The Magic’s in the Methods:
Horses, Cones, Circles, Vests and Science – Finding an Effective Treatment for
Autism Spectrum Disorder and other Disabilities with the Power of the Equine
Abstract:
The purpose of this presentation is to share with other centers, and with the PATH International
community the methods developed, through scientific research and study, at SpiritHorse
International. I wish to describe these methods to you, describe their benefits, and to share with
you how to implement these methods in order to bring greater results in therapeutic riding for
people with the targeted disabilities.
---------This presentation with discuss methods to rehabilitate the underdeveloped, left brain
hemisphere for people with ASD (autism spectrum disorder), traumatic brain injury, and other
related disabilities, through riding in balance-challenging circles; the development of neural
pathways in the brain by weaving through cones in a specific way; the methods used for
regulation in the brains of children with ASD; the development of speech using voice recorded
prompts; [and] the positive effect of these methods on the CARS (Childhood Autism Rating
Scale) autism rating of participants in this therapy.

Restarting the development of the left brain hemisphere for children with ASD;
restarting the development of the affecting brain hemisphere for people with specific
disabilities
The left hemisphere of the brain is underdeveloped in people with Autism Spectrum Disorder
(ASD), Traumatic Brain Injury and other specific disabilities. The right hemisphere in any infant
is the first to develop. In children with Autism, the left hemisphere’s development is stopped or
limited. Things like speech, for example, originate in the left hemisphere; many children with
Autism are speech delayed as a result of this underdevelopment, some even into adulthood.
The theory behind these methods is to stimulate and exercise the left hemisphere, causing it to
“wake up” so that it may develop to perform other, normal functions. Maintaining balance on
the horse causes this brain activity. On a horse, this process of balance-correction occurs
naturally and instinctively, without the client needing to be given or follow directions.
An excellent, safe way to target this “balancing” activity in the brain is for the rider to walk or
trot in small circles on the lunge line. This way, the action of each hemisphere is targeted and
isolated. That is, when a client is riding on a counter clockwise circle, the right hemisphere has
to work to balance the left side of the body (which is on the “inside” of the circle); when the
client rides a clockwise circle, the left brain hemisphere then has to work to balance the right
side of the body.
Preliminary to a study conducted by the University of Texas Southwestern Medical Center at
our facility, interns from a local university, who were studying childhood development,
collected data. These interns took measurements of the incidences of imbalance of clients with
autism, as they rode in small circles compared to typical children. Five children with autism and
five without trotted a total of 60 revolutions, first on counter clockwise circles, then in clockwise circles. In the group with ASD, on the counter clockwise circles, as their stronger, right
hemisphere controlled their balance, two incidences of unbalance were recorded. When riding
on clockwise circles, however, a total of twenty-eight incidences of imbalance were recorded for
riders with ASD. The first chart below compares riders with autism to the balance of a typical
child. After 12 weeks of therapy, the riders with ASD were balanced in the clockwise direction
as well as in the counter-clockwise direction as shown in the second chart.
Incidences of Unbalance Trotting in Circles
30
25
20
15
10
5
0
ASD
ASD
CW
CCW
Non-ASD Non-ASD
CW
CCW
Incidences of Unbalance
Riders With ASD Trotting in Circles
CW ASD Pre-Ride
30
25
CCW ASD PreRide
20
15
10
CW ASD After 12
Weekly Sessions
5
0
CCW ASD After
12 Weekly
Sessions
These preliminary study results are shown in the charts above, and demonstrate the stark
contrast in the left and right-hand balance of children with autism. Clearly, this is an area that
we can certainly utilize the movement of the horse, and the natural balancing reaction of the
rider, to stimulate the redevelopment of the left brain hemisphere in individuals with autism.
The right hemisphere of a child with Autism Spectrum Disorder actually performed better than
either hemisphere of a typical child. It makes one wonder that since the development of a child
with autism is concentrated in the right hemisphere, if the right hemisphere of a child with
autism is more developed than either hemisphere for a typical child.
As you will see, at the end of the UT Southwestern study, the effect of this weekly therapy on
the CARS Autism Rating (last chart of this presentation) of each child shows that these benefits
are not limited to improved balance alone, but positively affect the child’s development in
many other ways. SpiritHorse’ Medical Advisory Board theorized that this therapy had not
only helped rehabilitate, but actually jumpstarted the redevelopment of the affected brain
hemisphere. Because results of therapy showed an upward trajectory of growth and
development, and because the gains in these individuals’ development continued after therapy,
they theorized that therapy not only helped in the moment, but started the ball rolling for their
future progress.
This therapeutic method has been effective both for children with more involved disabilities
who are unable to trot on the horse, and for those who have not been in the program long
enough to have developed the balance to safely trot in either direction, and instead ride in very
small circles at the walk. One astonishing case we saw at SpiritHorse was with a young boy
diagnosed with Shaken Baby Syndrome, whose right brain hemisphere had been crushed. We
have seen that by applying this same principle of targeting the underdeveloped or affected
brain hemisphere at a walk for disabilities such as Shaken Baby Syndrome in this case, this
therapeutic process is opened up to many, many disabilities.

