Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation

Kristen Springer; Emily Boynton; Paige Hamilton; Hannah Hamsher; Maureen Piotrowski; Kelly McClintock; Daniel Martin

doi:doi:10.11648/j.ajap.20221104.11

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Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation

Kristen Springer, Emily Boynton, Paige Hamilton, Hannah Hamsher, Maureen Piotrowski, Kelly McClintock, Daniel Martin

Published in American Journal of Applied Psychology (Volume 11, Issue 4)

Received: 21 April 2022 Accepted: 7 May 2022 Published: 29 July 2022

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Abstract

Individuals with autism spectrum disorder (ASD) tend to have lower heart rate variability (HRV) and higher rates of emotional dysregulation when compared to their non-disabled peers. Evidence suggests hippotherapy increases individuals with ASD’s HRV and improves their emotion regulation skills. Accordingly, the current study examined hippotherapy’s influence on emotion dysregulation and HRV in children diagnosed with ASD. Participants included two male children, ages seven and eight, who attended six weeks of hippotherapy at Ride-on-Ranch, a therapeutic riding center in Lovettsville, VA. This single-subject design study used a concurrent mixed methods design, collecting quantitative and qualitative data simultaneously. The quantitative data included emotion dysregulation scores collected from the Emotion Dysregulation Inventory (EDI) and HRV scores from each participant. Pre- and post-test interviews, collected from the participants’ caregivers, measured their perceptions of their child’s emotion dysregulation. Both participants experienced statistically significant improvements in emotion dysregulation and marginally significant improvements in HRV. These results were consistent with the caregiver interviews, as the caregivers reported significant differences in their children’s emotion dysregulation after hippotherapy intervention. Based on these findings, the present study may contribute to a deeper understanding of alternative therapies for children with ASD to improve one’s physical, cognitive, and emotional states.

Published in	American Journal of Applied Psychology (Volume 11, Issue 4)
DOI	10.11648/j.ajap.20221104.11
Page(s)	101-112
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Hippotherapy, Autism Spectrum Disorder, Emotion Dysregulation, Heart Rate Variability, Occupational Therapy

