The Effect of Equine therapy on social indicators, Communication and Stereotyped Behaviors of Children with Autism Spectrum Disorder

Mansourjozan, Zahra; Zamani Sani, Hojjat; Hekmatmanesh, Amin; Aghdasi, Mohammad Taghi; Taheri Torbati, Hamidreza

doi:10.22089/mbj.2024.16757.2156

The Effect of Equine therapy on social indicators, Communication and Stereotyped Behaviors of Children with Autism Spectrum Disorder

Document Type : Research Paper

Authors

zahra mansourjozan ¹

hojjat Zamani Sani ¹

amin hekmatmanesh ²

mohammad taghi aghdasi ¹

hamidreza taheri torbati ³

¹ Department of Motor Behavior, Faculty of Sports Sciences, University of Tabriz, Tabriz, Iran.

² Department of Intelligent Machines, Faculty of Technology, LUT University, Lappeenranta, Finland.

³ Department of Motor Behavior, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad, Iran.

https://doi.org/10.22089/mbj.2024.16757.2156

Abstract

Extended Abstract
Background and Purpose
Over the past five decades, the prevalence of autism spectrum disorder (ASD) has risen markedly. ASD is a lifelong, intrinsic, and complex neurodevelopmental condition that affects social interactions, cognitive functions, and perceptual skills (1). Individuals diagnosed with ASD frequently present with a clinically significant and heterogeneous array of uncontrollable repetitive patterns, emotional dysregulation, and diminished verbal and non-verbal communication capacities during interpersonal exchanges, including reduced eye contact and restricted body language. These children typically encounter fundamental challenges in social interaction, interpreting social cues, establishing interpersonal relationships, joining peer groups, engaging in shared attention, imitation, and communication. Additionally, they experience difficulties in fine and gross motor skills, motor planning, coordination, static and dynamic postural control, alongside observable manifestations of aggression and hyperactivity (2, 3). ASD fundamentally impairs social interaction and interpersonal communication, giving rise to repetitive behaviors that significantly affect children's social lives with family and peers. Stereotypic behaviors can obstruct social integration, and severe behavioral difficulties may culminate in withdrawal and isolation for children with autism. Social skills encompass the abilities that facilitate effective communication and collaboration with others—including helping, initiating relationships, seeking assistance, encouraging and praising others, and expressing gratitude. Children with autism encounter substantial obstacles in these domains due to profound impairments in social interaction and communication (4). Children with ASD experience difficulties in social interactions and exhibit obsessive and repetitive behaviors that can lead to social problems, isolation, and physical harm. These behaviors, which may occur unintentionally and repetitively, are termed "stereotypies" and are associated with obsessive interests. This constellation of issues disrupts daily functioning, restricts engagement with the surrounding environment, and can precipitate aggression and physical injury to the child (5, 6). Sports and physical activity offer opportunities for group engagement. Furthermore, physical activity elevates heart rate, which may help mitigate stereotyped behaviors that interfere with learning. Consequently, physical activity has been extensively investigated as a vital component for the development of children with autism (7). The development of effective treatments for individuals with ASD has become a research priority. Among various animal-assisted therapies, equine therapy stands out as a distinctive approach incorporating the involvement of horses in specific therapeutic practices. The present study was conducted to examine the impact of equine therapy on the social interactions, communication, and repetitive behaviors of children with ASD, as discussed in the aforementioned contexts.
Methods
The present study was conducted with a specific purpose and employed a semi-experimental design utilizing a pre-test–post-test framework with a control group. Participants comprised 24 children (both boys and girls) diagnosed with ASD, aged 9 to 12 years, who were randomly assigned to either the control or experimental group. Mothers completed the Garz-2 test, which measured interaction variables related to social behavior and stereotyped behavior. The intervention for the experimental group was administered by the primary researcher under the supervision of a specialist psychiatrist. This group participated in sixteen sessions lasting 25 to 30 minutes each, characterized by varied tasks and distinct behavioral goals, conducted individually for each child. In this research, the results of the three subscales—stereotyped behavior and social interactions—from the Garz-2 test were compared in pre-test and post-test formats between the experimental and control groups. The assumption of normal distribution was assessed using the Shapiro-Wilk test, yielding a confidence level of (P > 0.05). For data analysis, repeated measures ANOVA and Bonferroni's post hoc test were utilized to evaluate differences between the experimental and control groups, using SPSS version 27 software.
Results
The findings of this study indicated that equine therapy significantly impacted the social communication of the experimental group, leading to improved scores. However, no statistically significant difference was observed in the variables related to stereotyped behavior and social interaction.
Conclusion
In analyzing these results, it can be concluded that stereotyped behaviors are actions occurring repetitively and associated with intense emotional discharge. The presence of horses appears to reduce both the frequency and intensity of such behaviors. According to researchers in equine therapy, this effect may help regulate autonomic nervous system functions—including blood pressure, heart rate, and respiration—thereby reducing anxiety levels, decreasing the intensity and frequency of stereotyped behaviors, and enhancing social communication (8). Equine therapy may encompass various self-regulation techniques, such as anger management, self-expression, assertiveness, emotional expression, active listening, feedback, reflection, and emotion management, along with strategies for effective interaction and communication. For instance, engagement with animals can enhance eye contact and improve communication skills in children, owing to the non-judgmental nature of this interaction (9). Animal intervention programs blend the physiological effects of stress reduction and oxytocin release with the psychological advantages of emotional support, sensory integration, and behavioral reinforcement to assist individuals with ASD (10). Given that individuals with ASD typically exhibit lower levels of the oxytocin hormone in blood plasma (11), it can be suggested that equine therapy stimulates the release of active neurochemicals—such as dopamine, serotonin, endorphins, and oxytocin—within the nervous system. This physiological response impacts overall brain metabolism, enhances mood, and subsequently increases the inclination for social communication in children with autism. The current research concludes that equine therapy, as a flexible and worthy intervention, serves as a valuable tool for understanding and communicating with children, positively influencing social communication. It is therefore recommended that child therapists and specialists incorporate equine therapy interventions alongside medical treatments to enhance social interaction.

