Study Animal Study arms Therapy intensity Outcomes measured Overall results Autism Spectrum Disorders
Becker et al. 2017 Dog AAT (n=16): Social skills training with therapy dog.
Control (n=14): Same curriculum without dog.
IQ above 70
1h per wk for 12wks for
both arms. CDI-2; RMET (Reading the Mind in the Eyes Test);
SLDT (Social Language Development Test); SRS-2.
Comparative reduction in symptoms in AAT group vs Control as measured by SRS-2. Reduction in depressive symptoms as measured by CDI-2. No difference in SLDT.
(Eta-squared reported)
CDI-2 Functional Problems: 0.14 CDI-2 Interpersonal Problems: 0.24 Petty et al. 2017 Horse EAT (n= 31)
Barn activity (n= 36)
EAT: 1h sessions including riding.
Control: Barn activity without horse contact.
Child’s Attitude and Behavior toward Animals”
(CABTA); Parent’s Account of Children's Relationships with Animals (PACRA).
EAT participants showed significantly more improvements acting in a caring manner toward household pets, suggesting a crossover effect of EAT
Borgi et al. 2016 Horse EAT (Equine Assisted Therapy) (n=15).
Control group (n=13) wait-list.
IQ above 70 in WISC-III
EAT: 25 weekly sessions for 6 mo, 60-70min in duration.
Vineland Adaptive Behavior Scale (VABS);
Tower of London (TOL).
Children attending EAT sessions showed an improvement in the socialization domain after the 6-months program involving horses, while children in the control group did not.
Planning time in the ToL exercise also showed significant improvement.
(Eta-squared reported) VABS Socialization: 0.23 VABS Motor Skills: 0.43 TOL Planning Time: 0.24 Hall et alia. 2016 Dog Family functioning scale
- Intervention (n= 22) - Control (n=14) Parenting stress index - Intervention (n=20) - Control (n= 14)
Brief FAM-III-General Scale; Parenting Stress Index-Short Form.
A significant effect of group revealed lower scores in the intervention group compared to the control group, reflecting decreased family difficulties and increased family strengths.
Gabriels et al. 2015 Horse EAT (n= 63) Barn activity (n= 64) BRIEF non-verbal IQ above 40
10-week interventions with a minimum of 45 minutes per session.
Aberrant Behavior Checklist-Community (ABC-C); Vineland Adaptive Behavioral Scales (VABS-II); Bruininks- Oseretsky Test of Motor
Results show significant
postintervention improvements in the EAT group compared to the BA control on the Irritability and Hyperactivity subscales of the ABC-C36 beginning by the fifth week of intervention.
Proficiency (BOT-2); Social Responsiveness Scale (SRS).
Effect sizes from linear mixed effects model:
ABC Irritability: 0.50 ABC Hyperactivity: 0.53 SRS Social Cognition: 0.41 SRS Social Communication: 0.63 SALT No. of different words used: 0.54 SALT No. of words used: 0.54 Lanning et al. 2014 Horse EAT (n=13)
Social Circles Control group (n=12)
EAT: weekly 1h sessions for 12 weeks.
Social Circles Group:1 weekly social activity session for 12 weeks.
Pediatric Quality of Life 4.0 Generic Core Scales (PedsQL); Child Health Questionnaire (CHQ).
No statistically significant differences between groups, though the EAT group appeared to show a tendency towards greater improvement.
CHQ Parental Time: (F=3.21, p=0.0923) eta squared: 0.17 CHQ Physical Summary Score:
(F=3.37, p=0.0850) eta squared: 0.17
Fung et al. 2014 Dog DAT (n=5)
Control (n=5) 3 pre and 3 post- intervention sessions for both groups, plus:
DAT: Structured play for 14 sessions.
Control: Structured play intervention in 14 sessions with doll.
Independent social and non- social behaviors scale;
Social behaviors divided into verbal and non-verbal subscales.
Small but statistically significant difference in verbal social behaviors.
No differences in other measures.