References

[1]	Ajzenman, H. F., Standeven, J. W., & Shurtleff, T. L. (2013). Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: A pilot study. American Journal of Occupational Therapy, 67, 653-663. https://doi.org/10.5014/ajot.2013.008383
[2]	American Hippotherapy Association. (2020). AHA, Inc. Terminology for Healthcare. https://www.americanhippotherapyassociation.org/assets/docs/AHA-%20Recommended%20Terminology.pdf
[3]	Baldwin, A. L., Rector, B. K., & Alden, A. C. (2018). Effects of a form of equine-facilitated learning on heart rate variability, immune function, and self-esteem in older adults. People and Animals: The International Journal of Research and Practice, 1 (1), 1-17. https://docs.lib.purdue.edu/cgi/viewcontent.cgi?article=1014&context=paij
[4]	Berkovits, L., Eisenhower, A., & Blacher, J. (2016). Emotion regulation in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 47 (1), 68–79. https://doi.org/10.1007/s10803-016-2922-2
[5]	Bloch, E. (2018). Hippotherapy: The lived experience of parents of children with autism. American Journal of Occupational Therapy, 72. 7211510169p1-7211510169p1. https://doi.org/10.5014/ajot.2018.72S1-PO2020
[6]	Cabiddu, R., Borghi-Silva, A., Trimer, R., Trimer, V., Ricci, P. A., Monteiro, C. I., & Carvalho, E. M. (2016). Hippotherapy acute impact on heart rate variability non-linear dynamics in neurological disorders. Physiology & Behavior, 159, 88-94. https://doi.org/10.1016/j.physbeh.2016.03.012
[7]	CDC. (2021). Health-Related Quality of Life (HRQOL). https://www.cdc.gov/hrqol/index.htm
[8]	CDC. (2020). Diagnostic Criteria. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/hcp-dsm.html
[9]	Cheng, Y., Huang, Y., & Huang, W. (2020). Heart rate variability in individuals with autism spectrum disorders: A meta-analysis. Neuroscience & Biobehavioral Reviews, 118, 463-471. https://doi.org/10.1016/j.neubiorev.2020.08.007
[10]	Cole, M. B. & Tufano, R. (2020). Applied theories in occupational therapy: A practical approach (2nd ed.). SLACK Incorporated.
[11]	Dampsey, E., Lassen, M., Bush, J., Holland, D., & Baldwin, A. (2017). The effects of equine-assisted psychotherapy on emotion regulation: Self-efficacy and self-awareness as potential mediators a dissertation submitted. In Fielding Graduate University. https://www.keulseweg.nl/media/onderzoek20.pdf
[12]	Ecker, S. & Lykins, A. (2019). Effects of short-term human-horse interactions on human heart rate variability: A multiple single case study. People and Animals: The International Journal of Research and Practice, 2 (1), 1-18. https://docs.lib.purdue.edu/paij/vol2/iss1/2
[13]	Garcia-Gomez, A., Guerrero-Barona, E., Garcia-Pena, I., Rodriguez-Jimenez, M., & Moreno Manso, J. M. (2020). Equine-assisted therapeutic activities and their influence on the heart rate variability: A systematic review. Complementary Therapies in Clinical Practice, 39, 1-8. https://doi.org/10.1016/j.ctcp.2020.101167
[14]	Garcia-Gomez, A., Risco, M. L., Rubio, J. C., Guerrero, E., & Garcia-Pena, I. M. (2014). Effects of a program of adapted therapeutic horse-riding in a group of autism spectrum disorder children. Electronic Journal of Research in Educational Psychology, 12 (1), 107-128. http://dx.doi.org/10.14204/ejrep.32.13115
[15]	Koca, T. T., & Ataseven, H. (2016). What is hippotherapy? The indications and effectiveness of hippotherapy. Northern Clinics of Istanbul, 2 (3), 247–252. https://doi.org/10.14744/nci.2016.71601
[16]	Léveillé, A., Rochette, A., & Mainville, C. (2017). Perceived risks and benefits of hippotherapy among parents of children currently engaged in or waiting for hippotherapy: A pilot study. Physiotherapy Theory and Practice, 33 (4), 269-277. https://doi.org/10.1080/09593985.2017.1302029
[17]	Loftis C. (2016) Mental Flexibility. In: Kreutzer, J., DeLuca, J., & Caplan B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_2123-2
[18]	Maresca, G., Portaro, S., Naro, A., Crisafulli, R., Raffa, A., Scarcella, I., Aliberti, B., & Gemelli, G., Calabrò, R. S. (2020). Hippotherapy in neurodevelopmental disorder: A narrative review focusing on cognitive and behavioral outcomes. Applied Neuropsychology: Child, 1–8. https://doi.org/10.1080/21622965.2020.1852084
[19]	Mazefsky, C. A., Yu, L., White, S. W., Siegel, M., & Pilkonis, P. A. (2018). The emotion dysregulation inventory: Psychometric properties and item response theory calibration in an autism spectrum disorder sample. Autism Research, 11 (6), 928–941. https://doi.org/10.1002/aur.1947
[20]	Nqwena, Z. & Naidoo, R. (2016). The effect of therapeutic horseback riding on heart rate variability of children with disabilities. African Journal of Disability, 5 (1), 1-8. https://doi.org/10.4102/ajod.v5i1.248
[21]	Pouw, L. B. C., Rieffe, C., Stockmann, L., & Gadow, K. D. (2013). The link between emotion regulation, social functioning, and depression in boys with ASD. Research in Autism Spectrum Disorders, 7 (4), 549–556. https://doi.org/10.1016/j.rasd.2013.01.002
[22]	Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5. https://doi.org/10.3389/fpubh.2017.00258
[23]	Tan, V. X.-L., & Simmonds, J. G. (2017). Parent perceptions of psychosocial outcomes of equine-assisted interventions for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48 (3), 759–769. https://doi.org/10.1007/s10803-017-3399-3
[24]	Thapa, R., Pokorski, I., Ambarchi, Z., Thomas, E., Demayo, M., Boulton, K., Matthews, S., Patel, S., Sedeli, I., Hickie, I. B., & Guastella, A. J. (2020). Heart rate variability in children with autism spectrum disorder and associations with medication and symptom severity. Autism Research, 14 (1), 75–85. https://doi.org/10.1002/aur.2437

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APA Style

Kristen Springer, Emily Boynton, Paige Hamilton, Hannah Hamsher, Maureen Piotrowski, et al. (2022). Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. American Journal of Applied Psychology, 11(4), 101-112. https://doi.org/10.11648/j.ajap.20221104.11

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ACS Style

Kristen Springer; Emily Boynton; Paige Hamilton; Hannah Hamsher; Maureen Piotrowski, et al. Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. Am. J. Appl. Psychol. 2022, 11(4), 101-112. doi: 10.11648/j.ajap.20221104.11

