Research progress on animal-assisted intervention in children with neurological diseases_West China Medical Journal

Authors：

WANG Qi ¹ ,  YU Qinming ² , ZHANG Chunyan ³

1. School of Humanities and Management, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;
2. Enrollment and Employment Department, Heilongjiang University of Traditional Chinese Medicine , Harbin, Heilongjiang 150040, P. R. China;
3. Rehabilitation Center, the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150040, P. R. China;

Corresponding author：

YU Qinming, Email: 4773615@qq.com

Keywords：

Animal-assisted intervention; children; neurological diseases

DOI：

10.7507/1002-0179.202203145

Video：

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Abstract Full text Figures/Tables Video References Cited by

Children’s neurological diseases are complex. Common clinical diseases include autism spectrum disorder, cerebral palsy, attention deficit/hyperactivity disorder, etc. The rehabilitation methods in China mainly start with children’s language and cognition. Animal-assisted intervention is a kind of psychosocial intervention, including animal assisted therapy, animal assisted education or animal assisted activities under specific conditions. With its popularity in the world, this field is rapidly approaching a paradigm shift and can be used as a new supplementary and alternative treatment for children’s neurological diseases. By analyzing the literature on animal-assisted intervention and research on children’s neurological diseases, this paper summarizes the application methods and effects of various types of animals in clinical practice, aiming to provide new intervention methods with scientific theoretical basis for the rehabilitation of children with neurological diseases in China and promote the further development of rehabilitation in China.

Citation： WANG Qi, YU Qinming, ZHANG Chunyan. Research progress on animal-assisted intervention in children with neurological diseases. West China Medical Journal, 2022, 37(9): 1400-1404. doi: 10.7507/1002-0179.202203145 Copy

