Preliminary efficacy of occupational therapy integrating horses on self-regulation in youth with autism spectrum disorder

马结合职业治疗对自闭症谱系障碍青少年自我调节的初步疗效

基本信息

批准号：
10533220
负责人：
Brittany Caitlin Peters
金额：
$ 19.57万
依托单位：
COLORADO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-21 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10533220
关键词：
Address Age Aggressive behavior Animals Anxiety Arousal Behavior Child Clinic Clinical Clinical Treatment Data Development Effectiveness of Interventions Elements Emotional Emotions Environment Equus caballus Evidence based practice Foundations Future Goals Health Personnel Health Services Accessibility Home Hospitalization Hour Hydrocortisone Hyperactivity Impairment Incidence Individual Informal Social Control Intervention Knowledge Lead Manuals Masks Measures Monitor National Institute of Child Health and Human Development Occupational Therapist Occupational Therapy Occupations Outcome Outcome Measure Outpatients Parents Performance Pharmaceutical Preparations Phase Physiological Prevalence Problem behavior Randomized Reporting Research Research Personnel Saliva Salivary Self-Injurious Behavior Services Severities Social Adjustment Social Interaction Standardization Therapeutic Intervention Third-Party Payer Time Treatment Protocols Youth adolescent with autism spectrum disorder alpha-amylase autism spectrum disorder behavior measurement comparison group cost dysphoria efficacious treatment experience improved improved outcome middle childhood repetitive behavior skills theories therapy outcome

项目摘要

PROJECT SUMMARY One in 54 children have Autism Spectrum Disorder (ASD) in the U.S., defined by impaired social interaction and restricted, repetitive behaviors. Impaired self-regulation is believed to be inherent in ASD, as evidenced by difficulty managing emotions, heightened physiological reactivity to daily activities, and increased problem behaviors such as hyperactivity, irritability, aggression, elopement, and self-injury. Growing evidence suggests that interacting with animals promotes self-regulation in youth with ASD. Integrating animals, such as horses, into therapy for youth with ASD may improve outcomes. However, very little is known about the efficacy of integrating horses into occupational therapy for youth with ASD, despite its growing prevalence in practice. This knowledge gap results in scant empirical information to guide occupational therapy and creates barriers to access services, as many third-party payers do not reimburse for occupational therapy that integrates horses. Consequently, there is a critical need to establish how to best integrate horses into occupational therapy for youth ASD, and empirically demonstrate the additive benefit horses have on therapy outcomes. Our long-term goal is to establish integrating horses into occupational therapy as an evidence-based practice to improve self-regulation in youth with ASD. Our team has created a theory-driven, standardized intervention manual called “Occupational Therapy in an Equine Environment: Harnessing Occupation for self-Regulation Skills” (OTEE HORS). OTEE HORS operationalizes the purposeful integration of horses into an occupational therapy intervention to optimize development of self-regulation skills. We also manualized a clinical treatment protocol, Occupational Therapy in a Clinic (OT Clinic), to serve as a control condition for all non-animal elements of the intervention. We have demonstrated that both OTEE HORS and OT Clinic are feasible to implement and acceptable to parents, youth, and occupational therapists. Our preliminary efficacy data suggest that both OTEE HORS may improve self-regulation in youth with ASD, but we have not yet compared OTEE HORS to OT Clinic. The goal of this project is to quantify the unique benefits of integrating horses in occupational therapy compared to occupational therapy in the clinic (i.e., OTEE HORS vs. OT Clinic) for improving self-regulation in youth with ASD. Sixty-four youth with ASD ages 6-11 years old will be randomized to OTEE HORS (N=32) or OT clinic (N=32). The specific aims are to 1) estimate the preliminary efficacy of OTEE HORS compared to OT Clinic on self- regulation, and 2) identify potential physiological mechanisms that explain how integration of horses in occupational therapy impacts self-regulation (salivary cortisol and salivary alpha-amylase). Our expected outcomes include preliminary efficacy data and identification of physiological mechanisms that explain how integrating horses into occupational therapy impacts self-regulation in youth with ASD.

项目摘要在美国，有54名儿童患有自闭症谱系障碍（ASD），由社会互动受损定义和受限制的重复行为。自我调节受损被认为是ASD固有的，如难以管理情绪，提高对日常活动的身体反应性以及增加问题诸如多动症，易怒，侵略性，私奔和自我伤害之类的行为。越来越多的证据表明与动物的互动促进了ASD青年的自我调节。整合动物，例如马为患有ASD的青年进行治疗可能会改善预后。但是，关于效率很少将马匹纳入ASD的青年占用疗法，目的地在实践中越来越流行。这种知识差距导致经验信息很少，以指导职业疗法，并为访问服务，因为许多第三方付款人都没有为整合马匹的占用治疗报销。因此，迫切需要建立如何最好地将马融入职业治疗青年ASD，并从经验上证明了马匹对治疗结果的额外好处。我们的长期目标是将马融入职业治疗作为循证实践改善ASD青年的自我调节。我们的团队创建了一个理论驱动的，标准化的干预措施手册称为“设备环境中的职业治疗：利用职业进行自我调节技能”（Otee Hors）。Otee Hors经营马匹有目的地将马融入占领治疗干预措施以优化自我调节技能的发展。我们还手动了临床治疗方案，诊所（OT诊所）的职业治疗，作为所有非动物的控制条件干预的要素。我们已经证明了Otee Hors和OT诊所都是可行的父母，青年和职业治疗师可以实施并接受。我们的初步效率数据表明两种Otee Hors可能会改善ASD年轻人的自我调节，但我们尚未比较 Otee Hors到OT诊所。该项目的目的是量化整合的独特好处与诊所的占领治疗相比诊所）改善ASD青年的自我调节。 64岁的6-11岁年轻人将被随机分为OTEE HOSS（n = 32）或OT诊所（n = 32）。具体目的是1）与OT诊所相比，估计Otee Hors的初步效率调节和2）确定潜在的生理机制，以解释马匹在占用治疗会影响自我调节（唾液皮质醇和唾液α-淀粉酶）。我们的期望结果包括初步效率数据和识别物理机制，以解释如何解释将马匹整合到占领治疗中会影响ASD青年的自我调节。