Developing neural pathways in the brain for people with Autism Spectrum Disorders to
increase levels of physical and cognitive functioning.
In 2008, Carnegie Mellon University and the University of Pittsburg Medical School developed
significant advances in software related to Functional Magnetic Resonance Imaging (FMRI).
This Imaging software is able to show a clearer picture of brain functions during an activity. For
example, as the subject does a “The London Bridge” puzzle, the FMRI is able to see all of the
brain’s functions during this process.
Utilizing this advanced imagery, the universities determined that, while certain areas of the
autistic brain did not function as a typical brain, the greatest difference was an insufficiency of
neural pathways. Neural pathways are the circuits in the brain that connect the cells, causing
the brain to function.
The brain, however, can build or develop new neural pathways. This is done through
“exercising the brain” both physically and cognitively. Children with Autism Spectrum
Disorder – and many other disabilities – have difficulty in both areas , to either a small or great
degree. According to a study done in 1998, researchers recorded a “delay” in the autistic brain
functions; that is, when given a command or told to do something, the child would have a delay
of processing time before that command sunk in and they completed the action.
So, to build an activity on the horse that would require both physical and cognitive activity,
involving speed of action, we decided to have the rider weave in and out of a row of traffic
cones placed at 5-foot intervals. Physically, the rider would have to balance on turns, and use
coordinated hand movements as they turned the horse around each cone; cognitively, the
activity requires quick decision making as the child has to switch hands and think through the
turns as he or she maneuvers the cones.
Reversing Under-Connectivity
In our preliminary record of data, our interns measured the
25
number of turns completed and missed by our riders with
number of right turns were, at first, missed by our riders.
Continuing in the same logic that identifies the left
hemisphere as underdeveloped, and the brain affected by
autism lacking in neural pathways, [our medical advisory
board] theorized the reason. That the right brain function
had the necessary strength and the required neural
20
Missed Turns
autism. As you can see in the chart to the right, a huge
R ight
B e f o re
15
10
5
Le f t
R ight
A fter
A fter
12
Le f t
12
Wk s .
Wk s . B e f o re
0
pathways to make the decision to turn left, and to have the
1
body follow suit – moving both hands into the correct position, turning the eyes and trunk in
the proper direction. But, that in turning right, using the weaker left hemisphere, this was not
the case. Because the autistic brain lacks neural pathways and the left hemisphere is weaker, the
child did not have the proficiency to perform the same task turning to right – and the difference
was stark. As the chart shows, more than 20 right turns were missed before therapy, while only
one or two left turns were missed. We also recorded about a three second delay in the
completion of these first right turns, meaning that sufficient neural pathways were not present
(the child did, eventually turn the pony right) but the connectivity was significantly delayed,
enough for the rider and pony to miss their right turn the majority of the time.
However, after 12 weeks of therapy, as shown on the chart above, weaving through cones and
“exercising” the brain, these children were no longer missing their right turns. According to our
medical advisory board, this suggested that the activity had built neural pathways in the brain,
thus allowing the child to complete these turns and giving the brain the strength to better
function for many tasks. For this exercise, we start with just a few cones, far apart. As the rider
builds the skills, we move these cones closer together and add more cones. This makes the
activity more challenging for the brain, and as we change up the exercise, the child too is proud
of his or her accomplishments – “Snickers and I did four cones today!”