1.	段远辉, 曹洁. 肠道菌群与儿童神经系统疾病的研究进展. 中国儿童保健杂志, 2022, 30(3): 281-284.
2.	魏玉会, 李瑞仕, 冯兆才. 肠道菌群与大脑发育相关性研究进展. 河南中医, 2021, 41(12): 1934-1938.
3.	O'Haire ME. Animal-assisted intervention for autism spectrum disorder: a systematic literature review. J Autism Dev Disord, 2013, 43(7): 1606-1622.
4.	Fine AH. Standing the test of time: reflecting on the relevance today of Levinson’s pet-oriented child psychotherapy. Clin Child Psychol Psychiatry, 2017, 22(1): 9-15.
5.	Corson SA, Corson EO, Gwynne PH, et al. Pet-facilitated psychotherapy in a hospital setting. Curr Psychiatr Ther, 1975, 15: 277-286.
6.	Arnon S, Fisher PW, Pickover A, et al. Equine-assisted therapy for veterans with PTSD: manual development and preliminary findings. Mil Med, 2020, 185(5/6): e557-e564.
7.	Lai NM, Chang SMW, Ng SS, et al. Animal-assisted therapy for dementia. Cochrane Database Syst Rev, 2019, 2019(11): CD013243.
8.	马慧, 敖勇前, 王庭照. 动物辅助干预在自闭症儿童康复中的应用. 中国特殊教育, 2018(9): 31-37.
9.	Rice CE, Carpenter LA, Morrier MJ, et al. Correction to: defining in detail and evaluating reliability of DSM-5 criteria for autism spectrum disorder (ASD) among children. J Autism Dev Disord, 2022. (2022-01-29)[2022-03-01]. https://link.springer.com/article/10.1007/s10803-022-05452-y.
10.	Baio J, Wiggins L, Christensen DL, et al. Prevalence of autism spectrum disorder among children aged 8 years-Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ, 2018, 67(6): 1-23.
11.	Guérin NA, Gabriels RL, Germone MM, et al. Reliability and validity assessment of the observation of human-animal interaction for research (OHAIRE) behavior coding tool. Front Vet Sci, 2018, 5: 268.
12.	Contalbrigo L, Borgi M, De Santis M, et al. Equine-assisted interventions (EAIs) for children with autism spectrum disorders (ASD): behavioural and physiological indices of stress in domestic horses (Equus caballus) during riding sessions. Animals (Basel), 2021, 11(6): 1562.
13.	Germone MM, Gabriels RL, Guérin NA, et al. Animal-assisted activity improves social behaviors in psychiatrically hospitalized youth with autism. Autism, 2019, 23(7): 1740-1751.
14.	Griffioen RE, van der Steen S, Verheggen T, et al. Changes in behavioural synchrony during dog-assisted therapy for children with autism spectrum disorder and children with down syndrome. J Appl Res Intellect Disabil, 2020, 33(3): 398-408.
15.	Byström K, Grahn P, Hägerhäll C. Vitality from experiences in nature and contact with animals-a way to develop joint attention and social engagement in children with autism?. Int J Environ Res Public Health, 2019, 16(23): 4673.
16.	Zhao M, Chen S, You Y, et al. Effects of a therapeutic horseback riding program on social interaction and communication in children with autism. Int J Environ Res Public Health, 2021, 18(5): 2656.
17.	London MD, Mackenzie L, Lovarini M, et al. Animal assisted therapy for children and adolescents with autism spectrum disorder: parent perspectives. J Autism Dev Disord, 2020, 50(12): 4492-4503.
18.	Griffioen R, van der Steen S, Cox RFA, et al. Verbal interactional synchronization between therapist and children with autism spectrum disorder during dolphin assisted therapy: five case studies. Animals (Basel), 2019, 9(10): 716.
19.	Ávila-Álvarez A, Alonso-Bidegain M, De-Rosende-Celeiro I, et al. Improving social participation of children with autism spectrum disorder: pilot testing of an early animal-assisted intervention in Spain. Health Soc Care Community, 2020, 28(4): 1220-1229.
20.	Nuntanee S, Daranee S. Effect of motorized elephant-assisted therapy program on balance control of children with autism spectrum disorder. Occup Ther Int, 2019, 2019: 5914807.
21.	Hill JR, Ziviani J, Driscoll C. “The connection just happens”: therapists’ perspectives of canine-assisted occupational therapy for children on the autism spectrum. Aust Occup Ther J, 2020, 67(6): 550-562.
22.	Ajzenman HF, Standeven JW, Shurtleff TL. Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study. Am J Occup Ther, 2013, 67(6): 653-663.
23.	Kalmbach D, Wood W, Peters BC. Parental perspectives of occupational therapy in an equine environment for children with autism spectrum disorder. Occup Ther Health Care, 2020, 34(3): 230-252.
24.	Chapman E, Baron-Cohen S, Auyeung B, et al. Fetal testosterone and empathy: evidence from the empathy quotient (EQ) and the “reading the mind in the eyes” test. Soc Neurosci, 2006, 1(2): 135-148.
25.	Grandin T. Case study: how horses helped a teenager with autism make friends and learn how to work. Int J Environ Res Public Health, 2019, 16(13): 2325.
26.	Malcolm R, Ecks S, Pickersgill M. ‘It just opens up their world’: autism, empathy, and the therapeutic effects of equine interactions. Anthropol Med, 2018, 25(2): 220-234.
27.	Hill J, Ziviani J, Driscoll C, et al. Canine-assisted occupational therapy for children on the autism spectrum: challenges in practice. Br J Occup Ther, 2020, 83(4): 215-219.
28.	Biddiss E, Chan-Viquez D, Cheung ST, et al. Engaging children with cerebral palsy in interactive computer play-based motor therapies: theoretical perspectives. Disabil Rehabil, 2021, 43(1): 133-147.
29.	Ang CS, MacDougall FA. An evaluation of animal-assisted therapy for autism spectrum disorders: therapist and parent perspectives. Psychol Stud (Mysore), 2022, 67(1): 72-81.
