Preliminary Evidence of Motor Outcomes in Children with Autism Spectrum Disorder Following Equine-Assisted Therapy and Dual-Task Training: A Pilot Study

Background: Equine-assisted therapy (EAT) is a supportive intervention for children with autism spectrum disorder (ASD). Aim: This pilot study evaluated the feasibility of a cognitive-motor EAT intervention to explore its preliminary effects on motor coordination in children with ASD. Methods: A single-group pre-test-post-test design was adopted. Twelve children (mean age: 10.08 +/- 1.51 years; ASD level 1-2) participated in a 16-week EAT program. The intervention integrated EAT with cognitive dual-task activities targeting attention and perceptual processing. Motor performance was assessed before and after the intervention using the Movement Assessment Battery for Children (MABC-2). Results: The RM-ANOVA examined pre-post changes. A significant improvement in the MABC-2 Total Test Score was observed (p = 0.036; eta p2 = 0.34; 95% CI [0.541, 13.792]), indicating a trend of improvement of global motor coordination. No significant improvements were observed in Manual Dexterity, Aiming and Catching, and Balance subscale scores. Conclusions: A cognitively enriched EAT program promoted improvements in overall motor competence in ASD children, even without measurable changes in specific motor skills. The intervention was feasible and well-tolerated, with high adherence and no adverse events. These preliminary findings support the feasibility and potential value of integrating cognitive-motor demands into EAT and provide a rationale for larger randomized controlled studies.