Equine-assisted therapy on autistic people

Last updated
Children on horseback at the Kabwe Center for Autistic Children (Zambia) Boy and Girl riding a hoarse in Kabwe.jpg
Children on horseback at the Kabwe Center for Autistic Children (Zambia)

Equine-assisted therapy or equine-assisted therapy on autistic people is a therapy using a mediating horse or pony. A session can take place on foot or on horseback. Equine-assisted therapy is one of the few animal-assisted therapies regularly studied for its effectiveness, and the most popular of all autism therapies.

Contents

For a long time, the effect of contact with horses on people with autism has been known only in fragmented terms, through isolated testimonials, such as that of Temple Grandin, a doctor of zootechnics, in her autobiography Emergence: Labeled autistic in 1986. Equine-assisted therapy was popularized by the 2009 book and film The horse boy , in which the author describes her autistic son's progress during a trip to Mongolia. Since 2005, various studies have examined the effectiveness of this intervention, which was upgraded from "controversial" to "promising" status in 2007. As the application of equine-assisted therapy to autistic people is recent, these studies remain few and far between.

Equine-assisted therapy offers clinically significant reductions in disability in the areas of communication, perception, attention and emotion regulation. It increases volition, reduces hyperactivity and improves sensory integration in people with autism. In 2016, the scientific community agreed that it was the most effective animal-assisted therapy available to people with autism. Using an animal capable of responding to specific needs, it is not, however, suitable for all autistic people. Furthermore, the sessions are relatively expensive, and require considerable human resources.

Definition

Regulation of emotional disorders Henriqueguri.PNG
Regulation of emotional disorders

The horse is the pioneering animal in animal-assisted therapy, and by far the most widely used in this type of intervention. [1] At the same time, equine-assisted therapy is the most popular animal-assisted therapy for autism. [2]

This therapy is described and conceived as a form of care, and not as a leisure activity or learning to ride adapted to autistic people. [3] Its aim is to provide therapeutic assistance. [3] The horse becomes a mediator between the autistic person and the therapist. [4] [5] Ideally, an equine-assisted therapy session should be led by one or more trained therapists, with both solid equestrian skills and experience in supporting people with disabilities. [6]

Therapeutic areas concerned

Equine-assisted therapy acts on the neuromuscular, relational, perceptive, attentional and emotional levels. [3] The horse stimulates various areas: communication (laughter, speech, etc. [7] ), relationships with others, motor behavior, attention, action planning, body awareness, self-confidence, relaxation, emotional regulation and sharing of emotions. [8] The relationship with the horse is highly "sensorial", charged with scents, contact and a variety of sensations, [4] making the equine-assisted therapy session a multi-sensory experience. The kinesthetic stimulation offered by the horse is unique among the animal therapies available to autistic people, since the horse (or pony) is the only mediating animal that can offer it. [9]

Relationship between horses and autistic people

Contact between a child and a horse TMPI mit Hesi.jpg
Contact between a child and a horse

French equine expert Isabelle Claude believes that the behavior of autistic people is close in some respects to that of the horse, notably in terms of sensory perception, tactile sensitivity, [10] olfactory need and attention to details and micro-signals. She adds that, like the horse, the autistic person is accustomed to expressing their emotional states, particularly their anger. [11] The ASBL Anthe-Anthesis (Belgian national association for therapy with horses) also likens the perception of autistic people to that of horses, in that both are situated in "the world of feeling". [12]

Temple Grandin, an American university professor with autism, likens the behavior of an autistic child to that of a wild horse in the process of being tamed: the reaction to touch and the way in which they are approached are, in her view, very similar. [13] Furthermore, in her book Animals in Translation , she compares the mode of consciousness and thought of animals to that of a so-called "learned" autistic person, asserting that spoken language is not necessary for thought, and that horses, among other animals, use a visual thinking similar to that of certain autistic people. [14]

In her psychology thesis (Université Rennes-II, 2010), Marine Grandgeorge notes that autistic children are generally more spontaneously interested in images of animals, including horses, than in images of objects. [15]

