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Dear Ms. Malcolm and Ms. Dean,

I had the pleasure of reading your article, “Horses, scientists and the search for effective autism treatment” (October 22, 2014), and am happy to see that Mr. Isaacson was able to find in horses something that is very motivating for his son, Rowan. For many parents, finding effective sources of motivation for engaging in the hard work of intervention is a very real challenge. The research tells us that discovering a child’s interests and aligning learning opportunities with activities that a child enjoys can have robust outcomes. One example of this is Pivotal Response Treatment, rooted in applied behavior analysis (ABA), a methodology that is well established in the scientific literature. However, recognition that riding a horse is motivating for an individual is a far cry from establishing it as an effective intervention in and of itself.

As Ms. Rogerson indicated, she followed the path of science and used ABA-based intervention with her son, Jack. It is important to understand, especially in light of some of the comments found in your article, that ABA is not at all a one-size-fits-all approach or a packaged treatment. Furthermore, most practitioners of ABA-based intervention will be the first to say that one cannot simply take an online webinar or perform a series of any specific things with children with ASD in order to realize a “cure.” Rather, ABA is a science that is based on the careful analysis of behavior (both adaptive and compromising), the environmental events that are implicated in the occurrence of that behavior, and systematically using motivators (i.e., reinforcers) to promote acquisition of new skills. In a very real sense, ABA is a science that emphasizes individuality and tailored intervention. The mode through which these experiences occur can and should vary from person to person, based on skills and preferences.

In a review of 250 published articles on animal-assisted therapy (AAT) Nimer, Janelle, & Brad Lundahl, 2007), the authors found the following:

  • Of the 250 available scholarly articles, 201 did not meet the basic standards of scientific rigor necessary for inclusion.
  • On the whole, AAT was associated with moderate effect size in improving outcomes across a variety of areas, and
  • “AAT shows promise as an additive to established interventions and research should investigate the conditions under which AAT can be most helpful” (emphasis added).

Our interest was piqued by the side-by-side comparison of the two families in your story, but also concerned that some readers might come away with the wrong idea. You imply that there are various paths that will work for a child with autism, and each parent must advocate for that path. However, it is important to be aware that many families spend precious time and resources on a variety of complementary and alternative medicine interventions that have not been evaluated scientifically and, in some cases, are not helpful and may even be harmful for a child. Horseback riding as a shared activity between parent and child may be a wonderful, joyful experience; however, it is not a scientifically substantiated intervention. Encouraging such an activity as anything other than an adjunct to effective, science-based intervention is probably a disservice to your readership.

Zachary Houston, MS, BCBA
Association for Science in Autism Treatment

 

References

Halliday, P., Houston, Z., Kinney, E., & Myers, S.M. (2012). Autism treatment reviews for physicians: The take-home messages. Science in Autism Treatment, 9(2), p. 1-6.

Nimer, J., & Lundahl, B. (2007). “Animal-assisted therapy: A meta-analysis.”Anthrozoos: A Multidisciplinary Journal of the Interactions of People & Animals 20(3), 225-238.

Zane, T. (n.d.). A Horse of a Different Color: A Review of the Effectiveness of Hippotherapy. Science in Autism Treatment. https://asatonline.org/research-treatment/resources/topical-articles/a-horse-of-a-different-color-a-review-of-the-effectiveness-of-hippotherapy/

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