30.	Wijker C, Kupper N, Leontjevas R, et al. The effects of animal assisted therapy on autonomic and endocrine activity in adults with autism spectrum disorder: a randomized controlled trial. Gen Hosp Psychiatry, 2021, 72: 36-44.
31.	Stavsky M, Mor O, Mastrolia SA, et al. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Front Pediatr, 2017, 5: 21.
32.	Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl, 2007, 109: 8-14.
33.	Stolz I, Anneken V, Froböse I. Measuring equine-assisted therapy: validation and confirmatory factor analysis of an ICF-based standardized assessment-tool. Int J Environ Res Public Health, 2022, 19(5): 2738.
34.	Lobato Rincón LL, Rivera Martín B, Medina Sánchez MÁ, et al. Effects of dog-assisted education on physical and communicative skills in children with severe and multiple disabilities: a pilot study. Animals (Basel), 2021, 11(6): 1741.
35.	Verschuren O, Takken T. Aerobic capacity in children and adolescents with cerebral palsy. Res Dev Disabil, 2010, 31(6): 1352-1357.
36.	Moraes AG, Copetti F, Ângelo VR, et al. Hippotherapy on postural balance in the sitting position of children with cerebral palsy-longitudinal study. Physiother Theory Pract, 2020, 36(2): 259-266.
37.	Deutz U, Heussen N, Weigt-Usinger K, et al. Impact of hippotherapy on gross motor function and quality of life in children with bilateral cerebral palsy: a randomized open-label crossover study. Neuropediatrics, 2018, 49(3): 185-192.
38.	Silkwood-Sherer DJ, McGibbon NH. Can hippotherapy make a difference in the quality of life of children with cerebral palsy? A pragmatic study. Physiother Theory Pract, 2020, 38(3): 390-400.
39.	Norrud BC, Råheim M, Sudmann TT, et al. Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy. J Bodyw Mov Ther, 2021, 26: 364-373.
40.	Mutoh T, Mutoh T, Tsubone H, et al. Effect of hippotherapy on gait symmetry in children with cerebral palsy: a pilot study. Clin Exp Pharmacol Physiol, 2019, 46(5): 506-509.
41.	Lucena-Antón D, Rosety-Rodríguez I, Moral-Munoz JA. Effects of a hippotherapy intervention on muscle spasticity in children with cerebral palsy: a randomized controlled trial. Complement Ther Clin Pract, 2018, 31: 188-192.
42.	Silva e Borges MB, Werneck MJ, da Silva Mde L, et al. Therapeutic effects of a horse riding simulator in children with cerebral palsy. Arq Neuropsiquiatr, 2011, 69(5): 799-804.
43.	Park IK, Lee JY, Suk MH, et al. Effect of equine-assisted activities on cardiac autonomic function in children with cerebral palsy: a pilot randomized-controlled trial. J Altern Complement Med, 2021, 27(1): 96-102.
44.	Suk MH, Kwon JY. Effect of equine-assisted activities and therapies on cardiorespiratory fitness in children with cerebral palsy: a randomized controlled trial. J Integr Complement Med, 2022, 28(1): 51-59.
45.	Matusiak-Wieczorek E, Dziankowska-Zaborszczyk E, Synder M, et al. The influence of hippotherapy on the body posture in a sitting position among children with cerebral palsy. Int J Environ Res Public Health, 2020, 17(18): 6846.
46.	Flores FM, Dagnese F, Copetti F. Do the type of walking surface and the horse speed during hippotherapy modify the dynamics of sitting postural control in children with cerebral palsy?. Clin Biomech (Bristol, Avon), 2019, 70: 46-51.
47.	Sandstrom A, Perroud N, Alda M, et al. Prevalence of attention‐deficit/hyperactivity disorder in people with mood disorders: a systematic review and meta‐analysis. Acta Psychiatr Scand, 2021, 143(5): 380-391.
48.	Schuck SEB, Johnson HL, Abdullah MM, et al. The role of animal assisted intervention on improving self-esteem in children with attention deficit/hyperactivity disorder. Front Pediatr, 2018, 6: 300.
49.	Schuck SE, Emmerson NA, Fine AH, et al. Canine-assisted therapy for children with ADHD: preliminary findings from the positive assertive cooperative kids study. J Atten Disord, 2015, 19(2): 125-137.
50.	Gilboa Y, Helmer A. Self-management intervention for attention and executive functions using equine-assisted occupational therapy among children aged 6-14 diagnosed with attention deficit/hyperactivity disorder. J Altern Complement Med, 2020, 26(3): 239-246.
51.	Aviv TM, Katz YJ, Berant E. The contribution of therapeutic horseback riding to the impr-ovement of executive functions and self-esteem among children with ADHD. J Atten Disord, 2020, 25(12): 1743-1753.
52.	White E, Zippel J, Kumar S. The effect of equine-assisted therapies on behavioural, psychological and physical symptoms for children with attention deficit/hyperactivity disorder: a systematic review. Complement Ther Clin Pract, 2020, 39: 101101.
53.	Lentini JA, Knox M. A qualitative and quantitative review of equine facilitated psychotherapy (EFP) with children and adolescents. Open Complement Med J, 2009, 1(1): 51-57.
54.	Yoo JH, Oh Y, Jang B, et al. The effects of equine-assisted activities and therapy on resting-state brain function in attention-deficit/hyperactivity disorder: a pilot study. Clin Psychopharmacol Neurosci, 2016, 14(4): 357-364.
55.	Luman M, Oosterlaan J, Sergeant JA. Corrigendum to “the impact of reinforce-ment contingencies on AD/HD: a review and theoretical appraisal” [Clinical Psychology Review 25 (2005) 183-213]. Clin Psychol Rev, 2005, 25(4): 533.