History

Since the end of the 20th century, there have been consistent but isolated accounts of the benefits that autistic people derive from contact with horses. Temple Grandin testifies to having spent a great deal of time observing horses and cows since childhood. [16] She started riding in the 1960s, [17] realizing that these large animals are often mistreated out of ignorance. [14] Riding and contact with horses calmed her anxieties and hyperactivity, [17] and she testifies that galloping calms her. [18] In France, several therapists work with autistic children using horses or ponies as mediators, including Isabelle Claude since the 1980s in Lorraine, [10] Claudine Pelletier-Milet at her riding hall in La Chapelle-Montligeon since 1999, [19] and Isabelle Chaveneau in Sevrey. [20] In 1989, D. Athy described the case of a horse that had been retired from racing and taken in by a home for autistic children. By caring for and riding the animal, the children's symptoms diminished. At the same time, the horse regained its performance and began racing again, its winnings being used to finance the center, in particular the purchase of other therapy horses for autistic children. [21]

American Hana May Brown publishes a testimonial about a non-verbal autistic child at her therapeutic riding center in Houston, who began to speak and made such progress that schooling became possible. Concordant testimonials led her to officially present horseback riding as a valid therapeutic option for autistic children in 1994. [22] In 1995-1996, Charlotte Daubrée observed five children with autism as part of her veterinary doctorate thesis in Clermont-Ferrand. This work enabled her to observe real progress, but the numbers involved were far too small to draw any conclusions. [23]

Impact of The horse boy

In 2009, the autobiographical book The horse boy was published in the United States and this bestseller inspired a film. An American father, Rupert Isaacson, testifies that only contact with his old mare calms Rowan, his autistic son. He travels to Mongolia with Rowan, recounting how he establishes communication with his child through horses, travel and shamanism. [24] Since then, he says, Rowan no longer "suffers from the dysfunctions associated with his disorder". [25] The book has been translated into many languages, including French. It is a "convincing plea for equine-assisted therapy", [26] [27] and motivates parents to try this intervention. [28] Isaacson does not use the word cure, but speaks of recovery and healing. [29] Press coverage of the book and film raised the question of whether the company of a horse could help all autistic children. [30] Since then, Isaacson has developed a method of helping autistic children through contact with horses, in Texas. [31]

"Several children have made capital progress during their passage, some even pronouncing their first words on horseback, to the amazement of their parents." [25]

Commenting on the bestseller of The horse boy, pediatrician Paul A. Offit warns of the lack of studies on the effectiveness of contact with horses, and the temptation to spend large sums on ineffective, poorly supervised therapies. [29]

First scientific evaluations

In 2005, there was no scientific literature on this intervention, which meant that the scientific community was unable to comment on its effectiveness. [32] In 2008, pediatrician Lisa A. Kurtz listed equine-assisted therapy as one of the "controversial" therapies, noting that some publications supported its efficacy as a complementary therapy. [33] Similarly, in her thesis published in 2008, French veterinary surgeon Laurence Duval-Desnoes considers that "there is very little truly scientific evidence today to show the beneficial effects that an autistic person can derive from contact with an animal. It's more often a question of observations, of isolated facts". [34]

The first scientific assessments of the autistic public were published in 2008 and 2009. According to an article published in The Guardian in February 2012, a growing number of health professionals are recognizing the effectiveness of equine-assisted therapy in helping people with autism. [35] According to French child psychiatrist Dr Laurence Hameury, of the CHRU (Centre hospitalier régional universitaire by its extension in French) de Tours (2017), "therapies including animal mediation are currently in full development, and their benefits are recognized and validated by scientific studies evaluating the results". [36]

Accessibility and practices

In France, 79.7% of the 232 animal-assisted therapy structures listed in this country offered interventions with autistic children using horses or ponies, in 2014. [37] In 2016, this intervention was described as booming in this country. [38] In 2018, an Indian woman came to France for training to develop equine-assisted therapy with the autistic public in India. [39]

In 2012, according to the French recommendations of the Haute Autorité de santé and the Agence nationale de l'évaluation et de la qualité des établissements et services sociaux et médico-sociaux (French national agency for the evaluation and quality of social and medico-social establishments and services) "activities carried out with animals cannot be considered, in the current state of knowledge, as therapeutic, but constitute practices that can participate in the personal and social development of certain children/adolescents with ASD, according to their centers of interest, if they benefit from specific support". [40]

Procedure

Interaction with the horse during a mounted equine-assisted therapy session Interaccion1.jpg
Interaction with the horse during a mounted equine-assisted therapy session