Wilcoxon Signed Rank Test
Baseline to posttreatment VSB AAPT (z=-2.02, p=0.43)
Gabriels et al. 2012 Horse EAT without wait-list (n=26)
EAT with wait-list (n=16) Non verbal IQ above 44
EAT: weekly 1h lessons
for 10 weeks. ABC-C; BOT-2; VABS-II;
SIPT (Praxis on Verbal Command, Postural Praxis).
Significant Improvements in Lethargy, Irritability, Stereoptic Movement and Hyperactivity.
Kern et al. 2011 Horse EAT (n=20) Waiting list control (n=24)
EAT: SpiritHorse riding program, weekly 60min sessions for 6 mo.
3mo waiting list control.
CARS; TCFES
(Timberlawn Parent-Child Interaction Scale).
Parent rated: SP (Sensory Profile); QLES (Quality of Life Enjoyment and Satisfaction Questionnaire);
(TSS) Treatment Satisfaction Survey.
Significant reduction in the severity of ASD symptoms only during the intervention period, with no significant changes in the waiting list control.
However no statistical test conducted to quantify the difference between groups.
Bass et al. 2009 Horse EAT (n=19)
Wait-list control (n=15) EAT: 1h session per wk
for 12wks. SRS; Sensory Profile (SP). EAT group exhibitedsignificantly greater sensory seeking, sensory sensitivity, social motivation, and less
inattention, distractibility, and sedentary behaviors.
(eta-squared) SP Overall: 0.26
SP Subscales: Sensory Seeking: 0.40;
SP Distractibility: 0.40;SP Sensory Sensitivity: 0.5; Sedentary: 0.375.
SRS Overall: 0.20
SRS Social Motivation Subscale: 0.16 Cerebral Palsy
Alemdaroglu et al.
2016 Horse EAT+TAU (n=9)
TAU (n=7) All included patients received the conventional rehabilitation program 5 days a week during the 5- week study period.
In addition the horseback riding therapy recieved two times a week (in 30- min sessions) for 5 weeks.
Modified functional reach test (MFRT); GMFCS.
Beneficial effect of horseback riding therapy on hip adductor spasticity when applied in addition to conventional rehabilitation in children with CP.
In Group 1, the MFRT
forward/right/left showed significant improvement after treatment.
In Group 2 there was no improvement in hip adductor spasticity after treatment.
Matusiak et al. 2016 Horse Intervention group (n=
19)
Control group (n= 20)
Once weekly 30-minute EAT sessions conducted by a qualified therapeutic team for 12 consecutive weeks.
The control group did not attend EAT. During the 12 weeks of the study, all participants from both groups performed their usual activities of daily living and attended different forms of rehabilitation.
Sitting Assessment Scale (SAS); Wilcoxon’s test was used to compare changes in the scores of position control and functions of the body parts between the first and last assessment in each group.
Statistically significant differences noted only in the scores for trunk position control and arm function.
Kwon et al. 2015 Pony EAT (n= 46)
Control (n= 46) EAT: 30 minutes of private therapy, twice a week for 8 weeks, in addition to conventional physiotherapy
Control group received 30 minutes of walking or
Gross Motor Function Classification System (GMFCS); Gross Motor Function Measure (GMFM- 66); Gross Motor Function Measure (GMFM-88);
Pediatric Balance Scale
Significant improvements in GMFM scores (both GMFM-66 and -88) and PBS scores for the EAT group
cycling twice a week for 8 weeks with
conventional physiotherapy.
(PBS).
Park et al. 2014 Horse EAT (n= 34)
Control group (n= 21) Subjects in both groups attended a weekly 30min session of outpatient physical and occupational therapy.
EAT: Biweekly 45min sessions for 8wk.
PEDI; GMFM. Significant improvements in both GMFM-66 and 88, with greater improvements for the EAT group.
Significantly greater improvements in all elements of PEDI for EAT over Control.
El-Meniawy et al. 2012 Horse Exercise group (n= 15) Exercise + EAT group (n= 15)
One hour, three times/week for three successive months of an exercise program.
In addition, the EAT group recieved EAT training once weekly for 13 weeks.
Formetric instrument system.
