Equine-Assisted Services for Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Area of Science:

• Pediatrics
• Neuroscience
• Therapeutic Interventions

Background:

• Attention-deficit/hyperactivity disorder (ADHD) impacts children's functioning.
• Equine-assisted services (EAS) are increasingly explored as a therapeutic approach.
• The International Classification of Functioning, Disability, and Health (ICF) provides a framework for evaluating these therapies.

Purpose of the Study:

• To systematically review the evidence on equine-assisted activities and therapies (EAATs) for children and youth (ages 6-18) with ADHD.
• To evaluate the effectiveness of EAATs based on the ICF framework.
• To identify gaps in the current research regarding EAATs for ADHD.

Main Methods:

• Systematic review of electronic databases from inception to December 2020.
• Inclusion of 12 articles: 8 non-controlled prospective studies and 4 randomized-controlled trials (RCTs).
• Assessment of study quality, with seven of moderate and five of moderate-high methodological quality.

Main Results:

• Evidence supports the effectiveness of EAATs, including equine-assisted physical therapy (EAPT) and therapeutic riding (TR).
• Improvements were noted in body functions and structures (mental, neuromusculoskeletal, cardiovascular) with EAPT.
• Limited evidence showed positive effects on activity and participation with TR; quality of life improved with both EAPT and TR.

Conclusions:

• Preliminary evidence suggests EAATs may benefit physiological functions in children with ADHD.
• Further research is required to establish the impact of EAATs on participation and quality of life.
• More controlled studies with larger sample sizes are needed to elucidate specific EAAT effects on ADHD core symptoms and consequences.