An equine-assisted therapy session can involve a variety of disorders or disabilities. There are also sessions entirely adapted to the special needs of autistic people. [2] Claudine Pelletier-Milet finds that children's sessions with ponies take place in a joyful, relaxed atmosphere. [19] These sessions can take place on foot or on horseback. The notion of equine-assisted therapy covers both types of intervention. Many autistic people are able to develop quite advanced riding skills during their sessions, so that the latter are often more akin to conventional riding lessons than therapeutic care. [6] A session is also an opportunity to share knowledge about the horse. [8]

According to Isabelle Claude, the sessions most often involve "deficit" autistic children (non-verbal or with numerous behavioral disorders), due to the high demand from families and health professionals, and much more rarely so-called Asperger's autistic people. [10] American Linda Kohanov uses an "emotional message interpretation grid" when working with Asperger's adults. [41] Claudine Pelletier-Milet encourages her patients to anchor themselves in the present moment, and to transcribe the emotions they feel into words. [19]

Walking sessions

Equine-assisted therapy sessions usually begin on foot, away from the animal. [6] The autistic person then creates an emotional bridge with the animal by grooming and touching it. [42] Sessions on foot are used to work on cognition, attention and social skills. [6] Sandrine Willems recounts having witnessed a case where an autistic child unable to wash himself learned to do so, presumably by grooming his horse during the on-foot equine-assisted therapy sessions. [43]

Mounted sessions

During mounted sessions, the horse's movement is used to work on mobility. [44] They can involve the therapist and up to three other people for individual intervention: one person to guide the horse, the therapist to move the rider and give instructions, and two people on the horse's sides to prevent falls resulting from loss of balance. [2]

Advantages and disadvantages

Animal-assisted therapy involves an animal that already shares a long history with human beings. [2] Psycho-pedagogue Jean-Pierre Juhel recommends horses for all autistic people, including those diagnosed with Asperger's syndrome. [4] While autistic children have difficult contact with peers and adults, they readily accept and seek contact with horses. [4] The autistic person generally testifies to feeling a profound sense of well-being during these sessions. [4] According to Amélie Tsaag Valren, the therapeutic setting is not compulsory to feel the benefits of horses. [45] Tactile contact with these animals (or even their simple observation) can be enough to remedy the anxiety that autistic people often experience. [45] On the other hand, France's EgaliTED collective is hostile to this intervention, which it classifies as "psychic care", calling it "a pony pompously renamed 'equine-assisted therapy". [46]

Advantages

According to Merope Pavlides, among autism interventions, equine-assisted therapy has many advantages and few disadvantages. [2] The effectiveness of contact with the horse depends largely on its non-judgmental nature. [19] The horse's presence creates a feeling of trust, whereas human relationships create stress, for fear of being judged. [47] Therapist Claudine Pelletier-Milet believes that the horse's effectiveness as a therapeutic partner stems largely from the fact that it does not talk, is non-judgmental, non-intrusive or demanding: she describes it as a "simple, honest and consistent" animal. [19] In their book on behavioral approaches to autism, Ron Leaf, John McEachin and Mitchell Taubman believe that "making contact with a massive animal, such as a horse, and maneuvering it successfully, brings a sense of self-actualization for the individual", although they add that there is a lack of data to back this up. [48] The herd behavior of the horse means that these animals have a natural tendency to follow each other, which avoids having to hold them all the time. [49] Temple Grandin focuses on the horse's movements, which create an imbalance that the autistic person has to compensate for, leading to work on body posture. [27]

Laurence Duval-Desnoes points out that the size of the horse "makes it possible to work with subjects whose reactions are unpredictable, who may become violent and strike the animal; indeed, it is rare for a child or even an adult to hurt a horse with their bare hands", all the more so as the animals chosen for therapy are generally chosen for their calm temperament. [49] She adds that the position of the horse's eyes, far apart from each other, can be reassuring for autistic people, who don't like to be approached and looked at head-on. [49] The Belgian association Anthesis emphasizes the horse's ability to decipher body language, and its sensitivity to voice intonation. This constitutes "an important therapeutic potential for work with autistic children". [12]

