The effectiveness of Equine-Assisted Services for the population with autism spectrum disorder (ASD)

Many studies have been published providing evidence regarding the effectiveness of Equine-Assisted Services for individuals with ASD, especially children and adolescents.

It is common to find reports from families, professionals, and institutions describing significant changes and gains in children who undergo interventions with horses.

But at the same time, a question deserves to be asked:

What has science actually shown?

More than just seeking simple answers, understanding what research shows—and also recognizing what we don't yet know—is a way to offer increasingly ethical, safe, and evidence-based interventions.

The number of searches has grown.

Two decades ago, there were few studies on the subject, and there were not even any systematic reviews registered in the area of health and well-being.

Today, this scenario has changed significantly. Proof of this is the number of systematic reviews registered in PROSPERO, which is an international registry platform for systematic reviews in the area of health and well-being. In 2026 alone, we can observe 9 registered reviews, a number never before reached.

In recent years, there has been significant growth in scientific production involving people with ASD and interventions with horses.

This growth demonstrates that the area is maturing.

But scientific growth also means asking increasingly specific questions.

What do the studies indicate?

In general, the evidence demonstrates benefits and improvement in:

• social communication;

• social cognition;

• behavioral regulation;

• and motor coordination.

  
  

We know that there are still limitations and considerations in the studies. It is possible to identify specific difficulties and challenges, such as:

• failing to detail specifically which equine-assisted service is being offered and to demonstrate a clear step-by-step explanation of the intervention applied.

• Variable response: not all individuals with ASD respond in the same way, and levels of support directly influence the results.

• Access and cost: sessions can be expensive and require specialized facilities and trained personnel.

• lack of profile of the intervention equine.

• The absence of a description of the saddling equipment used when engaging in riding activities.

Understanding the whole picture is important, so in addition to seeing the benefits already found and outcomes that show us evidence, it is also necessary to look at the challenges and difficulties.

Recognizing promising results does not mean stating that all people with ASD will respond in the same way, or that any intervention with horses will produce the same effects, or even that any person with ASD will benefit from the interventions, considering the outcomes already mentioned above.

Science invites us precisely to look at these differences.

Therefore, comparing results between different studies remains a challenge.

And perhaps that's precisely where one of the great opportunities for the development of our field lies: to better describe what we do.

The horse is not the treatment.

Research does not show that simply interacting with a horse produces any specific results.

The potential benefits are related to planned interventions, conducted by qualified professionals, with defined objectives and the intentional participation of the intervention horse within a structured proposal.

I.e:

It's not just the presence of the horse that makes a difference. It's the quality of the intervention built in partnership with him.

This leads us to an important reflection.

If two interventions use horses but have different objectives, professionals, strategies, horse characteristics, equipment, and handling methods, can we really consider them the same intervention?

This is an important question for those who produce knowledge and for those who work in practice.

The future of research lies in the questions.

Perhaps the most significant change in recent years lies precisely in the way we ask questions.

For a long time, the question was:

"Do horses help people with autism?"

Today, we can ask much more important questions:

What age group?

What level of support?

What are the outcomes?

What are the objectives?

Under what conditions?

Which strategies?

Which components of the intervention might influence the outcomes?

The focus shifts from simply investigating whether equine interventions can benefit people with ASD to understanding what is done, how it is done, and what results truly matter to the individual and their family.

This change seems simple, but it represents an important step forward.

No intervention should be justified solely on the basis that interaction between humans and horses is beneficial.

It is necessary to clearly describe the intervention, justify the choices made, define objectives, and evaluate the results.

What we are doing needs to be described.

If we want to produce more consistent evidence, perhaps we need to start by asking very basic questions about our own practice:

Are we clearly describing what we are doing?

Do we know how to explain why we choose a particular horse, piece of equipment, or activity?

What mechanism of change do we hope to achieve?

What goals are we pursuing?

What outcomes do we want to evaluate?

How do we know that a change has occurred?

And perhaps the most important question:

Did this change make a difference in the life of the person with ASD and their family?

The future of Equine-Assisted Services

Studies conducted so far have already demonstrated the benefits for this population, but we need to advance the evidence. The future of Equine-Assisted Services lies in understanding which interventions truly make a difference, for whom, under what conditions, and through what mechanisms.

This requires research.

It requires qualified professionals.

It requires a clear description of the practices.

It requires an evaluation of results.

It requires dialogue between different areas of knowledge.

It also requires acknowledging the limitations of the evidence we have today.

Science does not weaken a field when it shows that there are still unanswered questions.

It strengthens the field by giving us better questions to investigate.

This type of reflection can help us build increasingly qualified, responsible, and evidence-based Equine-Assisted Services — with interventions designed for people's needs and actions that respect the horses involved at every stage.

Because strengthening an area isn't just about stating that it works. It's about having the courage to investigate how, when, for whom, and under what conditions it works.