Case Studies and Clinical Findings


The College of William & Mary study validates that therapeutic riding benefits children with autism. The study was conducted in 2011. Researchers at the School of Education followed 21 autistic children who participated in 30 weeks of therapeutic riding, in collaboration with their classroom teachers, to rate their behavior over that time period. The study was concluded in winter 2011 and the findings were just published in March 2012.

They found that symptoms diminished whenever children participated in the therapeutic riding program. The children were calmer, improved their relationships with others, and they were more engaged in learning. They saw less fear, more confidence, less repetitive behaviors, more appropriate social responses and less discomfort with physical contact. However, the positive results lasted only as long as the kids continued to ride. Six weeks later, their autistic symptoms receded to pre‐study levels.

“This is an exciting study for parents and teachers of children with autism,” said study researcher Sandra Ward, a school psychology professor specializing in assessment at the School of Education. “There is a significant decrease in autism symptoms, especially with regard to social interaction, that manifests in the child’s classroom behavior.”


Washington University’s Program in Occupational Therapy completed a breakthrough study on the therapeutic impact of equine therapy for children with cerebral palsy. The 2008 study found that therapeutic riding improves both head and trunk stability and upper extremity function in children with cerebral palsy. The study proved that this type of therapeutic activity makes a measurable and visible difference in basic skills that form the foundation of most functional activities of everyday life.

The year‐long study primarily involved measuring stability changes in children with cerebral palsy after 12 weeks of therapeutic riding. The researchers were most impressed that children actually sustained the benefits of their therapeutic riding for several months after their riding sessions stopped. “The subjects were incorporating improvements from riding into their daily life,” says one researcher. “They actually maintained a continuum of measurable improvement—better head and trunk stability and improved control of their arms as they reach—even months after their riding sessions ended.


Michigan State University conducted a study to determine the effects of therapeutic horseback riding on the balance of individuals with mental disabilities. The study was conducted in 1989. Eight subjects were initially tested on four standing balance items and six quadruped balance items. Six months passed with no intervention. The intention of this time lapse was to use the subjects as their own control. After this delay, the subjects were tested again using the same procedure as in the initial testing. They were then involved in a 6‐month therapeutic riding program designed to provide vestibular stimulation in a variety of ways, with the horse’s movement as a base. A third identical testing session occurred at the end of the therapeutic riding program.

The results of the study showed that significant improvement was seen on standing and quadruped balance after the therapeutic riding program. It is concluded that if programming goals for individuals with mental disabilities include improved balance, then therapeutic riding may be beneficial to those goals. 


Horses & Humans Research Foundation published research from Margaret Bass, PhD., on the effect of therapeutic horseback riding on social functioning in children with autism. The 2009 study evaluated the effects of therapeutic horseback riding on social functioning in children with autism. Their team hypothesized that participants in the experimental condition compared to those on the wait-list would demonstrate significant improvement in social functioning following a 12-weeks horseback riding intervention.

Autistic children exposed to therapeutic horseback riding exhibited greater sensory seeking, sensory sensitivity, social motivation, and less inattention, distractibility, and sedentary behaviors. The results provide evidence that therapeutic horseback riding may be a viable therapeutic option in treating children with autism spectrum disorders.


Journal of the American Physical Therapy Association presented a 1988 case study on the effect of therapeutic horseback riding on posture in children with cerebral palsy. The purpose of this study was to measure postural changes in children with spastic cerebral palsy after participation in a therapeutic horseback riding program. Eleven children with moderate to severe spastic cerebral palsy, aged 2 years 4 months to 9 years 6 months, were selected for this study and underwent postural assessments according to a repeated-measures design. Assessment of posture was performed by a panel of three pediatric physical therapists, using a postural assessment scale designed by the author. A composite score for each test interval was calculated for each child, and a median score was calculated for the entire group at each test interval. Data were analyzed using a Friedman test

A statistically significant difference was found between the three test intervals with significant improvement occurring during the period of therapeutic riding. Clinical improvements were also noted in muscle tone and balance as evidenced by improved functional skills. These results constitute the first objective measure supporting the efficacy of therapeutic horseback riding on posture in children with cerebral palsy.


The Human-Animal Bond Initiative and the Journal of the American Veterinary Medical Association published research from Lana Kaiser in 2006 on the effects of a therapeutic riding program on at-risk and special education children. The case study focused on the effects of a therapeutic riding program on psychosocial measurements among children considered at risk for poor performance or failure in school or life and among children in special education programs. 17 at-risk children (6 boys and 11 girls) and 14 special education children (7 boys and 7 girls) were observed. For the at-risk children, anger, anxiety, perceived self-competence, and physical coordination were assessed. For the special education children, anger and cheerfulness were measured, and the children’s and their mothers’ perceptions of the children’s behavior were assessed. Measurements were made before and after an 8-session therapeutic riding program.
For boys enrolled in the special education program, anger was significantly decreased after completion of the riding program. The boys’ mothers also perceived significant improvements in their children’s behavior after completion of the program. Results suggest that an 8-session therapeutic riding program can significantly decrease anger in adolescent boys in a special education program and positively affect their mothers’ perception of the boys’ behavior.
Occupational Therapy and Health Care Journal published a study in 2002 on the effects of therapeutic riding on sitting posture in individuals with disabilities.  Three participants (ages 10–40) with various disabilities were recruited from a therapeutic riding center in the Midwest. The researchers took measures of the sitting posture of these participants before and after an eight week therapeutic riding program. Posture measures were taken using a super VHS video-camera and motion analysis equipment. The video data was analyzed using motion analysis software. Angles were calculated from the sitting posture of participants, and analyzed for any change from pre-test to post-test periods.