Limits and disadvantages

Contact with horses does have its limits. Temple Grandin admits "painfully" that observing and then understanding how animals feel has not helped her to better understand human relationships. [50] What's more, the attention to detail shown by non-deficit autistic people can lead to anger and even regression if a change is made in the course of the equine-assisted therapy session. [10] Another difficulty lies in the cost of this intervention, which is one of the most expensive among the therapies offered to autistic people. In the United States, the cost is annually around $ 5 000 per person. [42]

The very large size of a horse can cause anxiety for the person, "as soon as you have to approach it or ride on it". [49] There is a risk of knocks, falls or wound infection when working with the animal, as well as a risk of allergy (frequent) or zoonosis (very few cases reported). In a few cases, the presence of the animal can generate human behavioral disorders: phobia, "excessive attachment", vulnerability to the animal's death. The horse itself may experience stress due to the behavioral inconsistencies of the person being cared for, or even be the victim of abuse. [51]

In France, this practice is not regulated, the only registered profession being that of equine technician, and this can lead to abuse. [52]

Scientific evaluations of effectiveness

Standardized scientific evaluation of equine-assisted therapy applied to autism is hampered by the heterogeneity of autism spectrum disorders, and the impossibility of evaluating sufficiently large samples due to material constraints. [53] In addition, the studies carried out present methodological weaknesses. [52] On the scale of scientific validation of complementary therapies for autism established by Gardner T. Umbarger in 2007, distinguishing between recommended, promising, emerging and non-recommended therapies, equine-assisted therapy is considered "promising", meaning that at least 4 studies of acceptable quality and 2 of high quality are evaluating its results. [54] A review of the scientific literature was devoted to pet therapy for people with autism in 2012. It concluded that the results were unanimously positive, despite the studies' weaknesses, highlighting the need to pursue this research more rigorously. [55]

The first evaluations were carried out on a wide range of disabled children. It wasn't until 2008 that the American Alexandra Dingman published the first study [56] devoted to the specific case of autistic children brought into contact with horses. [57] In 2009, 19 children with ASD and 15 control children were followed for 12 weeks. The conclusion was that "autistic children exposed to equine-assisted therapy showed greater sensory seeking, sensory sensitivity, social motivation, and less inattention, distraction, and sedentary behaviors". [58] Research carried out on 16 children aged 2 to 14 receiving one session of horse therapy per week for 10 weeks, in Texas, led to "significant improvement" and the same conclusion, in 2010. [59] A study published the same year involved 60 children followed for 20 weeks. They showed improved motor control and sensory integration. [60]

In 2011, a study was published on 24 children with ASD, assessed using a global autism symptom severity scale. It concluded that these "results suggest that children with ASD benefit from assisted equestrian activities". [61] In 2012, a preliminary study looked at 42 participants diagnosed with autism spectrum disorder, aged 6 to 16, during their 10 weekly lessons, along with 16 controls. They showed "significant improvements on measures of irritability, lethargy, stereotyped behaviors, hyperactivity, expressive language skills, motor skills, and motor and verbal planning skills", as well as "significant improvements in self-regulatory behaviors". The study suggests that these improvements are linked to equine-assisted therapy, [62] and that the movement created by the animal leads to a positive effect on motor skills. [63] In 2013, the American Occupational Therapy Association studied six children with ASD, aged 5 to 12, during 12 horse therapy sessions of 45 minutes each. It concludes that equine-assisted therapy has a positive influence on children with ASD, and can be a useful therapeutic tool for this population. Postural sway decreased significantly post-intervention. Significant improvements were also observed in global adaptive behaviors, leisure demand and social interactions. [64]

Research conducted at the University of Washington in 2014 also concludes that equine-assisted therapy "can significantly improve balance, social responsiveness and other life events". [65] To address the lack of comparative studies, 13 children with ASD participate in 9 weeks of equine-assisted therapy, and are compared to 12 children cared for by non-equine social programs. Parents noted significant physical, emotional and social improvement in their child after the first 6 weeks, superior to that of children participating in the non-equine program. [66]

A study of six children in Joué-lès-Tours, France, found "clear improvement from the very first session" in communication, development, and motor, emotional and perceptual regulation. [67] The children seemed calmed, became aware of the effect of their actions on the pony, and sought interaction. [68] A 16-week program investigated the willingness of three autistic children, revealing an increase in willingness over time. This preliminary evidence shows that "improved willpower may be an important and underestimated benefit of equine-assisted therapy for children with autism". [69] The potential of horse therapy for women may also be underestimated, as many girls and women with Asperger's have horses as a special area of interest, but are deterred from riding in a riding hall because of social relationships with other girls or teenagers. [45] Indeed, riding is notoriously more popular with girls, who are more interested in contact with animals than boys. [70]