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AMA Style

Kristen Springer, Emily Boynton, Paige Hamilton, Hannah Hamsher, Maureen Piotrowski, et al. Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. Am J Appl Psychol. 2022;11(4):101-112. doi: 10.11648/j.ajap.20221104.11

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@article{10.11648/j.ajap.20221104.11,
  author = {Kristen Springer and Emily Boynton and Paige Hamilton and Hannah Hamsher and Maureen Piotrowski and Kelly McClintock and Daniel Martin},
  title = {Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation},
  journal = {American Journal of Applied Psychology},
  volume = {11},
  number = {4},
  pages = {101-112},
  doi = {10.11648/j.ajap.20221104.11},
  url = {https://doi.org/10.11648/j.ajap.20221104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajap.20221104.11},
  abstract = {Individuals with autism spectrum disorder (ASD) tend to have lower heart rate variability (HRV) and higher rates of emotional dysregulation when compared to their non-disabled peers. Evidence suggests hippotherapy increases individuals with ASD’s HRV and improves their emotion regulation skills. Accordingly, the current study examined hippotherapy’s influence on emotion dysregulation and HRV in children diagnosed with ASD. Participants included two male children, ages seven and eight, who attended six weeks of hippotherapy at Ride-on-Ranch, a therapeutic riding center in Lovettsville, VA. This single-subject design study used a concurrent mixed methods design, collecting quantitative and qualitative data simultaneously. The quantitative data included emotion dysregulation scores collected from the Emotion Dysregulation Inventory (EDI) and HRV scores from each participant. Pre- and post-test interviews, collected from the participants’ caregivers, measured their perceptions of their child’s emotion dysregulation. Both participants experienced statistically significant improvements in emotion dysregulation and marginally significant improvements in HRV. These results were consistent with the caregiver interviews, as the caregivers reported significant differences in their children’s emotion dysregulation after hippotherapy intervention. Based on these findings, the present study may contribute to a deeper understanding of alternative therapies for children with ASD to improve one’s physical, cognitive, and emotional states.},
 year = {2022}
}

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TY  - JOUR
T1  - Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation
AU  - Kristen Springer
AU  - Emily Boynton
AU  - Paige Hamilton
AU  - Hannah Hamsher
AU  - Maureen Piotrowski
AU  - Kelly McClintock
AU  - Daniel Martin
Y1  - 2022/07/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ajap.20221104.11
DO  - 10.11648/j.ajap.20221104.11
T2  - American Journal of Applied Psychology
JF  - American Journal of Applied Psychology
JO  - American Journal of Applied Psychology
SP  - 101
EP  - 112
PB  - Science Publishing Group
SN  - 2328-5672
UR  - https://doi.org/10.11648/j.ajap.20221104.11
AB  - Individuals with autism spectrum disorder (ASD) tend to have lower heart rate variability (HRV) and higher rates of emotional dysregulation when compared to their non-disabled peers. Evidence suggests hippotherapy increases individuals with ASD’s HRV and improves their emotion regulation skills. Accordingly, the current study examined hippotherapy’s influence on emotion dysregulation and HRV in children diagnosed with ASD. Participants included two male children, ages seven and eight, who attended six weeks of hippotherapy at Ride-on-Ranch, a therapeutic riding center in Lovettsville, VA. This single-subject design study used a concurrent mixed methods design, collecting quantitative and qualitative data simultaneously. The quantitative data included emotion dysregulation scores collected from the Emotion Dysregulation Inventory (EDI) and HRV scores from each participant. Pre- and post-test interviews, collected from the participants’ caregivers, measured their perceptions of their child’s emotion dysregulation. Both participants experienced statistically significant improvements in emotion dysregulation and marginally significant improvements in HRV. These results were consistent with the caregiver interviews, as the caregivers reported significant differences in their children’s emotion dysregulation after hippotherapy intervention. Based on these findings, the present study may contribute to a deeper understanding of alternative therapies for children with ASD to improve one’s physical, cognitive, and emotional states.
VL  - 11
IS  - 4
ER  -

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Author Information

Kristen Springer

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Emily Boynton

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Paige Hamilton

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Hannah Hamsher

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Maureen Piotrowski

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Kelly McClintock

Division of Occupational Therapy, Shenandoah University, Winchester, United States
Daniel Martin

Division of Occupational Therapy, Shenandoah University, Winchester, United States