1. 段远辉, 曹洁. 肠道菌群与儿童神经系统疾病的研究进展. 中国儿童保健杂志, 2022, 30(3): 281-284.
2. 魏玉会, 李瑞仕, 冯兆才. 肠道菌群与大脑发育相关性研究进展. 河南中医, 2021, 41(12): 1934-1938.
3. O'Haire ME. Animal-assisted intervention for autism spectrum disorder: a systematic literature review. J Autism Dev Disord, 2013, 43(7): 1606-1622.
4. Fine AH. Standing the test of time: reflecting on the relevance today of Levinson’s pet-oriented child psychotherapy. Clin Child Psychol Psychiatry, 2017, 22(1): 9-15.
5. Corson SA, Corson EO, Gwynne PH, et al. Pet-facilitated psychotherapy in a hospital setting. Curr Psychiatr Ther, 1975, 15: 277-286.
6. Arnon S, Fisher PW, Pickover A, et al. Equine-assisted therapy for veterans with PTSD: manual development and preliminary findings. Mil Med, 2020, 185(5/6): e557-e564.
7. Lai NM, Chang SMW, Ng SS, et al. Animal-assisted therapy for dementia. Cochrane Database Syst Rev, 2019, 2019(11): CD013243.
8. 马慧, 敖勇前, 王庭照. 动物辅助干预在自闭症儿童康复中的应用. 中国特殊教育, 2018(9): 31-37.
9. Rice CE, Carpenter LA, Morrier MJ, et al. Correction to: defining in detail and evaluating reliability of DSM-5 criteria for autism spectrum disorder (ASD) among children. J Autism Dev Disord, 2022. (2022-01-29)[2022-03-01]. https://link.springer.com/article/10.1007/s10803-022-05452-y.
10. Baio J, Wiggins L, Christensen DL, et al. Prevalence of autism spectrum disorder among children aged 8 years-Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ, 2018, 67(6): 1-23.
11. Guérin NA, Gabriels RL, Germone MM, et al. Reliability and validity assessment of the observation of human-animal interaction for research (OHAIRE) behavior coding tool. Front Vet Sci, 2018, 5: 268.
12. Contalbrigo L, Borgi M, De Santis M, et al. Equine-assisted interventions (EAIs) for children with autism spectrum disorders (ASD): behavioural and physiological indices of stress in domestic horses (Equus caballus) during riding sessions. Animals (Basel), 2021, 11(6): 1562.
13. Germone MM, Gabriels RL, Guérin NA, et al. Animal-assisted activity improves social behaviors in psychiatrically hospitalized youth with autism. Autism, 2019, 23(7): 1740-1751.
14. Griffioen RE, van der Steen S, Verheggen T, et al. Changes in behavioural synchrony during dog-assisted therapy for children with autism spectrum disorder and children with down syndrome. J Appl Res Intellect Disabil, 2020, 33(3): 398-408.
15. Byström K, Grahn P, Hägerhäll C. Vitality from experiences in nature and contact with animals-a way to develop joint attention and social engagement in children with autism?. Int J Environ Res Public Health, 2019, 16(23): 4673.
16. Zhao M, Chen S, You Y, et al. Effects of a therapeutic horseback riding program on social interaction and communication in children with autism. Int J Environ Res Public Health, 2021, 18(5): 2656.
17. London MD, Mackenzie L, Lovarini M, et al. Animal assisted therapy for children and adolescents with autism spectrum disorder: parent perspectives. J Autism Dev Disord, 2020, 50(12): 4492-4503.
18. Griffioen R, van der Steen S, Cox RFA, et al. Verbal interactional synchronization between therapist and children with autism spectrum disorder during dolphin assisted therapy: five case studies. Animals (Basel), 2019, 9(10): 716.
19. Ávila-Álvarez A, Alonso-Bidegain M, De-Rosende-Celeiro I, et al. Improving social participation of children with autism spectrum disorder: pilot testing of an early animal-assisted intervention in Spain. Health Soc Care Community, 2020, 28(4): 1220-1229.
20. Nuntanee S, Daranee S. Effect of motorized elephant-assisted therapy program on balance control of children with autism spectrum disorder. Occup Ther Int, 2019, 2019: 5914807.
21. Hill JR, Ziviani J, Driscoll C. “The connection just happens”: therapists’ perspectives of canine-assisted occupational therapy for children on the autism spectrum. Aust Occup Ther J, 2020, 67(6): 550-562.
22. Ajzenman HF, Standeven JW, Shurtleff TL. Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study. Am J Occup Ther, 2013, 67(6): 653-663.
23. Kalmbach D, Wood W, Peters BC. Parental perspectives of occupational therapy in an equine environment for children with autism spectrum disorder. Occup Ther Health Care, 2020, 34(3): 230-252.
