Evidence map›Paper›PMID 42859339›Full record

ArticleJournal of autism and developmental disorders2026

Effects of Incorporating Horses into Occupational Therapy on Adrenocortical and Sympathetic Nervous System Reactivity and Regulation in Autistic Children: A Randomized Controlled Trial.

Ellen M Rankins, Stephen Aichele, Douglas A Granger, Susan Hepburn, Robin Gabriels, Arlene A Schmid, B Caitlin Peters

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of autism and developmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05846932 (Preliminary Efficacy of Occupational Therapy Integrating Horses on Self-regulation in Youth With Autism Spectrum Disorder), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05846932 nacompletednot on this map

Preliminary Efficacy of Occupational Therapy Integrating Horses on Self-regulation in Youth With Autism Spectrum Disorder

TypeinterventionalSponsorColorado State UniversityRan2023 to 2025Enrolled73ConditionsAutism Spectrum DisorderArmsOTEE HORS, OT Clinic
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ellen M RankinsTemple Grandin Equine Center, Department of Animal Sciences, Colorado State University, Spur Campus, 4817 National Western Dr, Denver, CO, 80216, USA.
Stephen AicheleDepartment of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA.
Douglas A GrangerDepartment of Psychology, University of California at Irvine, Irvine, CA, USA.
Susan HepburnDepartment of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA.
Robin GabrielsUniversity of Colorado Anschutz Medical Campus and the Children's Hospital Colorado, Aurora, CO, USA.
Arlene A SchmidDepartment of Occupational Therapy, Colorado State University, Fort Collins, CO, USA.
B Caitlin PetersTemple Grandin Equine Center, Department of Animal Sciences, Colorado State University, Spur Campus, 4817 National Western Dr, Denver, CO, 80216, USA. caiti.peters@colostate.edu.ORCID http://orcid.org/0000-0001-5145-2929

Funding

BuildStrong Foundation BuildStrong FoundationCarl and Caroline Swanson Foundation Carl and Caroline Swanson FoundationEunice Kennedy Shriver National Institute of Child Health and Human Development R21HD109957
6 · The paper itself

Abstract

purposeThe study prospectively investigated adrenocortical and autonomic nervous system reactivity and regulation as autistic children participated in a randomized controlled trial of occupational therapy in an equine environment (OT-Equine).

methodsAutistic children (n = 72, ages 6-11 yrs) were randomly assigned for 10 weeks to OT-Equine or clinic-based occupational therapy (OT-Clinic). Saliva samples (later assayed for cortisol and alpha-amylase, [sAA]) were collected before (pre-session), during (within-session), immediately after (post-session), and 20-minutes after (post-session + 20) each 1-hour weekly session. Data were analyzed with a generalized linear mixed-effects model.

resultsAcross the 10 sessions, pre-session sAA significantly increased (exp(b) = 1.02 per week, p < 0.05). Within sessions, sAA increased (exp(b) = 1.22; p < 0.01) during therapy and recovered post-session + 20. Group differences in sAA changes were non-significant. By contrast, pre-session cortisol concentrations were stable across the 10-weeks (exp(b) = 1.01; p > 0.05). Within session, however, cortisol concentrations decreased from pre- to post- and post-session + 20, with greater reductions among OT-Equine participants (exp(b) = 0.77; p < 0.01). Changes in cortisol were associated with improved treatment outcomes.

conclusionThe pattern of reactivity and recovery in sAA suggests that children experienced autonomic/sympathetic arousal in response to therapy sessions, perhaps associated with excitement and positive affect. Moreover, stable pre-session cortisol concentrations across sessions for both groups, and declining cortisol concentrations within sessions for the OT-Equine group, suggests OT-Equine participants also held subjective experiences characterized by familiarity and low levels of distress. Taken together, findings suggest the integration of horses into occupational therapy for autistic children creates an exciting positive therapeutic environment, associated with improved treatment outcomes. The study was registered as a clinical trial at clinicaltrials.gov (NCT05846932, registered April 26, 2023).

Indexed as

Alpha-amylaseAutismBiobehavioralCortisolEquine-assisted servicesHippotherapy

Identifiers

PMID42859339

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.