Emotional and Motor Improvements in Children With ADHD Following Equine-Assisted Occupational Therapy.

No control group: every child was measured before and after the same session, so the changes could come from being outdoors with a horse, from the extra adult attention, from being asked the same questions twice, or simply from time passing. One session only, and outcomes were measured immediately afterwards, so the study says nothing about whether any of these changes lasted or carried into school or home. Only 31 children took part and they were recruited as a convenience sample from a single riding centre, so these children may not look like the ones on your caseload. The authors themselves note that the results may be influenced by confounding factors such as the change in environment, and that the study does not allow generalisation. All the children were novice riders in their third to fifth session, and the authors say the effect may not be present in more experienced riders. Children with additional developmental disorders, moderate to severe cognitive impairment, neurological disorders such as epilepsy, or severe sensory loss were excluded, so the study says nothing about them.

The authors declared no potential conflicts of interest and stated that they received no financial support for the research, authorship or publication of the article.

Do not read these improvements as proof that equine-assisted occupational therapy works for children with ADHD. There was no comparison group and no blinding of the children, and everyone was tested only before and immediately after one session, so a good mood after a ride, the novelty of the setting, or answering the same questions a second time could account for all of it.