to children with autism and intellectual disability of medium-severe degrees in improving social functioning.

Notes: Fondazione VSM di Villa Santa Maria