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How are equine or animal-assisted therapies used for autism?Ā 

Posted
Updated
ByMy Patient Advice
Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Equine- and animal-assisted therapies offer structured interactions with horses or other animals to support confidence, regulation and communication. Although widely used in community and charity settings, these approaches are not recommended as core autism interventions in national clinical guidance. NICE CG170 and NICE CG142 do not include equine or animal-assisted therapies, and they do not appear on NHS.uk autism support pages. Updated NICE surveillance also found no new evidence strong enough to change this position according to 2021 review. 

Learn more about Autism testing & diagnosis

What research shows about benefits 

A growing research base suggests that equine-assisted interventions may help some autistic people, especially children, develop social, emotional and motor skills. 

  • A 2022Ā systematic reviewĀ found consistent improvements inĀ social functioningĀ after equine-assisted or therapeutic riding sessions, with some gains continuing beyond the intervention.Ā 
  • A 2018Ā equine therapy reviewĀ reported improvements inĀ behaviouralĀ skills,Ā socialĀ communicationĀ and someĀ motor outcomes, though many studies were small andĀ unblind.Ā 
  • New evidence from 2025Ā prospective studyĀ shows gains inĀ adaptiveĀ behaviour,Ā communication,Ā and daily living skills after 20 structured sessions.Ā 
  • A 2024Ā systematic reviewĀ found consistent improvements inĀ balance,Ā posture,Ā and coordination.Ā Ā 

Not all evidence is positive: some experimental analysis report little or no change in core autistic behaviours. 

How these therapies work 

Recent theoretical work suggests several mechanisms that may explain emerging benefits: 

  • AĀ theoretical frameworkĀ ofĀ Rhythmic horse movementĀ may support postural control and balance.Ā 
  • Shared focus on the horseĀ can act as a natural motivator for communication and turn-taking.Ā 
  • Structured routinesĀ provide predictability, which many autistic people find regulating.Ā 
  • Calming sensory experiencesĀ around animals may support emotional regulation and engagement.Ā 

These mechanisms are promising but still require more robust testing. 

Use in UK services and charities 

Equine-assisted activities are offered by charities such as the Riding for the Disabled Association, which reports improvements in confidence, enjoyment and social participation based on internal outcome monitoring. UK autism organisations, including entries in the NAS service directory, position these activities as enriching experiences rather than evidence-based autism treatments. 

Limitations, risks and accessibility 

  • Evidence isĀ emerging, with small samples and limited long-term follow-up.Ā 
  • ResearchĀ largely focusesĀ onĀ children, with minimal data for autistic adults.Ā 
  • Accessibility may be limited byĀ the cost,Ā location,Ā and availability of trained staff.Ā 
  • Physical risks (falls, allergies) and safeguarding requirements meanĀ programmesĀ must be delivered by qualified practitioners.Ā 

Takeaway 

Equine- and animal-assisted therapies can enrich wellbeing and support social and motor development for some autistic people. But they remain complementary or experimental approaches, not core autism interventions recommended by NICE and NHS. They work best as optional, goal-focused activities within a broader, personalised support plan. 

Beatrice Holloway, MSc
Author

Beatrice Holloway is a clinical psychologist with a Masterā€™s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS
Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.Ā 

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