Post-treatment results favored EAT group on Lateral deviation, Pelvic tilts, and Surface rotation.
Kwon et al. 2011 Pony EAT (n= 16) Control (n= 16)
EAT: 30 minutes of private therapy, twice a week for 8 weeks, in addition to conventional physiotherapy.
Control group received 30 minutes of walking or cycling twice a week for 8 weeks with
conventional physiotherapy.
Gait parameters; Pelvic and Hip Kinematics; GMFM;
PBS.
Significant improvements (as Cohen’s d) in EAT over control for:
Avg. Pelvic Anterior Tilt: 0.967 Pelvic Anterior Tilt at initial contact:
0.903
Pelvic Anterior Tilt at terminal stance:
0.958
Hip flexion at initial contact: 0.812 Hip range of flexion/extension: 0.861 GMFM-E: 0.753,
GMFM-66: 1.138 PBS: 1.12.
McGibbon et al. 2009 Horse EAT (n= 25)
Control group (n= 22) One session of 10-minute EAT intervention.
One 10-minute session of barrel-sitting.
EMG. There was no difference in adductor
muscle asymmetry between the groups prior to the interventions of EAT or barrel-sitting. After intervention, the EAT group demonstrated significantly less adductor muscle asymmetry than the barrel-sitting group.
Davis et al. 2008 Horse EAT (n=50)
Control (n=49) EAT: 10 weekly sessions of 30-40 minutes in duration.
Control group performed their usual activities.
GMFCS; Cerebral Palsy Quality of Life
Questionnaire for Children (Self reported and parent proxy); GMFM; Child health Questionnaire.
No significant differences were found on ANCOVA between groups. Only a small effect size was observed for parent-reported quality of life questionnaire (eta-squared=0.06).
Benda et al. 2003 Horse EAT group (n= 7)
Control group (n= 8) One session of 8 minutes of EAT.
One session of 8 minutes of symmetric seating practice on a barrel.
EMG. Mean change in asymmetry scores:
EAT: 55.5; Control: 11.9.
Mean change in percentage
improvement from pretest to post-test:
EAT: 64.6%; Control:-12.8%.
Mackinnon et al. 1995 Horse EAT (n=10)
Wait-list control (n=9) IQ above 70
Weekly EAT for 1h for
6mo. GMFM; Fine motor
component of the Peabody Developmental Motor Scale; VABS subscale;
Harter Self-perception Scale.
The results were inconclusive for all measurements.
Down syndrome Satiansukpong et al.
2016 Elephant AAT (n=8): Thai
Elephant-Assisted Therapy Program and Regular School Activities.
Control (n=8): Regular school activities only.
EAT: 16 treatment
sessions over 8 weeks. Beery test of Visual-Motor Integration (VMI);
Bruininks-Oseretsky test of Motor Proficiency
(BOMPT2); Postural control record form.
Significant difference in VMI between EAT and control (Mann-Whitney U statistic 13.5). No significant difference in balance or postural control.
Griffioen et al. 2014 Dolphin Group A (n=18): Dolphin assisted therapy
Group B (n=10):
Swimming therapy (no animal)
Group C (n=17): Waitlist for 6 weeks
IQ above 40
Dolphin AT: 6 weekly, 1h sessions.
Swimming: 6 weekly, 1h sessions.
Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER).
No significant changes for any of the variables in control conditions. Effect sizes (eta-squared):
"Verbalization": 0.15
"Recognition of Persons": 0.12.
Pain
Calcaterra et al. 2015 Dog AAT group (n= 20) Standard care group (n=
20)
20 minutes of AAT 2 hours after surgery in the postoperative care.
EEG activity; Cerebral prefrontal oxygenation;
Heart rate, Blood pressure;
Oxygen saturation; Salivary
A significant reduction in pain socres was observed favoring the AAT group.
No differences observed for cortisol.
On vital signs, only a significant group interaction was observed for heart rate.
cortisol levels; Faces pain scale.
Barker et al. 2015 Dog DAT (n= 20)
Puzzle group (n=20) DAT: Single 10min session.