In 2016, according to a review of the available scientific literature, there is a consensus that equine-assisted therapy is the most useful animal therapy for people with autism. [71]

Equine-assisted therapy may not be effective for all people with autism. In a study of four children in Bosnia-Herzegovina, only two experienced positive effects. [72] Similarly, in the areas of fine motor skills, social cognition and social awareness, research has so far (2011) shown no significant results. [9]

Related Research Articles

<span class="mw-page-title-main">Asperger syndrome</span> Neurodevelopmental diagnosis now categorized under ASD

Asperger syndrome (AS), also known as Asperger's syndrome, is a neurodevelopmental condition characterized by significant difficulties in social interaction and nonverbal communication combined with restricted and repetitive patterns of behavior and interests. The syndrome has been merged with other conditions into autism spectrum disorder (ASD) and is no longer considered a stand-alone diagnosis. It was considered to differ from other diagnoses that were merged into ASD by relatively unimpaired spoken language and intelligence.

Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10. These disorders comprise developmental language disorder, learning disorders, motor disorders, and autism spectrum disorders. In broader definitions ADHD is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.

Autism spectrum disorders (ASD) are neurodevelopmental disorders that begin in early childhood, persist throughout adulthood, and affect three crucial areas of development: communication, social interaction and restricted patterns of behavior. There are many conditions comorbid to autism spectrum disorders such as attention-deficit hyperactivity disorder and epilepsy.

Ole Ivar Løvaas was a Norwegian-American clinical psychologist and professor at the University of California, Los Angeles. He is most well known for his research on what is now called applied behavior analysis (ABA) to teach autistic children through prompts, modeling, and positive reinforcement. The therapy is also noted for its use of aversives (punishment) to reduce undesired behavior, however these are now used less commonly than in the past.

Applied behavior analysis (ABA), also called behavioral engineering, is a psychological intervention that applies approaches based upon the principles of respondent and operant conditioning to change behavior of social significance. It is the applied form of behavior analysis; the other two forms are radical behaviorism and the experimental analysis of behavior.

High-functioning autism (HFA) was historically an autism classification where a person exhibits no intellectual disability, but may experience difficulty in communication, emotion recognition, expression, and social interaction.

A hug machine, also known as a hug box, a squeeze machine, or a squeeze box, is a deep-pressure device designed to calm hypersensitive persons, usually individuals with autism spectrum disorders. The therapeutic, stress-relieving device was invented by livestock equipment designer Temple Grandin while she was attending college.

The following outline is provided as an overview of and topical guide to autism:

<span class="mw-page-title-main">Treatment and Education of Autistic and Related Communication Handicapped Children</span> University Organization

The University of North Carolina TEACCH Autism Program creates and disseminates community-based services, training programs, and research for individuals of all ages and skill levels with autism spectrum disorder (ASD), to enhance the quality of life for them and their families across the lifespan.

<span class="mw-page-title-main">Autism therapies</span> Therapy aimed at improving quality of life and adaptive skills in autistic people

Autism therapies include a wide variety of therapies that help people with autism, or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.

Pivotal response treatment (PRT), also referred to as pivotal response training, is a naturalistic form of applied behavior analysis used as an early intervention for children with autism that was pioneered by Robert Koegel and Lynn Kern Koegel. PRT advocates contend that behavior hinges on "pivotal" behavioral skills—motivation and the ability to respond to multiple cues—and that development of these skills will result in collateral behavioral improvements. In 2005, Richard Simpson of the University of Kansas identified pivotal response treatment as one of the four scientifically based treatments for autism.

<span class="mw-page-title-main">Animal-assisted therapy</span> Alternative or complementary type of therapy

Animal-assisted therapy (AAT) is an alternative or complementary type of therapy that includes the use of animals in a treatment. The goal of this animal-assisted intervention is to improve a patient's social, emotional, or cognitive functioning. Studies have documented some positive effects of the therapy on subjective self-rating scales and on objective physiological measures such as blood pressure and hormone levels.

