How Are We Doing? Beth Lanning, PhD, MCHES Baylor University.

How Are We Doing?Beth Lanning, PhD, MCHESBaylor University

Where are we in the research process?

Areas of Growth

• Autism Spectrum Disorder

• Veterans

• At risk populations (e.g., teens, sexual abuse survivors, trauma survivors)

AUTISM SPECTRUM DISORDER

• Social functioning• Randomized• TR group= 19• Waitlist = 15• Improved in several areas

– Sensory integration, directed attention, social motivation

– Decreased inattention and distractibility

• Two groups– Therapeutic riding = 10– Social circles = 8

• Findings– Both groups improved in

several quality of life domains

– Significant changes in social functioning, emotional functioning, and physical functioning after 6 weeks of TR

• Seven children– 4 in TR, 3 control– 9 week TR session

• Results– No significant difference

in groups on participant affect, off-task behavior, problem behavior, compliance, or language.

• All research is important

• 42 children with ASD, aged 6-16

• Compared to subset of 16 in control group

• 10 weeks of TR• Improvement in:

– Self-regulation, adaptive expressive language skills, motor skills, verbal praxis/motor planning

– Some were significantly different

• Large RCT– 127 Children aged 6-16

years– 10 week TR

intervention and control (barn group)

– Significant improvements in irritability, hyperactivity, social cognition, and social communication

VETERANS

• First published study on EAA and veterans

• Mixed-method, pilot study

• Participants completing 12 weeks of TR reported an increase in scores over time in six of the eight health domains

• Emerging themes from answers to questions supported change in quality of life scores.

Lanning, Beth A, PhD, MCHES; Krenek, Nancy, PT, HPCS. Journal of Rehabilitation Research and Development50.8(2013): vii-xiii.

• 5 veterans• Examined Self-efficacy• Significant increase in

scores over time.

• Benefits– Decrease in spasms– Increase in muscle

strength– Emotional benefits

Coming soon

• Effects of Equine Assisted Activities on PTSD Symptoms, Coping Self-Efficacy, Emotional Regulation and Social Engagement in Military Veterans.– Jessica Bibbo, Sarah Williams, Rebecca Johnson and Steve

Osterlind, (Research Center for Human-Animal Interaction, University of Missouri)

• Study- 36 veterans with median age of 53.• Randomly assigned to 6 week TR or waitlist

– PTSD scores decreased. (Preliminary)

AT-RISK POPULATIONS

• Nonrandom convenience sample of 164 at risk 3rd-6th grade children.

• Trend data reflected improvement in several behavioral outcomes.

• 15 children and 15 adolescents

• No comparison group• EGALA methods• Depression and

trauma symptoms improved over time.

• 26 at risk youth randomly assigned to control (TAU) or EAL group

• 5 week program with 6 month follow-up

• Measurements: level of hope and depression

• Levels of hope increased and depression decreased significantly in the EAL group

• 113 children randomly assigned to EFL or waitlist.

• 11 week program• Measured social

competence and behavior• Moderate positive effect

size on decision making, self-awareness, self-management

CURRENT STUDYEFFECTS OF EAA ON PTSD AND FUNCTIONING OF COMBAT VETERANS

Background Information

• Subsample of larger ongoing study

• Post 9/11 combat veterans

• 8 week therapeutic riding program

• Quasi-experimental, mixed method, repeated measure design.

• Two groups: waitlist/control and TR group

• Four therapeutic riding facilities

• Standardized TR curriculum

Subsample

• 20 participants who completed TR program

• 14 control group members

• PTSD and depression symptoms

• TR group: 12 Males, 8 Females, M= 34.5 years old.

• Control group: 9 Males, 5 Females, M =39.3 years old

Measurements

• SF 36v2 Quality of Life instrument– Mental Health components: Mental Health,

Role-Emotional, Social Functioning

• Major Depression Inventory

• Semi-structured questions

Quantitative Results

• Significant decrease TR group depression symptoms over 8 weeks (mean scores 31.7 at baseline dropped to 23.5 post: total 8 points). clinical significance = 5 points

• Significant difference in social functioning between groups (TR improved 3.5 points while the control mean score decreased 5 points over time)

Significant difference in TR group mental health scores over time. Control group scored lower over time.

• Significant difference in TR group role-emotional scores over time. Control group scored lower over time.

Qualitative FindingsEquine-Veteran Interaction

Questions

1. Why did you decide to try the therapeutic riding program?

2. Describe your life before starting the program.

3. Have you experienced a change in behavior or attitude since participating in the program? Yes or No. If yes, in what ways have you changed since being involved in the program?

4. If yes, how soon did you start to notice a difference?

5. Is working with a horse different than working with a person? If so, how?

6. Did you learn anything about yourself from working with a horse? If so, what?

7. Where do you see yourself in the next 5 years? 10 years?

Process of Analysis

• All answers were recorded and transcribed

• Development of codes based on previous research and revised through coding process.

• Coding by two independent coders

• Establishment of acceptable inter-coder reliability k = .70 (70%)

Codes and Emerging Themes

• Condensed to 14 codes– Codes most identified (4)

• Behavior Change- Experienced a change in behavior

• More Comfortable – more comfortable around people

• Self-assurance- feels more confident and hopeful• Responds to environment-horse is responsive to

person and environment

Correlation with Mental Health

Correlations with Specific Behavior Change Characteristics

Descriptive Statistics

• Cross Tabs using most frequent codes vs. level of improvement in mental health and depression symptoms

• Findings– 68% of participants indicating an improvement in

social functioning and 95% experiencing less depression symptoms also reported feeling that their behavior and attitude improved as a result of the program.

• Findings (cont.)– 65% of participants indicating a lower level of

depression symptoms post intervention also indicated the way the horse interacts with the person and environment was important.

– Feelings of self-assurance were most reflected in role-emotional scores and depression scores.

Emerging Themes

• Social Comfort– I socialize with humans better now that I’ve won the

respect and trust of a horse.– I’m more outgoing. I’m more willing to get out and try

new things and talk to new people, which is huge for me because I don’t do new people.

• Horse-Human Receptivity– Horses are just very straightforward. They either like

what you’re doing or they don’t, and they let you know, right away.

– With an animal I just have that instant, you know, I’m able to talk to them even though they can’t talk back. I actually enjoyed that.

– The horse kind of mirrors you. It mirrors your attitude and your emotions.

• Emotional Safety– It’s [the horse-human relationship] a very honest and

open relationship from the very start, which is exactly what veterans need.

– I don’t feel as stressed out working with Merlin – I just feel different with the horse. It’s just like a bond

instead of… you learn to trust them easier, I guess. – I feel more comfortable with a horse. A horse isn’t

judging me. A horse isn’t, you know, looking at my every move.

Conclusion

• Findings are preliminary so conclusions should be drawn with caution.

• Preliminary data support characteristics of the equine-veteran relationship positively influence mental health and reduce depression symptoms.

• Findings provide ‘windows and doorways’ through which we can examine further the unique relationship between a horse and a human.

Now What?

Autism Spectrum Disorder

Veterans

At Risk Populations

Questions

Contact Information

Beth Lanning, PhD, MCHES

Robbins College of Health and Human Sciences

Baylor University

[email protected]

254-710-4027