Horse therapy offers promise for neurodivergent kids, young adults

The history of humans and horses has been intertwined for more than 5,000 years.

Mongol horsemen spread an empire across Asia’s great seas of grass. Conquistadors reintroduced horses into North America, with herds now roaming wild across the American west and North Carolina’s Outer Banks. ND How many fields have horses helped humans plow over millennia?

Occupational therapy student Ashley Wilhite, right, interacts with a therapy study participant and his horse.

Occupational therapy student Ashley Wilhite, right, interacts with a therapy study participant and his horse. (Contributed photo)

Horses are integral to the humanity’s history.

And now researchers at East Carolina University’s College of Allied Health Sciences are again asking horses for assistance — to help neurodivergent kids and young adults integrate more fully into society.

Heather Panczykowski, an assistant professor of occupational therapy at ECU, has spent her career researching how to use horses to improve health outcomes for patients with cancer, and children and teens with special needs and their families. Her research focus has shifted in recent years to therapeutic uses for horses for autistic and other non-neurotypical younger people.


On Wednesday nights in the fall of 2022, a group of about 10 kids and young adults — ranging from eight to 21— gathered at a barn just outside of Greenville to, at first, simply learn how to be around horses safely. Then the group progressed to grooming the animals before learning the basics of leading a 1,200-pound beast around at the end of a rope.

Helping individual participants was a crucial part of the Wednesday night group sessions at the barn, and that is the long-range goal is research — to see if using equines in activities in conjunction with OT interventions improves self-regulation and social skills in the children and young adults who participated. Each participant and caregiver collaboratively decided on social skills that were that person’s focus for the duration of the therapy program.

“We are also looking at parent perceptions of that program, what their thought processes are regarding barriers to the program and what their child gained from their participation — did they build friendships while they were in the program,” she said.

Panczykowski uses horses in her therapy research model because unlike dogs, which aim to please and crave attention, horses have a unique ability to read intention in the humans that are around them. And because of their strength and size, horses can influence the rhythm of interaction with people.

“The horse is really cool, because it’s a reflective animal,” she said. “The horse last night didn’t want to move forward with the group of children and teens leading it because they were not all working together.”

The objective of the activity, Panczykowski said, was to have a team lead a horse through an obstacle course which takes clear communication with both human and horse teammates. Horses can detect a range of emotions and will react these back to participants, a major goal of the therapy’s learning experience.

“When the horse would not move forward, participants had to figure out if they were being confusing to the animal,” Panczykowski explained. “Were the participants giving out opposite cues of which way to proceed through the obstacle course? These types of opportunities are fertile ground for social learning.”

After horse interaction activities, group and individual discussions occurred with participants to help make connections between skills learned at the barn and everyday interactions with friends and family, Panczykowski said.

Panczykowski is credentialed with the American Hippotherapy Association, which gives her a unique set of skills when exploring novel ways to provide interventions to participants. She also partners with a local therapeutic horsemanship program run by certified therapeutic riding instructors. The unique blend of the disciplines of occupational therapy and a certified therapeutic riding instructor knowledgeable in teaching horsemanship and riding skills has been a creative collaboration to develop innovative programs.

Ashlyn Batten, a certified therapeutic riding instructor, is co-founder of Moonbeams and Miracles Therapeutic Horsemanship Center where the group takes place. She partnered with Panczykowski in the development of the program and agrees that the older group of kids in the research project have developed strong social skills and friendships, and that the young group has also developed significantly.

“The younger ones, it’s been cool watching from the first week when they were kind of wild and we couldn’t really get them to focus very well,” Batten said. “Now they listen to my instructions for three to five minutes and start working on the skill they are given to work on. I’ve seen a lot of improvement in both groups, just kind of in different aspects.”

These kids are super smart, but they need extra strategies or tools that will make being around other people easier for them.
- Heather Panczykowski, assistant professor of occupational therapy

Panczykowski and Batten’s program entitled “Find Your Herd” is broken into two main parts. The first part revolves around learning basic horsemanship, where participants learn how to engage with and behave around horses individually and as a team. The second includes a variety of challenging games and activities that occur with or without the horse.

The goal of each of the parts is to teach participants social conventions (eye contact, not interrupting the speaker), communication skills (listening and offering ideas), and how to function as a team that works toward a common goal. Although there is a large emphasis on team work, the social skill focus is individualized. Each participant and caregiver collaboratively decide on social skills or emotional regulation that will be the focus for the duration of the program. These goals are reviewed and discussed at the beginning and end of each group.

The overall objective is for participants to understand how to function better in society and increase their emotional self-regulation. For neurodiverse kids and young adults, making friends and knowing how to control anger, for instance, can be impediments to integration into society in the same ways as neurotypical people their age.

Working together to achieve a common goal with the horse is a huge step for participants to develop social skills.