Social Stories were devised as a tool to help individuals with ASD better understand the nuances of interpersonal communication so that they could "interact in an effective and appropriate manner". Although the prescribed format was meant for high functioning people with basic communication skills, the format was adapted substantially to suit individuals with poor communication skills and low level functioning. The evidence shows that there has been minimal improvement in social interaction skills. However, it is difficult to assess whether the concept would have been successful if it had been carried out as designed.

<span class="mw-page-title-main">Equine-assisted therapy</span> Physical or mental therapy using horses

Equine-assisted therapy (EAT) encompasses a range of treatments that involve activities with horses and other equines to promote human physical and mental health. The use of EAT has roots in antiquity, and EAT applies to physical health issues in modern form dates to the 1960s. Modern use of horses for mental health treatment dates to the 1990s. Systematic review of studies of EAT as applied to physical health date only to about 2007, and a lack of common terminology and standardization has caused problems with meta-analysis. Due to a lack of high-quality studies assessing the efficacy of equine-assisted therapies for mental health treatment, concerns have been raised that these therapies should not replace or divert resources from other evidence-based mental health therapies.

<span class="mw-page-title-main">Autistic art</span> Art created by autistic artists to capture the autistic experience

Autistic art is artwork created by autistic artists that captures or conveys a variety of autistic experiences. According to a 2021 article in Cognitive Processing, autistic artists with improved linguistic and communication skills often show a greater degree of originality and attention to detail than their neurotypical counterparts, with a positive correlation between artistic talent and high linguistic functioning. Autistic art is often considered outsider art. Art by autistic artists has long been shown in separate venues from artists without disabilities. The works of some autistic artists have featured in art publications and documentaries and been exhibited in mainstream galleries. Although autistic artists seldom received formal art education in the past, recent inclusivity initiatives have made it easier for autistic artists to get a formal college education. The Aspergers/Autism Network's AANE Artist Collaborative is an example of an art organization for autistic adults.

<span class="mw-page-title-main">Classic autism</span> Neurodevelopmental condition

Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism,Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.

<span class="mw-page-title-main">Autism spectrum</span> Neurodevelopmental disorder

Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder characterized by deficits in social communication and social interaction, and repetitive or restricted patterns of behaviors, interests, or activities, which can include hyper- and hyporeactivity to sensory input. Autism is a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.

The Association for Science in Autism Treatment (ASAT) is a non-profit autism organization. It was founded in 1998 and is currently based in Hoboken, New Jersey. Members of its advisory board include Eric Fombonne and Stephen Barrett, Tristam Smith was one of its board members until his death in August 2018. A report by the Association for Behavior Analysis International mentioned ASAT's website as a useful resource for parents of children with autism, as does the website of the University of North Texas and that of the University of Michigan Health System.

The history of autism spans over a century, autism has been subject to varying treatments, being pathologized or being viewed as a beneficial part of human neurodiversity. The understanding of autism has been shaped by cultural, scientific, and societal factors, and its perception and treatment change over time as scientific understanding of autism develops.

The diagnosis of autism is based on a person's reported and directly observed behavior. There are no known biomarkers for autism spectrum conditions that allow for a conclusive diagnosis.