Developing speech in speech delayed clients using a voice recorder .
For clients who are, as we term it, “pre-verbal,” we use a voice recorder to encourage speech.
These small recorders are attached to a strap and buckled to the front of the saddle. There are
two recorders, one on either side of the saddle. On one we record “Go,” on the other “Trot.”
This allows the preverbal riders to hear the word and they are encouraged to say it themselves.
It also allows them to see the use in language – to have a concrete, measurable result of their
words – when the child says “Go” the pony goes! It also allows these clients to participate in the
decision-making process on the horse, being able to choose and indicate what they want to do,
despite their language limit. All of our ponies are trained to respond to the recorders.
During a therapy session, we stop the pony as much as 20-30 times and encourage the rider to
“tell” the pony to go using the buttons. As the sessions continue and we wean our clients off the
buttons, riders are encouraged to say the word themselves. Pam’s daughter Kela was diagnosed
with Autism Spectrum Disorder and began riding at SpiritHorse at the age of three. At this
time, she was preverbal. We used the buttons in our therapy sessions with Kela and, Pam
writes, “Kela went from not going near her horse to leading the horse by the end of the fall
session. She said her first word while riding Eeyore. She said ‘go’ and I began to cry.”
Over SpiritHorse’ past twelve years, we have heard 108 riders speak their first words with this
method!

Using Pressure Vests to developing Regulation in Clients with Autism Spectrum
Disorder.
Many people with Autism Spectrum Disorder have difficulty regulating the connections from
body sensors to the “brain map” location that is identified with that sensor. There is a place in
the brain called a “brain map” for each sense such as sight, hearing, etc. (The Brain That
Changes Itself, Norman Doidge)
So, every time we use that sense or function, we go to that specific “brain map.” For persons
with autism, these sensors are at times not securely attached to the “brain map” and the person
with autism struggles to make a solid connection. During this struggle, it is very difficult for a
person with autism to focus their attention on a person or a task. Some symptoms of this,
during a therapeutic riding session, I know many of us are familiar with. The rider may run
around the facility, say “no” to everything asked, sit on the ground, turn in circles (if you’ll
notice, always in a counter-clockwise direction) and simply not engage in activities.
Temple Grandin’s famous “squeeze machine” inspired us to try 3-day Eventing safety vests to
assimilate the pressure that she, and many others with autism, have found so calming. We place
the vests on our riders with autism who are having trouble
RESPONSES WITH AND WITHOUT VEST
regulating, thus applying pressure to their torso. The vests go
on quite tight and snug, to create the calming “squeeze”
sensation. About 75% of the time, we have seen riders be able
to calm down, achieve regulation and go on with the lesson,
12
10
8
6
whether that be brushing their pony, mounting, riding, or
4
whatever the task may be. As you will see in our chart to the
2
right, the data recorded by the University interns bears
0
witness to the power this pressure can have in aiding and
W/O
VEST
W/O
VEST
POS
POS
NEG
NEG
calming children with autism. This method is thus a great
practical way to help the child learn to regulate while providing the calm they need.

Positive effect of these methods on the CARs Autism Rating of individuals with
disabilities receiving therapy through the SpiritHorse methods.
Finally, what is most important to note, and what is at the core
39
of what I want to share with you today is that
the study done by UT Southwestern, the
Severe
38
informal data collected by our interns, and
37
our experience with consistent use of the
36
methods at SpiritHorse show that these
Mild/Moderate
34
“target areas” are never isolated in their
gains. That is, going around in circles doesn’t
just make the child with Autism balanced on
35
33
Non-Autistic
32
circles, and using a vest to regulate doesn’t
31
mean that the child has to wear a vest for the
30
rest of his or her life. Rather, the study
-3
0
3
6
Months of Intervention (First Month Pre-Ride)
showed – as our experience at SpiritHorse has, over and over
again – that these changes cross over into so many other areas. And for the children with
Autism who participated in our study, this meant a significant and steady decrease in their
CARS Autism ratings as their ability to empathize became stronger.
From autism to Eagle scout: a previous client is now completing his Eagle Scout badge in
service at SpiritHorse! This healthy, bright young man is now giving back to the community
that helped him overcome the obstacles of autism at a young child.
Research Associated with the study “Prospective Trial of Equine-assisted Activities in Autism
Spectrum Disorder” published in peer-reviewed journal “Alternative Therapies in Health and
Medicine,” May/June 2011, Vol. 17. No. 3.
Participating Researchers and Institutions:
Janet K. Kern, PhD Autism Treatment Center, Dallas, Texas; Department of Psychiatry University of
University of Texas Southwestern Medical Center at Dallas.
Charles Fletcher SpiritHorse Therapeutic Riding Center, Corinth, Texas
Carolyn Garver, PhD Autism Treatment Center, Dallas
Jyutika A. Mehta, PhD Texas Woman’s University, Denton
Madhukar H. Trivedi, MD Department of Psychiatry at the UT Southwestern Medical Center
Bruce D. Grannemann, MA Department of Psychiatry at the UT Southwestern Medical Center