Article Message
This study examined the effect of equine therapy on social interactions, communication, and repetitive behaviors in children with Autism Spectrum Disorder (ASD). Twenty-four children aged 9–12 years participated in a semi-experimental pre-test/post-test design with a control group. Results showed that equine therapy significantly improved social communication in the experimental group. However, no statistically significant differences were observed in stereotyped behaviors or social interaction variables. Equine therapy appears to regulate autonomic nervous system functions and stimulate neurochemicals such as oxytocin and dopamine, thereby reducing anxiety and enhancing mood. Although repetitive behaviors did not show significant change, the improvement in social communication supports equine therapy as a valuable complementary intervention alongside medical treatments for children with ASD.
Ethical Considerations
This study was approved by the Research Council of the Faculty and received ethical approval from the University Ethics Committee (Ethics Code: IR.TABRIZU.REC.1402.073).
Authors' Contributions
Conceptualization: Zahra Mansourjozan, Seyed Hojjat Zamani Sani, Amin Hekmatmanesh, Mohammad Taghi Aghdasi, Hamid Reza Taheri. Data Collection: Zahra Mansourjozan. Data Analysis: Zahra Mansourjozan, Seyed Hojjat Zamani Sani, Amin Hekmatmanesh, Mohammad Taghi Aghdasi, Hamid Reza Taheri. Manuscript Writing: Zahra Mansourjozan, Seyed Hojjat Zamani Sani, Amin Hekmatmanesh. Review and Editing: Zahra Mansourjozan, Seyed Hojjat Zamani Sani, Amin Hekmatmanesh, Mohammad Taghi Aghdasi, Hamid Reza Taheri. Responsible for funding: None. Literature Review: Zahra Mansourjozan, Seyed Hojjat Zamani Sani, Amin Hekmatmanesh. Project Manager: Seyed Hojjat Zamani Sani, Amin Hekmatmanesh.
Conflict of Interest
According to the authors, this article has no conflict of interest.
Acknowledgments
This study is derived from the doctoral dissertation of the first author. We hereby express our gratitude and appreciation for the cooperation of the Faculty of Physical Education and Sports Sciences, Ferdowsi University of Mashhad, as well as the Perceptual-Motor Development and Growth Laboratory located in the Central Laboratory of the University of Tabriz, and all the participants and individuals who assisted us in conducting this research.

Keywords

Equine Therapy

Autism Spectrum Disorder

Stereotyped Behavior

Social Interaction

Social Communication

Prevalence

Subjects

Development of physical activity, motor development and improvement of motor skills for differently abled people

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