Horse Programs for Autistic Children

The study will use a single subject, multiple cross-over (N-of-1) study design with multiple baseline across participants. Different treatment conditions will consist of treatment with horse present (A; intervention condition), and treatment without horse present (B; control condition). Participants will be assigned randomly to a randomly generated sequence of multiple episodes (individual therapy sessions) of both treatment conditions. A 2-week baseline condition will commence at the same time for all participants. The baseline period will consist of the participants usual routine, with no additional interventions or changes. Through random assignment, 2 participants will then commence the intervention. A further 2 participants will commence treatment after 4 weeks from baseline, and the last two after 6 weeks from baseline. Treatment adherence will be monitored through a session attendance checklist, and reasons for non attendance will be recorded. Intervention: A mindfulness-based, cognitive-behavioural therapy intervention (MCBT) will be provided in a farm setting and will be adapted to allow for the inclusion of a horse in some of the scheduled activities. The intervention will consist of 60-minute therapy sessions, provided on a weekly basis for 8 consecutive weeks. The intervention will be provided by a PhD candidate./ student researcher. The student researcher is currently enrolled in the Clinical Psychology Doctorate program at Curtin University and has completed all clinical training of this program, is a registered psychologist and has completed the AHPRA practice requirement of the clinical psychology registrar program (endorsement pending completion of the Doctorate Program). Through their training and experience working as a psychologist in private practice, the student researcher has obtained knowledge and experience in providing psychological interventions to a variety of clients from different age groups and cultural backgrounds. The research student also has over 10 years experience of volunteering and working in equine- assisted therapy programs providing services to autistic children. The student researcher will be supervised by Dr Trevor Mazzuchelli who has extensive experience in working with children with a range of disabilities. Dr Trevor Mazzucchelli held a position as clinical psychologist with the Disability Services Commission for 14 years, specialising in working with children with developmental disabilities (including ASD) and their families. A standardised treatment program will be manualised and documented in detail, including clear description of comparable activities in the control and intervention conditions. The treatment activities will be based on a mindfulness based CBT program, Participants will interact with the horse through observing the horse, brushing the horse, groundwork/ leading/ walking the horse, and being led on horseback). Examples of specific activities in the treatment condition (with the horse) will include : mindful breathing while standing with the horse (control: mindful breathing while standing in nature), mindful walking/ focussing on movement in the body and rhythm while leading the horse (control condition: mindful walking without horse);noticing/ observing body sensations and linking it to emotions and states of arousal using observations of the horse as a metaphor/ comparison (control: noticing and observing feelings while in nature); noticing and engaging the 5 senses while grooming the horse (control: noticing the 5 senses in nature). Target behaviour will be monitored by the parent during each phase of the study via daily completion of the Parent Daily Report checklist (PDR; Chamberlain & Reid, 1987). A web-based version of the PDR will be used. Parents will receive reminders, prompting completion in line with the observation schedule. During the initial 2-week baseline phase, the PDR will be completed daily, to ascertain target behaviour stability. Subsequently, the PDR will be collected 3 times per week, to reduce participant burden. Idiosyncratic indices of happiness will be identified for each participant in line with protocols suggested by Parson et al. (2012) and replicated by Ramey et al., 2022 and observed and scored based on the recording of sessions. A rater blind to the session number will view videos of treatment sessions and use a scatter plot to code for indices of happiness and participation. The standardised measures are intended to be completed online but can also be requested as paper and pen version by the participant. If necessary, the independent rater could also complete these measures with the participants via phone, if neither the online nor paper- pen version is appropriate for a particular participant. All standardised self-report measures will be administered at the beginning of the baseline phase, after the 8 weeks of overall intervention.