Findings showed significant changes in four of the eight measures of sitting posture, which suggests a positive effect of therapeutic riding on sitting posture in people with physical disabilities.


St. Louis University conducted a study in 2009 to identify changes in dynamic trunk and head stability and functional reach through Hippotherapy. The objective was to determine if Hippotherapy (therapy using a horse) improves head/trunk stability and upper extremity (UE) reaching/targeting in children with spastic diplegia cerebral palsy (SDCP). Eleven children, age 5-13, were with SDCP were evaluated along with 8 children in the same age bracket without disabilities. Hippotherapy intervention was performed at three therapeutic horseback riding centers with pre-postoperative follow-up with a 12-week intervention followed by 12-week washout period after intervention.

Significant changes with large effect sizes in head/trunk stability and reaching/targeting were found after the 12 week Hippotherapy session, and changes were retained after a 12-week washout period. The study concluded that Hippotherapy improves trunk/head stability and UE reaching/targeting. These skills form the foundation for many functional tasks. Changes are maintained after the intervention ceases providing a skill foundation for functional tasks that may also enhance occupational performance and participation.


The Journal of Occupational Therapy presented findings in 2015 on a comparison of equine-assisted intervention and conventional play-based early intervention for mother-child dyads with insecure attachment. Insecure attachment, both of the child and of the mother, has been identified as a risk factor for early regulation disorders and further child development. Based on accumulating evidence of effectiveness of animal-assisted interventions, the study implemented an Equine-Assisted Intervention (EAI) as an early intervention approach for mother–child-dyads and investigated its effects in comparison to a conventional play-based early intervention (PBI) in a randomized controlled trial. Both interventions took place once a week for 45 minutes over a period of 8 weeks and aimed at improving maternal caregiving and security in the mother–child relationship.

Twenty mother–child dyads (children aged 12 to 24 months) from a high-risk background, in some of which the child already displayed dysregulation symptoms, were investigated. Attachment of mother and child, maternal caregiving, and interaction within the dyad were assessed before and after the intervention. Overall both approaches led to significant improvements in mother–child relationship and interaction, both having specific advantages over the other. When given the choice, the majority of mothers would prefer EAI, which points to a potential motivational effect.


Tufts University and at Washburn University recently completed a 2015 study to investigate the effectiveness of equine facilitated psychotherapy (EFP) in the treatment of posttraumatic stress symptoms in children and teens. The team was led by principal investigator and Cummings School Research Assistant Professor Megan Mueller, Ph.D., and co-investigator Leslie McCullough, Ph.D. of Washburn University, to explore the effects of the human-animal bond on the effectiveness of the EFP program. Participants ages eight to 18 were selected from a therapeutic treatment facility and placed either in a group of students receiving EFP or in a group of students who continued to receive the usual treatment from the therapeutic facility. Youth in the EFP program attended EFP sessions once a week for 10 sessions and all youth were asked to complete a brief survey at the beginning of the program, at week 5, and at week 10.

The data suggests that both the treatment and control groups experienced a significant reduction in post-traumatic stress symptoms, and the human animal bond was correlated with reduction in symptoms for the treatment group. These findings suggest additional evidence regarding the role of the human-animal bond in clinically based treatment, and could be useful in advancing awareness of EFP as a viable psychotherapeutic intervention.


Health Care in the Community presented research in 2005 by Pamela N. Schultz PhD. RN, to test the efficacy of Equine Assisted Psychotherapy (EAP) in a cross-sectional group of children referred to a psychotherapist for various childhood behavioral and mental health issues. The study evaluated 63 children over an 18-month period who participated in an average of 19 EAP sessions. Scores on the Children’s Global Assessment of Functioning (GAF) Scale were determined pre- and post-treatment. EAP was evaluated as a modality designed to address self-esteem and personal confidence, communication and interpersonal effectiveness, trust, boundaries and limit-setting, and group cohesion form.

Univariate analysis showed that the greatest improvement in the GAF scores occurred in the youngest of the subjects. Children in the group who had a history of physical abuse and neglect had a statistically significant greater percentage improvement in GAF scores after treatment than those who did not have a history of abuse and neglect. The study demonstrated a quick response to EAP, especially in younger children.


Washington State University published a study in 2010 to examine Equine Assisted Psychotherapy (EAP) as a treatment for post-war post-traumatic stress disorder (PTSD) in combat veterans.  EAP is a form of psychotherapy focused on helping people overcome emotional trauma by working with horses. PTSD is a psychobiological reaction that can emerge due to unresolved somatic and psychological responses in the aftermath of life-threatening and other traumatic experiences. veterans. Sufferers often display behaviors which are dangerous for their own safety and the safety of others. The lack of effective treatment for veterans with PTSD leads to an increased risk for anxiety, drug and alcohol dependency, depression, suicide, and violence towards others.

The study revealed that there is a high rate of satisfaction reported by veterans, practitioners, and veterans’ families through EAP treatment. It is believed that EAP will help veterans safely re-integrate into society and live higher quality lives.