Therapeutic Horseback Riding for Youth With Autism and Psychiatric Comorbidities: A Randomized Trial.

Authors

Robin L Gabriels, Caiti Peters, Zhaoxing Pan, Tamara Merritt, Madison Widick, Carla Mazefsky, Mathew Siegel

Published in

Pediatrics. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

Autism spectrum disorder care is often complicated by co-occurring psychiatric symptoms. Equine-assisted services show promise for improving behavioral outcomes in this population. We aimed to examine benefits of equine-assisted services for youth with autism at higher risk for mental health interventions.
A total of 236 youth with autism and psychiatric comorbidity (aged 6-16 years.) were enrolled in a randomized controlled multisite clinical trial, stratified by nonverbal IQ, and assigned to 1 of 3 intervention arms: therapeutic horseback riding (THR), no horse contact barn activity (BA), or waiting period followed by a BA/THR hybrid. Caregivers completed outcome measures. Speech outcomes were evaluated by blinded raters. Intervention methods expand those from a previous efficacy trial.
Intent-to-treat analyses with 169 participants completing at least 1 intervention lesson revealed that compared with the waitlist control (n = 28), both THR (n = 74) and BA (n = 67) interventions showed clinically significant reductions in co-primary outcomes of irritability (P < .0001; THR effect size d = 1.15; BA effect size d = 1.04) and hyperactivity (THR P < .0001, effect size d = 1.06; BA P = .005, effect size d = 0.68). The THR group showed significantly greater reductions in hyperactivity compared with the BA group (P = .03; effect size d = 0.39) beginning at intervention week 4. Additional significant improvements in THR and BA groups vs the waitlist control were seen in emotional regulation and social behaviors.
Equine-assisted activities are an effective intervention to address behavior challenges in youth with autism and psychiatric comorbidity; THR may offer additive reductions in hyperactivity.

PMID:
42849910
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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