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APA Style

Kristen Springer, Emily Boynton, Paige Hamilton, Hannah Hamsher, Maureen Piotrowski, et al. (2022). Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. American Journal of Applied Psychology, 11(4), 101-112. https://doi.org/10.11648/j.ajap.20221104.11

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ACS Style

Kristen Springer; Emily Boynton; Paige Hamilton; Hannah Hamsher; Maureen Piotrowski, et al. Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. Am. J. Appl. Psychol. 2022, 11(4), 101-112. doi: 10.11648/j.ajap.20221104.11

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AMA Style

Kristen Springer, Emily Boynton, Paige Hamilton, Hannah Hamsher, Maureen Piotrowski, et al. Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation. Am J Appl Psychol. 2022;11(4):101-112. doi: 10.11648/j.ajap.20221104.11

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@article{10.11648/j.ajap.20221104.11,
  author = {Kristen Springer and Emily Boynton and Paige Hamilton and Hannah Hamsher and Maureen Piotrowski and Kelly McClintock and Daniel Martin},
  title = {Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation},
  journal = {American Journal of Applied Psychology},
  volume = {11},
  number = {4},
  pages = {101-112},
  doi = {10.11648/j.ajap.20221104.11},
  url = {https://doi.org/10.11648/j.ajap.20221104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajap.20221104.11},
  abstract = {Individuals with autism spectrum disorder (ASD) tend to have lower heart rate variability (HRV) and higher rates of emotional dysregulation when compared to their non-disabled peers. Evidence suggests hippotherapy increases individuals with ASD’s HRV and improves their emotion regulation skills. Accordingly, the current study examined hippotherapy’s influence on emotion dysregulation and HRV in children diagnosed with ASD. Participants included two male children, ages seven and eight, who attended six weeks of hippotherapy at Ride-on-Ranch, a therapeutic riding center in Lovettsville, VA. This single-subject design study used a concurrent mixed methods design, collecting quantitative and qualitative data simultaneously. The quantitative data included emotion dysregulation scores collected from the Emotion Dysregulation Inventory (EDI) and HRV scores from each participant. Pre- and post-test interviews, collected from the participants’ caregivers, measured their perceptions of their child’s emotion dysregulation. Both participants experienced statistically significant improvements in emotion dysregulation and marginally significant improvements in HRV. These results were consistent with the caregiver interviews, as the caregivers reported significant differences in their children’s emotion dysregulation after hippotherapy intervention. Based on these findings, the present study may contribute to a deeper understanding of alternative therapies for children with ASD to improve one’s physical, cognitive, and emotional states.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Hippotherapy for Children with ASD: Heart Rate Variability and Emotion Dysregulation
AU  - Kristen Springer
AU  - Emily Boynton
AU  - Paige Hamilton
AU  - Hannah Hamsher
AU  - Maureen Piotrowski
AU  - Kelly McClintock
AU  - Daniel Martin
Y1  - 2022/07/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ajap.20221104.11
DO  - 10.11648/j.ajap.20221104.11
T2  - American Journal of Applied Psychology
JF  - American Journal of Applied Psychology
JO  - American Journal of Applied Psychology
SP  - 101
EP  - 112
PB  - Science Publishing Group
SN  - 2328-5672
UR  - https://doi.org/10.11648/j.ajap.20221104.11
AB  - Individuals with autism spectrum disorder (ASD) tend to have lower heart rate variability (HRV) and higher rates of emotional dysregulation when compared to their non-disabled peers. Evidence suggests hippotherapy increases individuals with ASD’s HRV and improves their emotion regulation skills. Accordingly, the current study examined hippotherapy’s influence on emotion dysregulation and HRV in children diagnosed with ASD. Participants included two male children, ages seven and eight, who attended six weeks of hippotherapy at Ride-on-Ranch, a therapeutic riding center in Lovettsville, VA. This single-subject design study used a concurrent mixed methods design, collecting quantitative and qualitative data simultaneously. The quantitative data included emotion dysregulation scores collected from the Emotion Dysregulation Inventory (EDI) and HRV scores from each participant. Pre- and post-test interviews, collected from the participants’ caregivers, measured their perceptions of their child’s emotion dysregulation. Both participants experienced statistically significant improvements in emotion dysregulation and marginally significant improvements in HRV. These results were consistent with the caregiver interviews, as the caregivers reported significant differences in their children’s emotion dysregulation after hippotherapy intervention. Based on these findings, the present study may contribute to a deeper understanding of alternative therapies for children with ASD to improve one’s physical, cognitive, and emotional states.
VL  - 11
IS  - 4
ER  -

Copy | Download