Effects of Equine-Assisted and Simulated Riding Interventions on Engagement and Sensory Processing in Children with Autism Spectrum Disorder

Introduction

Research has shown that interventions including horses have been found to significantly improve socialization and problem-solving skills in children with ASD. Technological advances have expanded intervention options to include horse-riding simulators designed to replicate the movement of the horse. However, it is unclear whether a child’s preference, as measured by their level of engagement, effects the therapeutic outcomes of these interventions. Further, existing research has not determined any connection between sensory processing patterns and response to the sensory input provided by the horse, or possibly, the more accessible option of a horse-riding simulator.  

The objective of this research is to provide a foundation for data-driven decision-making when considering use of the horse and horse-riding simulator to improve functional outcomes in children with autism. The objectives of this study were to:

1. Determine if there were statistically significant differences in levels of engagement between the horse and horse-riding simulator, and 

2. Determine if there was a relationship between sensory processing patterns and engagement between these two riding interventions.

Methods

Using a one-group, quasi-experimental repeated measures design, 15 children aged 5–12, each participated in two separate visits. On the first visit, each child engaged in a tabletop activity for 10-minutes to attain a baseline of level of engagement. The child then completed 5 assessments of the Evaluation of Ayres Sensory Integration (EASI) including Postural Control, Balance, Ocular Motor, Ocular Praxis, and Bilateral Integration while parents completed the Sensory Processing Measure-2. Following the assessments they rode on a Miracolt™ riding simulator for 20-minutes. During the second visit, they rode a horse for 20 minutes. During each condition participants engaged in therapeutic activities (i.e.: Simon Says, Eye Spy, and catching games). Both visits were videotaped for data analysis.

Results

Results indicated no significant difference in levels of engagement between the horse and horse-riding simulator. However, positive relationships between engagement and sensory processing were uncovered using the EASI. There was a statistically significant, strong positive correlation between engagement on the horse (rs =.74, p<.001) and a moderate correlation on the riding simulator (rs = .55, p=.03) on the postural control test. Additionally, moderate negative correlations were found in levels of engagement and touch on the SPM-2 for both the horse (rs= -.60, p=.02) and riding simulator. (rs= -.52, p=.04). 

Discussion

The results of this pilot study provide food for thought for health care providers. The findings of this pilot study provide valuable insight into the relationship between engagement and sensory processing in children with (ASD) during equine-assisted and simulated riding interventions. While no statistically significant differences in engagement levels were found between the horse and the riding simulator, the strong correlations between engagement and sensory processing—particularly postural control and tactile sensitivity—suggest that individual sensory profiles may play a critical role in determining therapeutic responsiveness.

The strong positive correlation between postural control and engagement on the horse (rs = .74) and the moderate correlation on the simulator (rs = .55) indicate that children with stronger postural control may be more engaged during riding activities, regardless of modality. This supports previous research suggesting that postural stability is foundational to participation in dynamic activities and may enhance a child’s ability to attend and interact during therapy.

Conversely, the moderate negative correlations between engagement and tactile sensitivity (touch) on the SPM-2 for both conditions suggest that children with heightened tactile defensiveness may be less engaged, potentially due to discomfort or overstimulation. This finding aligns with existing literature on sensory modulation difficulties in children with ASD and underscores the importance of tailoring interventions to individual sensory needs.

The lack of significant difference in engagement between the horse and simulator suggests that simulated riding may be a viable alternative, particularly in settings where access to live horses is limited. However, the nuanced sensory experiences provided by each modality—such as the unpredictability and multisensory input of a live horse versus the controlled environment of a simulator—may influence outcomes in ways not fully captured by engagement alone.

These results highlight the need for further research with larger sample sizes to explore how specific sensory processing patterns influence engagement and therapeutic outcomes. Future studies should also consider longitudinal designs to assess sustained effects over time and include qualitative measures to capture children's preferences and emotional responses to each modality.

Application of this Work to the Body of Knowledge

Ultimately, this study contributes to a growing body of evidence supporting individualized, sensory-informed approaches to intervention planning for children with ASD. By understanding how sensory processing influences engagement, clinicians can make more informed decisions about the use of equine-assisted and simulated riding therapies to support functional outcomes.

Limitations 

Lack of randomized condition order and small sample size.