Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design

Journal of Autism and Developmental Disorders https://doi.org/10.1007/s10803-023-06174-5 ORIGINAL PAPER Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design Juan Vives-Vilarroig3 · Paola Ruiz-Bernardo1 · Andrés García-Gómez2 Accepted: 27 October 2023 © The Author(s) 2024 Abstract The aim of this research was to study the effect of a horseback-riding programme on postural control in a group of autistic children (ASD). Nine children aged 9 to 12 years participated in this study through a multiple baseline across subjects design. The whole programme took place over nine months. Participants followed a previously developed specific horseback-riding programme, consisting of 45-minute sessions held twice a week for at least three months. To evaluate postural control, the average velocity of the centre of pressure displacement was measured by means of a posturographic platform. Results indicated that this intervention with horses had a positive effect on the postural control in children with ASDs. Keywords Horse-assisted activities · Autism spectrum disorder · Postural control · Horseback riding therapeutics Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by a significant deficit in social communication and repetitive behaviours, restricted interests, and/or atypical sensory behaviour. The spectrum of autism refers to the great variability of the symptoms presented by each affected individual. ASD is often associated with other disorders or medical conditions and may co-occur with intellectual disability and language impairment, ranging from mutism to articulatory and grammatical correction. In all cases adaptive skills are significantly impaired and can be classified into three levels of severity depending on the support required (APA, 2013). Paola Ruiz-Bernardo Juan Vives-Vilarroig Andrés García-Gómez 1 Universidad Jaume I. Castellón, Av. Vicent Sos Baynat, s/n, Castellón de la Plana 12071, España 2 Universidad de Extremadura. Badajoz, Av. de Elvas, s/n, Badajoz 06006, España 3 Universidad Cardenal Herrera, CEU, Castellón, C. Grecia, 31, Castellón de la Plana 12006, España In recent years, ASD has become one of the most prevalent neurodevelopmental disorders in children due, partly, to new diagnostic criteria, greater sensitivity in society, and increased specialist training (Hyman et al., 2020). It is currently estimated that one in 59 children under the age of 8 years has symptoms that meet ASD criteria (Maenner et al., 2020). ASD Associated Disorders ASD is a complex reality and has often been associated with other disorders such as stress (Ogawa et al., 2017; Corbett et al., 2016), anxiety (Ezell et al., 2019), sleep (Neumeyer et al., 2019), gastrointestinal (Madra et al., 2020), obsessive–compulsive (Martin et al., 2020), attention deficit hyperactivity (Muskens et al., 2017), sensory processing (Rydzewska et al., 2019), and motor disorders (Licari et al., 2020), among others. There is often a circular relationship between some of these disorders and the expression of ASD symptoms. For instance, greater sleep disturbances may induce higher severity of expression of ASD symptoms and vice versa, as do anxiety, sensory processing disorders, and motor disorders (Cohen et al., 2014; Mazurek & Petroski, 2015). The relationship between some of these disorders and ASD is sometimes so close, as in the case of motor disorders, that some authors have even considered them to be 13 Journal of Autism and Developmental Disorders typical of autism (Crespo-Eguílaz & Narbona-García, 2009; MacDonald et al., 2012, 2013). Motor Disorders and Postural Control Although not regarded as an essential symptom of ASD, motor disorders appear as an associated symptomatology in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (APA, 2013), as these symptoms seem to show a peculiar and different functioning from other conditions such as developmental coordination disorders. (Caeyenberghs et al., 2016; Valverde-Esteve et al., 2020). Dziuk et al. (2007) have suggested that movement impairments in ASD have more similarities than differences with impairments found in developmental coordination disorder. Jansiewicz et al. (2006) found impaired balance and gait, slower speed of timed movements and greater “sprawl” movements in autistic children than in normotypical children. However, the breadth of the autistic spectrum makes it difficult to establish a common pattern. Also, Fournier et al. (2010) argued that the deficit of postural control, which is basic for a good balance control, is an aspect that is repeated throughout the autism spectrum, presenting a less stable and more variable posture in comparison with neurotypical children of the same age. This was also endorsed by Lourenço et al. (2020) since, in his research, autistic children presented significantly lower scores in relation to motor skills, including balance. In several studies, such as that of Fernándes (2020), it was observed that autistic people scored significantly lower on the balance scales. Similarly, Larson and Mostofosky (2009) found in their work that autistic children have greater difficulty in balance and gait compared to normotypical children. Moreover, motor disorders can help to establish the diagnosis and obtain prognostic indicators regarding the adaptive behaviour of these individuals (Stevenson et al., 2017). However, although very common, motor disorders are often not systematically assessed by diagnostic teams (Licari et al., 2020). The typology of motor disorders in ASD is very diverse. Some of the most common problems are difficulties in general dynamic coordination, problems in flexibility and motor tone, gait disorders, difficulties in fine motor coordination, motor praxis, and difficulties in postural control and balance (Paquet et al., 2016; Wang et al., 2016; Molloy et al., 2003; Lum et al., 2020). Among these motor difficulties, balance disorders are of particular interest as they directly affect the success of carrying out everyday activities (Travers et al., 2017). Balance is the ability of our body to remain upright through compensatory movements when stationary or in motion (Mosston & Ashworth, 2008). Balance provides the body with a stable basis for locomotion and manual and 13 facial actions, thus facilitating effective interaction with the environment, both physical and social (Adolph & Franchak, 2017). In fact, everyday tasks such as soaping and getting out of the shower, cooking, or dressing become more difficult if there is a lack of good stability in the upright position (Smith & Fisher, 2018). We use the term ‘postural control’ to refer to the complex ability that involves different sensory–motor processes and that aims to achieve a correct balance in both static and dynamic activities (Winter et al., 1990; Westcott et al., 1997). Guzmán-Muñoz et al (...truncated)