Puzzle group had sessions of same duration.
Pain NRS; Anxiety NRS;
attachment Questionnaire for Children (aQC;) Family life Space Diagram (FlSD)
No significant differences observed between groups for pain or anxiety.
Further analysis showed a possible moderating effect of attachment.
Braun et al. 2009 Dog AAT (n=18): Interaction with dog under
established AAT in acute care setting.
Control (n=39): No interaction due to fear of animal or unavailability.
15-20min AAT session.
15min sitting quietly in control.
Pain by Wong-Baker FACES Pain Rating Scale;
Blood Pressure, Heart Rate, Respiratory Rate.
AAT group experienced significant reduction in pain compared with control (eta-squared: 0.13). Difference in only respiratory rate for vital signs, which was higher in AAT group (eta-squared:
0.11).
Other conditions (benign joint hypermobility syndrome and Post-Traumatic Stress Disorder) Dietz et al. 2012 Dog TAU (n= 32)
DAT (n= 60)
DAT+Storytelling (n=61)
TAU: topics and activities related to common struggles for survivors of sexual abuse consisted of 12 sessions.
DAT alone: one time per month for an average of four visits by the dogs during each child's treatment for 10 to 15 minutes.
DAT+Storytelling; DAT intervention + therapeutic storytelling.
Trauma Symptom Checklist for Children (TSCC)
Significant differences in overall score of TSCC, favoring DAT+Storytelling over the controls.Significant decrease in the sexual concerns subscale in Dogs+Storytelling but not in DAT alone group.
Mosulishvili et al. 2013 Horse (n=96) Divided into two age-groups and assigned to condition:
EAT (n=21;22) Control (n=26;27):
Established physical therapy protocol for BJHS
3 phases of 3mo duration with 3 procedures per week.
Beiton table; Dynamometry, Goniometry; Strength and Endurance of Abdominal Tension and spinal erector muscles.
Reduction in recurvation of knee joint, and improvement in femoral quadriceps muscle strength, in active vs. control.
AAPT: Animal-Assisted Play Therapy; AAT, animal-assisted therapy; ABC-C, Aberrant Behavior Checklist-Community; ANCOVA, analysis of covariance; aQC, Attachment Questionnaire for Children; ASD, autism spectrum disorder; BA: Barn Activity; BJHS, benign joint hypermobility syndrome; BOMPT, Bruininks-Oseretsky Test of Motor Proficiency; BOT, Bruininks-
Oseretsky Test; CABTA, Child’s attitude and behavior toward animal; CARS: Childhood Autism Rating Scale; CDI, Children’s Depression Inventory; CHQ, Child Health Questionnaire; CP, cerebral palsy; DAT, dog-assisted therapy; EMG, electromyographic; FAM-III: Family Assessment Measure-III; FLSD, family life space diagram; GMFCS, Gross Motor Function
Classification System; GMFM, Gross Motor Function Measure; MESSIER, Matson Evaluation of Social Skills for Individuals with Severe Retardation; MFRT, Modified Functional Reach Test;
NRS: Numerical Rating Scale; PACRA, parent’s account of children’s relationships with animals; PBS, Pediatric Balance Scale; PEDI, Pediatric evaluation of disability inventory; PedsQL:
Pediatric Quality of Life; PTSD, posttraumatic stress disorder; QLES, Quality of Life Enjoyment and Satisfaction Questionnaire; RMET, Reading the Mind in The Eyes Test; SAS, Sitting Assessment Scale; SIPT: Sensory Integration and Praxis Test; SLDT, Social Language Development Test; SP, Sensory Profile; SRS, Social Responsiveness Scale; SRS-2, Social Responsiveness Scale, 2nd Edition; TAU, treatment as usual; TCFES: Timberlawn Couple and Family Evaluation Scales; TOL, Tower of London; TSCC, Trauma Symptom Checklist for Children; TSS, Treatment satisfaction Survey; VABS, Vineland Adaptive Behavior Scale; VMI, visual-motor integration; VSB: Verbal Social Behavior; WISC: Wechsler Intelligence Scale for Children.