References

  1. Philippe (2014 , p. 109)
  2. 1 2 3 4 5 Pavlides (2008 , p. 131)
  3. 1 2 3 Hameury et al. (2010 , p. 657)
  4. 1 2 3 4 5 Juhel & Hérault (2003 , pp. 217–218)
  5. "Un instrument vivant de thérapie pour les enfants handicapés et autistes". Le Monde (in French). p. 2003.
  6. 1 2 3 4 Pavlides (2008 , p. 133)
  7. "L'équithérapie ou la rééducation par le plaisir". ladepeche.fr (in French). Retrieved 25 October 2015.
  8. 1 2 Hameury et al. (2010 , p. 658)
  9. 1 2 Beiger & Jean (2011)
  10. 1 2 3 4 Claude (2015 , p. 148)
  11. Claude (2015 , p. 149)
  12. 1 2 "Autisme et hippothérapie". Anthe-Anthesis ASBL (in French). Retrieved 17 February 2016.
  13. Grandin, Temple (1996). My Experiences with Visual Thinking Sensory Problems and Communication Difficulties. Center for the Study of Autism.
  14. 1 2 Grandin, Temple (2006). L'Interprète des animaux (in French). Odile Jacob. ISBN   978-2-7381-1824-0.
  15. Grandgeorge (2010 , pp. 28–29)
  16. David-Weill (13 March 2014). "Cécile David-Weill : Temple Grandin, la star des autistes". Le Point (in French). Retrieved 22 February 2016.
  17. 1 2 Grandin, Temple (2011). Ma vie d'autiste (in French). Paris: Odile Jacob. pp. 83–92. ISBN   978-2-7381-0265-2.
  18. Duval-Desnoes (2008 , p. 105)
  19. 1 2 3 4 5 Pelletier-Milet (2012)
  20. De Wailly, Philippe (2015). "L'Avenir de la méthode". Ces animaux qui nous guérissent (in French). Le Courrier du Livre. p. 267. ISBN   978-2-7029-1579-0.
  21. Athy, D. (1989). "Dog day afternoons". Ohio Med. 85 (3): 177–179. PMID   2726131.
  22. Brown (1996)
  23. Duval-Desnoes (2008 , pp. 72–74)
  24. Isaacson (2011)
  25. 1 2 Neff, Kristin (2013). S'aimer : Comment se réconcilier avec soi-même (in French). Translated by Lavigne, Patricia. Place Des Editeurs. p. 248. ISBN   978-2-7144-5523-9.
  26. ""L'enfant cheval", bel hommage d'un père à son fils autiste". Pelerin (in French). Retrieved 3 December 2015.
  27. 1 2 Mitchinson, John (2009). "How the Horse Boy conquered autism". Telegraph.co.uk. Retrieved 25 April 2016.
  28. Womack, Philip (2010). "Equine-assisted therapy and autism: Horsing around brings out the best". Telegraph.co.uk. Retrieved 25 April 2016.
  29. 1 2 Rich, Motoko (2009). "A Gallop Toward Hope: One Family's Adventure in Fighting Autism". The New York Times. ISSN   0362-4331 . Retrieved 29 March 2016.
  30. Anderson, John (25 September 2009). "A Horse and His Boy". Wall Street Journal. Retrieved 29 March 2016.
  31. "R. Isaacson aide les autistes par l'équithérapie". France 3 Côte d’Azur (in French). 11 April 2012. Retrieved 3 December 2015.
  32. Coleman, Mary (2005). "Horse and pony riding and autism". The Neurology of Autism. Oxford University Press. ISBN   9780198040217.
  33. Kurtz, Lisa A. (2008). Understanding Controversial Therapies for Children with Autism, Attention Deficit Disorder, and Other Learning Disabilities: A Guide to Complementary and Alternative Medicine. Jessica Kingsley Publishers. p. 208. ISBN   9781843108641.
  34. Duval-Desnoes (2008 , p. 70)
  35. McVeigh, Tracy (25 February 2012). "Not just horsing around … psychologists put their faith in equine therapies". The Observer. Retrieved 25 October 2015.
  36. Hameury (2017 , p. 13)
  37. Philippe (2014 , p. 170)
  38. Rambaud, Aude (2016). "L'équithérapie, une pratique en pleine expansion". sante.lefigaro.fr (in French). Retrieved 17 May 2016.
  39. Griveau, Julien (2018). "Autisme : l'équithérapie traverse les frontières". La Nouvelle République (in French). Retrieved 5 August 2018.
  40. "Recommandations de bonnes pratiques professionnelles". Haute autorité de Santé et ANESM (in French).
  41. Kohanov, Linda (2015). Comme les chevaux... Ensemble et puissants (in French). Le Courrier du Livre. p. 589. ISBN   978-2-7029-1582-0.
  42. 1 2 "How Your Autistic Child Can Benefit from equine-assisted therapy". Autism Spectrum Disorder Foundation. Retrieved 17 February 2016.
  43. Willems, Sandrine (2011). L'Animal à l'âme. Sciences humaines (in French). Seuil. p. 347. ISBN   978-2-02-105731-7.