While just being in the barn and with new people can be challenging for participants in the program, Panczykowski said that she intentionally makes certain situations more difficult. She needs her participants to help themselves recognize their emotional boundaries, and how to walk back from the edge of behaviors that aren’t socially inclusive.

“We want to try to push some buttons, see what we get and have them learn strategies, or at least talk through them, so that they can think about it at home and with their friends,” Panczykowski said. “These kids are super smart, but they need extra strategies or tools that will make being around other people easier for them.”

A challenge that many neurodiverse people face, particularly children, is recognizing in the moment if their actions are socially acceptable.

Batten said that the horses somehow know if a child is focusing on the task at hand or hasn’t listened to the instructions for the specific learning event.

“We’ve had kids in both groups that have been really focused and the horse really responds and then other ones who just are not super focused,” Batten said. “It’s as if the horse is saying, ‘If you’re not going make me do it, I’m not going to do it.’”

Five students from ECU’s occupational therapy program are involved in program. In the fall semester, the students participated in research coursework that included observational studies with the participants and interviews with parents. In the spring semester, the students will write up their research in formal papers.

The research that Panczykowski and her students have done isn’t going unnoticed by peers in her field. She’d been asked by other university researchers for details about the program, to the point that her team is developing a manual that outlines her strategies for the therapeutic use of ground-based horsemanship.

While the research findings aren’t fully in yet, Panczykowski already knows how she wants to adjust the program.

“We need to have more of a parent education component at the beginning, before the program even starts, to get them on board and understand model more, what we’re doing and why we’re doing it,” she said.


Society will forgive a lot of things if people are socially appropriate, Panczykowski said.

“One of the goals I have right now is to have the participants to look in the direction of the person (they are talking to) because when you have autism it’s really hard to look into people’s eyes, or if you’re overly shy,” Panczykowski said.

Another of the goals of the program is to simply give the participants the opportunity to make friends and have fun like any other kid.

“The kids that I have right now…” Panczykowski said with a wistful smile. “Oh, my goodness, they are so happy to be there. Laughter. I haven’t heard so much laughter than I did this semester.”

Pam Smith’s son Lawson Ross started therapeutic riding after he turned two and is now 15. He has been working with instructors from Moonbeams and Miracles all that time. She said Panczykowski’s new research is different: it has brought a shy child out of his shell.

Horse therapy study participants work together on an exercise with a horse. (Contributed photo)

Occupational therapy student Jill Donaldson works with a horse and therapy study participants.

Occupational therapy student Jill Donaldson works with a horse and therapy study participants. (Contributed photo)

Smith said that Lawson likely wouldn’t have the opportunities to learn how appropriately interact socially with his peers without the group horsemanship program.

“This is something that he gets to do, that is his, and since he’s started this group, I can see how he is talking more, he’s more attentive when he talks,” Smith said. “It’s a 10-week program and we are in week four. There are other kids his age, girls and guys, and when we pull up I see all the guys shake hands and pat each other on the back and that’s been a big deal. He normally would just stand back, and I’ve seen all of these kids be more engaged.”

If there is one thing that Panczykowski hopes that her “kids” take away from the sessions is self-awareness and self-reliance.

“They have to try to come up with ways of managing behaviors and reactions and if not, we offer suggestions because adults have a tendency to say, ‘No, do it like that,’” Panczykowski said. “They may not do it the same way because their brain works a little bit different, like everybody else’s does, but they get there. So let them get there. Let them figure it out.”

Student learning

Jill Donaldson, a public health undergraduate major from Raleigh, said that equine therapy is new to her, but she has worked with kids in the past and she’s motivated to continue working with youth.

“My mom was a teacher, so I thought about teaching, but I decided that was too many children to be in charge of at once,” Donaldson said. “I found OT and realized that I could have one kid for thirty minutes at a time, and that sounded great. I also like the opportunity to help parents advocate for their children in school and get resources kids need.”

Students from Donaldson’s cohort in the OT program were offered the chance to rank order their preferences of participating in required research projects lead by members of the OT faculty. The team of students supporting Panczykowski’s horse therapy research were all motivated by the chance to work with disabled kids and to be outdoors while doing so, and will have the opportunity to give poster presentations based on their participation in the research project.

Donaldson said that the participants and their parents were polled at the beginning of the program to see what goals each had. At the completion of the 10-week program parents will be surveyed again to gauge their impressions of the program’s effectiveness.

“What we see at the barn is sometimes different than what the parents see at home, so it will be interesting to see if the parents are noticing the growth that we are seeing,” Donaldson said.

Learning consequences for actions and understanding how to empathize with others is key to being socially appropriate, and the horse is a perfect way to help program participants learn those lessons.

“It’s very visible how the horse is feeling,” Donaldson said. “If you don’t communicate clearly with a horse, they aren’t going to do what you want. And we’re working on teamwork as a whole. Being able to read all of that language at once is what happens in a classroom or in a social setting and they are able to get clear feedback from the horse, which doesn’t always happen with other people.”