Equine-assisted services for motor outcomes of autistic children: A systematic review

The purpose of this systematic review was to synthesize the research literature on equine-assisted services for motor outcomes of autistic children. Eligible articles published between June 2012 and June 2023 were identified through electronic database searches, including PubMed, PsycINFO, CINAHL, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were adopted. Twelve articles met the inclusion criteria, and the extracted data included study characteristics, equine-assisted service features, and major motor outcome findings. Significant improvements were identified in coordination, strength, balance, posture, and overall motor skills, affirming the efficacy of equine-assisted services in enhancing motor outcomes of autistic children. To advance future equine-assisted service studies, prioritization of motor outcomes as primary variables is recommended. This emphasis should be evident in research aims, standardized measures, and terminology used to describe equine-assisted services.Lay abstract Equine-assisted services use various aspects of horses, like their movement, warmth, and size, to enhance individuals' overall well-being. Many studies have underscored the positive impact of equine-assisted services on autistic children, affecting areas such as social interaction, communication, engagement, stereotypical behaviors, and motor functions. Given the growing recognition of motor functions as clinical specifiers in autism, it is imperative to specifically investigate how equine-assisted services influence these outcomes. To address this, we conducted a systematic review to synthesize existing literature on the effects of equine-assisted services on motor outcomes of autistic children. Our review encompassed study characteristics, features of equine-assisted service interventions, and major motor outcomes. We also evaluated the methodological quality of the equine-assisted service studies to offer insights for future research directions. Through thorough database searches and the use of the standardized procedure of conducting a systematic review (The Preferred Reporting Items for Systematic Reviews and Meta-analyses), 12 research studies were identified and included. These studies reported the effects of various equine-assisted service types (such as therapy, horsemanship, or learning) on motor outcomes of autistic children. Significant enhancements in coordination, strength, balance, posture, and overall motor skills indicate the effectiveness of equine-assisted services in improving motor outcomes of autistic children. Building on these findings, we provide recommendations for future research endeavors aimed at enhancing the reliability and validity of using equine-assisted services to improve motor outcomes of autistic children. This work contributes to a deeper understanding of how equine-assisted services can benefit this population and guides the development of more effective equine-assisted service interventions.