  44. Pavlides (2008 , p. 132)
  45. 1 2 3 Tsaag Valren, Amélie (2015). "L'équithérapie pour le traitement du syndrome d'Asperger" (in French).
  46. "Prises en charge". collectif EgaliTED. Retrieved 12 April 2016.
  47. Tsaag Valren, Amélie (2015). "Le cheval et l'empathie". Cheval Savoir (in French) (62).
  48. Leaf, Ron Leaf; McEachin, John; Taubman, Mitchell (2010). L'approche comportementale de l'autisme: Bonnes et mauvaises pratiques, ce qu'il fallait en dire (in French). Translated by Biesse, Sandrine. Pearson Education France. p. 322. ISBN   9782744075001.
  49. 1 2 3 4 Duval-Desnoes (2008 , p. 81)
  50. Joubert, Martin (2015). L'enfant autiste et le psychanalyste : Essai sur le contre-transfert dans le traitement des enfants autistes. Fil rouge (le) (in French). Presses Universitaires de France. p. 272. ISBN   978-2-13-074047-6.
  51. Duval-Desnoes (2008 , pp. 69–70)
  52. 1 2 Picard, Nathalie (2017). "L'animal, thérapeute au banc d'essai". Le Monde.fr (in French). ISSN   1950-6244 . Retrieved 4 December 2017.
  53. Hameury (2017 , p. 37)
  54. Umbarger, Gardner (2007). "State of the Evidence Regarding Complimentary and Alternative Medical Treatments for Autism Spectrum Disorders". Education and Training in Developmental Disabilities. 42 (4). ISSN   1547-0350 . Retrieved 28 April 2017.
  55. O'Haire (2012)
  56. Lanning et al. (2014 , p. 1898)
  57. Dingman, Alexandra (2008). "Hoof prints: equine-assisted therapy for children with autistic children" (PDF). Encounter: Education for Meaning and Social Justice. 21 (4): 11–13.
  58. Bass, Duchowny & Llabre (2009)
  59. Bragonje, S. (2010). "The effect of equine assisted therapy in children with autism spectrum". Medicine, Psychology. S2CID   22968688.
  60. Yee-Pay, Wuang; Chih-Chung, Wang; Mao-Hsiung, Huang; Chwen-Yng, Su (2010). "The Effectiveness of Simulated Developmental Horse-Riding Program in Children With Autism". Adapted Physical Activity Quarterly. 27 (2): 113–126. doi:10.1123/apaq.27.2.113. PMID   20440023.
  61. Kern, Janet K.; Fletcher, Charles; Garver, Carolyn; Mehta, Jyutika (2011). "Prospective trial of equine-assisted activities in autism spectrum disorder". Alternative Therapies in Health and Medicine. 17 (3): 14–20. ISSN   1078-6791. PMID   22164808 . Retrieved 29 March 2016.
  62. Gabriels et al. (2012)
  63. Raj, Ajai (2012). "Horses Soothe Kids with Autism". Scientific American. Retrieved 17 February 2016.
  64. Ajzenman, Heather; Standeven, John; Shurtleff, Tim (2013). "Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study". The American Journal of Occupational Therapy. 67 (6): 653–663. doi:10.5014/ajot.2013.008383. ISSN   1943-7676. PMID   24195899 . Retrieved 17 February 2016.
  65. "Research Shows Combining Horses and Children with Autism May Improve Motor Performance and Behavior". The Equine chronicle. 2014. Retrieved 7 February 2016.
  66. Lanning et al. (2014 , p. 1897)
  67. Hameury et al. (2010 , p. 655)
  68. Hameury et al. (2010 , p. 656)
  69. Taylor, Renee; Kielhofner, Gary; Smith, Caitlin; Butler, Sherri (2009). "Volitional Change in Children With Autism: A Single-Case Design Study of the Impact of Hippotherapy on Motivation". Occupational Therapy in Mental Health. 25 (2): 192–200. doi:10.1080/01642120902859287. ISSN   0164-212X. S2CID   146353358 . Retrieved 26 October 2015.
  70. Grandgeorge (2010 , p. 43)
  71. Borgi, Marta; Loliva, Dafne; Cerino, Stefania; Chiarotti, Flavia (2016). "Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder". Journal of Autism and Developmental Disorders. 46 (1): 1–9. doi:10.1007/s10803-015-2530-6. ISSN   1573-3432. PMID   26210515. S2CID   254566648 . Retrieved 29 March 2016.
  72. Memisevic, Haris; Hodzic, Saudin (2010). "The Effects of Equine-Assisted Therapy in Improving the Psycho-Social Functioning of Children With Autism". Journal of Special Education and Rehabilitation. 11. ISSN   1857-663X . Retrieved 26 October 2015.

Bibliography