24. Chapman E, Baron-Cohen S, Auyeung B, et al. Fetal testosterone and empathy: evidence from the empathy quotient (EQ) and the “reading the mind in the eyes” test. Soc Neurosci, 2006, 1(2): 135-148.
25. Grandin T. Case study: how horses helped a teenager with autism make friends and learn how to work. Int J Environ Res Public Health, 2019, 16(13): 2325.
26. Malcolm R, Ecks S, Pickersgill M. ‘It just opens up their world’: autism, empathy, and the therapeutic effects of equine interactions. Anthropol Med, 2018, 25(2): 220-234.
27. Hill J, Ziviani J, Driscoll C, et al. Canine-assisted occupational therapy for children on the autism spectrum: challenges in practice. Br J Occup Ther, 2020, 83(4): 215-219.
28. Biddiss E, Chan-Viquez D, Cheung ST, et al. Engaging children with cerebral palsy in interactive computer play-based motor therapies: theoretical perspectives. Disabil Rehabil, 2021, 43(1): 133-147.
29. Ang CS, MacDougall FA. An evaluation of animal-assisted therapy for autism spectrum disorders: therapist and parent perspectives. Psychol Stud (Mysore), 2022, 67(1): 72-81.
30. Wijker C, Kupper N, Leontjevas R, et al. The effects of animal assisted therapy on autonomic and endocrine activity in adults with autism spectrum disorder: a randomized controlled trial. Gen Hosp Psychiatry, 2021, 72: 36-44.
31. Stavsky M, Mor O, Mastrolia SA, et al. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Front Pediatr, 2017, 5: 21.
32. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl, 2007, 109: 8-14.
33. Stolz I, Anneken V, Froböse I. Measuring equine-assisted therapy: validation and confirmatory factor analysis of an ICF-based standardized assessment-tool. Int J Environ Res Public Health, 2022, 19(5): 2738.
34. Lobato Rincón LL, Rivera Martín B, Medina Sánchez MÁ, et al. Effects of dog-assisted education on physical and communicative skills in children with severe and multiple disabilities: a pilot study. Animals (Basel), 2021, 11(6): 1741.
35. Verschuren O, Takken T. Aerobic capacity in children and adolescents with cerebral palsy. Res Dev Disabil, 2010, 31(6): 1352-1357.
36. Moraes AG, Copetti F, Ângelo VR, et al. Hippotherapy on postural balance in the sitting position of children with cerebral palsy-longitudinal study. Physiother Theory Pract, 2020, 36(2): 259-266.
37. Deutz U, Heussen N, Weigt-Usinger K, et al. Impact of hippotherapy on gross motor function and quality of life in children with bilateral cerebral palsy: a randomized open-label crossover study. Neuropediatrics, 2018, 49(3): 185-192.
38. Silkwood-Sherer DJ, McGibbon NH. Can hippotherapy make a difference in the quality of life of children with cerebral palsy? A pragmatic study. Physiother Theory Pract, 2020, 38(3): 390-400.
39. Norrud BC, Råheim M, Sudmann TT, et al. Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy. J Bodyw Mov Ther, 2021, 26: 364-373.
40. Mutoh T, Mutoh T, Tsubone H, et al. Effect of hippotherapy on gait symmetry in children with cerebral palsy: a pilot study. Clin Exp Pharmacol Physiol, 2019, 46(5): 506-509.
41. Lucena-Antón D, Rosety-Rodríguez I, Moral-Munoz JA. Effects of a hippotherapy intervention on muscle spasticity in children with cerebral palsy: a randomized controlled trial. Complement Ther Clin Pract, 2018, 31: 188-192.
42. Silva e Borges MB, Werneck MJ, da Silva Mde L, et al. Therapeutic effects of a horse riding simulator in children with cerebral palsy. Arq Neuropsiquiatr, 2011, 69(5): 799-804.
43. Park IK, Lee JY, Suk MH, et al. Effect of equine-assisted activities on cardiac autonomic function in children with cerebral palsy: a pilot randomized-controlled trial. J Altern Complement Med, 2021, 27(1): 96-102.
44. Suk MH, Kwon JY. Effect of equine-assisted activities and therapies on cardiorespiratory fitness in children with cerebral palsy: a randomized controlled trial. J Integr Complement Med, 2022, 28(1): 51-59.
45. Matusiak-Wieczorek E, Dziankowska-Zaborszczyk E, Synder M, et al. The influence of hippotherapy on the body posture in a sitting position among children with cerebral palsy. Int J Environ Res Public Health, 2020, 17(18): 6846.
46. Flores FM, Dagnese F, Copetti F. Do the type of walking surface and the horse speed during hippotherapy modify the dynamics of sitting postural control in children with cerebral palsy?. Clin Biomech (Bristol, Avon), 2019, 70: 46-51.
47. Sandstrom A, