Autism Therapy: pilot study

definition of pilot study: Type of scientific study designed to test the value and logistics of doing a larger study using the same design. Pilot studies usually test a smaller sample size. It is a way for scientists to work out the kinks before doing a larger-scale study. The results of a pilot study might not be conclusive because of the small sample size. The scientists would need to do a larger study in order to test whether the results are valid.

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J Autism Dev Disorder, by Wood, JJ, Drahota A., Sze K., Dyke Van M., Decker K., Fujii C., Bahng C., and Renno P., published in 2009, summarized Apr 15, 2010

Core autism symptoms such as social communication deficits may be improved by cognitive behavioral therapy (CBT).

Social communication problems have proven hard to change through social skills training. This pilot study was designed to see the effect of a CBT program on parent-reported core autism symptoms. The study had 19 children (7 to 11 years old) with high-functioning autism who received 16 sessions of CBT. The CBT program focused on children’s emotion regulation, on-site social coaching, parent training, and school support. The authors found that parent-reported autism symptoms were lower in the CBT group than in the waitlist control group.


Journal of Autism and Developmental Disorders, by JJ, Wood, A Drahota, K Sze, M VanDyke, K Decker, C Fujii, C Bahng, and P Renno, published in 2009, summarized Jan 6, 2010

Cognitive behavioral therapy (CBT) may be helpful for reducing autism symptoms, such as poor social responsiveness and low social motivation, in school-age children.

This pilot study asked whether cognitive behavioral therapy may be helpful for children with autism (ages 7-11 years old). Nine children received cognitive behavioral therapy for 3 months, and an additional10 children did not receive therapy until 3 months later (wait-listed controls). Parents were asked to score their autism symptoms before and after treatment. Children who received therapy improved as compared to children who did not receive therapy. The improvements lasted at least 3 months after the therapy was stopped.


Child Care Health Dev., by Sandler, AD, and Blodfish JW, published in 2008, summarized Sep 17, 2009

A placebo effect may allow doctors to lower the prescribed doses of drug therapy for behavioral disorders like ADHD and autism.

This pilot study looked at whether children who knowingly took placebo together with their regular drug therapy could lower their drug dose. In the study, there were 26 children (7-15 years old) with attention-deficit hyperactivity disorder (ADHD). The researchers wanted to find out if children could use lower drug therapy doses with this treatment. They told the parents and the children that they were taking placebo with their medications. The children were taking "stimulant drugs" (not named in the article) for their ADHD. When the drug dose was cut in half and placebo added, behaviors remained the same for 8 out of 26 patients. In other words, the children behaved as if they were taking a full dose of drug. The authors think that this placebo effect might be helpful for lowering doses of medication for children.


Focus on Autism and Other Developmental Disabilities, by Reaven, JA, Blakely_Smith A., Nichols S., Dansari M., Flanigan E., and Hepburn S., published in 2009, summarized Apr 16, 2009

Group cognitive-behavioral therapy may be helpful in reducing symptoms of anxiety in children with autism.

The purpose of this study was to assess whether group (parent and child) cognitive-behavioral psychotherapy could reduce anxiety symptoms in children with high-functioning autism. The study used two measures of anxiety: parent reports, and child reports. Parents noted a decrease in anxiety symptoms after the group therapy intervention. The study had only 33 children with an average age of 12. The authors also note that the study did not have a control group.


Stephen Camarata, Ph.D. and Mark Wallace, Ph.D., researchers at the Vanderbilt Kennedy Center, received funding to study the results of sensory integration therapy on children with autism. Sensory integration therapy (SIT) is a treatment for autism that is used with a lot of children; however, it has does not yet have a lot of evidence-based research to support it. Sensory integration therapy typically uses techniques to help children overcome tactile sensitivities. Camarata and Wallace plan to do a pilot study with 40 children to compare SIT to "a well-established language acquisition technique." They will study children's brain waves to measure socialization and behavior. Camarata and Wallace explain "It is not known whether children with autism have a 'sensory processing deficit' or whether higher cognitive functions — which develop later — are involved."

Read original article: Autism Study to Evaluate Sensory Integration Therapy



Please comment on this autism topic.

SpiritHorse Therapeutic Riding

Sep 17, 2007 by Anonymous

SpiritHorse therapeutic provides free, private equine-assisted healthcare in our award winning programs to over 450 children with disabilities each week at our facilities just north of Dallas, Texas. One hundred-sixty of these children have been diagnosed with autism spectrum disorder.

We provide healthcare rather than the customary recreation the therapeutic riding industry is known for. We have developed eleven specific methods for intervention with autism and an instructor who is our autism specialist. These methods are based upon the elements of Alternative Behavior Analysis the Developmental, Individual Differences, Relationship-Based method (DIR Floortime) and the knowledge that specific physical activity can create neurological changes. We have a distinct advantage in crossing the first hurdle of DIR/Floortime which is finding something with which to engage the child. Children love ponies. We have been very successful in developing experience sharing with the rider, their parent, the pony, and their instructor.

One beautiful day this spring Nathan (a five year old boy with autism who has learned to speak since coming to SpiritHorse) was riding Fudge along the trail with his instructor Nikki leading and his mom walking alongside. He reached out and took his Mom's hand and said: "I love you mommy". We believe that he did this because the experience was so wonderful that he just had to share it. When his Mom regained control she tearfully said: "That is the first time he ever told me he loves me". These things happen often at SpiritHorse.

Using these methods we have developed, we have heard thirty-one children with autism speak their first word on one of our ponies.

We have discovered that our riders with autism prefer to turn left rather than right. Our medical advisory board is of the opinion that this is because the right hemisphere of the brain develops first and when the left hemisphere starts to develop, its development is delayed with the onset of autism, and of course the less developed left hemisphere controls the right side of the body. Incidentally, language comes from the left hemisphere and this developmental delay of the left hemisphere is the reason that many children with autism have delayed language.

We performed a pilot study with five riders with autism doing a sitting trot in a twenty foot circle a total of 60 counter-clockwise and 60 clockwise revolutions. We recorded only two incidences of unbalance in the counter-clockwise direction and a total of twenty-eight incidences of unbalance in the clockwise direction. We also noticed a significant number of negative non-verbal reactions in the clockwise direction. After twelve weekly lessons, all of these children were balanced in both directions with no negative non-verbal responses. Our medical advisory board is of the opinion that we are building synapses (circuits that make the brain function) in the left hemisphere through the work in the clockwise direction, and thereby reversing autism to some degree.

We also performed a study of five of our children who do not have a diagnosis of autism and they were equally balanced in both directions at the outset.

Additionally, we conducted a pilot study by having five children with a diagnosis of autism weave in and out of a line of traffic cones. We found that these children missed five times more right turns than left. The left hemisphere, most affected by autism, did not respond well on the right turns. Very interestingly, we noticed a two to three second delay in the movement of the right arm when turning right, enough delay that a cone was often missed.

After twelve weekly lessons, these children missed very few turns and neither direction was predominate. Very interestingly, the delay in the movement of the right hand for right turns disappeared. Our medical advisory board believes that we are reversing under-connectivity with this exercise.

Following the lead of Temple Grandin who invented the "squeeze machine", we use riding safety vests strapped very tightly to help our riders with autism who have difficulty in regulating. These vests are very different from the weighted vests often used for children with autism. The weighted vests place pressure on the shoulders, while these vests are adjusted to place pressure on the trunk, more like Temple Grandin's machine. For those with this symptom the results are often dramatic.

The impact of our methods for children with autism has been under study by the University of Texas Southwestern Medical School for over one year. Dr. Janet Kern, assistant professor of their Department of Psychiatry commented: "The preliminary results are excellent".

SpiritHorse has just reached an agreement with the University of North Texas Biofeedback/Rehab Department to perform EEGs and brain mapping on our riders with autism before and after each lesson. Through these tests they can objectively measure many brain functions, including under-connectivity. They will also measure rhythm, which a recent study showed its development to be an intervention with autism. We develop rhythm to a maximum degree in our riding program.

With these measurements we hope to further refine and develop additional methods for intervention with autism. We also have plans to provide free training to therapeutic riding instructors from around the world to develop autism specialists that will change programs at other centers from recreation to healthcare.

SpiritHorse was awarded the coveted Dallas Ft Worth Alliance for Healthcare Excellence Servant Leadership Award for 2006 for: "High quality, affordable healthcare in the North Texas Area". The award was won by Baylor Hospital Systems in 2005 and Parkland Hospital in 2004. We are very proud to have been recognized by North Texas health professionals for our work with children with autism.

Charles I. Fletcher
Founder/President
SpiritHorse Therapeutic


Riding Therapy

Aug 20, 2007 by Anonymous

I have had such tremendous luck with rding therapy. My son (Prader-Willi Syndrome) has been up on a horse since he was 1 year old. At three, he can ride in jump position for 20 minutes (which says a lot about his strength and balance!). He now receives hippotherapy twice a week.

There are many places where you can get riding therapy. I think it is worth calling your local stables and seeing if they can make recommendations. To see an example of a hippotherapy riding center, look at the Web site for the SpiritHorse Therapeutic Riding Center (www.spirithorsetherapy.com).

SpiritHorse Therapeutic provides free, private equine-assisted healthcare in our award winning programs to over 450 children with disabilities each week at our facilities just north of Dallas, Texas.  One hundred-sixty of these children have been diagnosed with autism spectrum disorder. We provide healthcare rather than the customary recreation the therapeutic riding industry is known for. We have developed eleven specific methods for intervention with autism and an instructor who is our autism specialist. These methods are based upon the elements of Alternative Behavior Analysis (ABA), the Developmental, Individual Differences, Relationship-Based method (DIR/Floortime) and the knowledge that specific physical activity can create neurological changes. We have a distinct advantage in crossing the first hurdle of DIR/Floortime which is finding something with which to engage the child. Children love ponies. We have been very successful in developing experience sharing with the rider, their parent, the pony, and their instructor. One beautiful day this spring Nathan (a five year old boy with autism who has learned to speak since coming to SpiritHorse) was riding Fudge along the trail with his instructor Nikki leading and his mom walking alongside. He reached out and took his Mom's hand and said: "I love you mommy". We believe that he did this because the experience was so wonderful that he just had to share it. When his Mom regained control she tearfully said: "That is the first time he ever told me he loves me". These things happen often at SpiritHorse.Using these methods we have developed, we have heard thirty-one children with autism speak their first word on one of our ponies. We have discovered that our riders with autism prefer to turn left rather than right. Our medical advisory board is of the opinion that this is because the right hemisphere of the brain develops first and when the left hemisphere starts to develop, its development is delayed with the onset of autism, and of course the less developed left hemisphere controls the right side of the body. Incidentally, language comes from the left hemisphere and this developmental delay of the left hemisphere is the reason that many children with autism have delayed language.We performed a pilot study with five riders with autism doing a sitting trot in a twenty foot circle a total of 60 counter-clockwise and 60 clockwise revolutions. We recorded only two incidences of unbalance in the counter-clockwise direction and a total of twenty-eight incidences of unbalance in the clockwise direction. We also noticed a significant number of negative non-verbal reactions in the clockwise direction. After twelve weekly lessons, all of these children were balanced in both directions with no negative non-verbal responses. Our medical advisory board is of the opinion the we are building synapses (circuits that make the brain function) in the left hemisphere through the work in the clockwise direction, and thereby reversing autism.                                                                                 We also performed a study of five of our children who do not have a diagnosis of autism and they were equally balanced in both directions at the outset.Additionally, we conducted a pilot study by having five children with a diagnosis of autism weave in and out of a line of traffic cones. We found that these children missed five times more right turns than left. The left hemisphere, the side most affected by autism, did not respond well on the right turns. Very interestingly, we noticed a two to three second delay in the movement of the right arm when turning right, enough delay that a cone was often missed. After twelve weekly lessons, these children missed very few turns and neither direction was predominate. Very interestingly, the delay in the movement of the right hand for right turns disappeared. Our medical advisory board believes that we are reversing under-connectivity with this exercise.Following the lead of Temple Grandin Ph.D. an individual who has been dagnosed with Asperger's and who invented the "squeeze machine", we use riding safety vests adjusted very tightly to help our riders with autism who have difficulty in regulating. These vests are very different from the weighted vests often used for children with autism. The weighted vests place pressure on the shoulders, while these vests are adjusted to place pressure on the trunk, more like Dr. Grandin's machine. For those with this symptom of autism the results are often dramatic.The impact of our methods for children with autism has been under study by the University of Texas Southwestern Medical School for over one year. Dr. Janet Kern, assistant professor of their Department of Psychiatry commented recently: "The preliminary results are excellent". SpiritHorse has just reached an agreement with the University of North Texas Biofeedback/Rehab Department to perform EEGs and brain mapping on our riders with autism before and after each lesson. Through these tests they can objectively measure many brain functions, including under-connectivity. They will also measure rhythm using the Interactive Metronome. A recent study showed the  development of rhythm to be an intervention with autism. We develop rhythm to a maximum degree in our riding program. With these measurements we hope to further refine our methods and develop additional methods for intervention with autism. We also have plans to provide free training to therapeutic riding instructors from around the world to develop autism specialists that will change programs at other centers from recreation to healthcare.SpiritHorse was awarded the coveted Dallas/Ft Worth Alliance for Healthcare Excellence "Servant Leadership Award" for 2006 for: "Thje highest quality, affordable healthcare in the North Texas area". The award was won by Baylor Hospital Systems in 2005 and Parkland Hospital in 2004. We are very proud to have been recognized by North Texas health professionals for our work with children with autism. Charles I. FletcherFounder/PresidentSpiritHorse Therapeutic



Please comment on pilot study or other autism therapy topics.

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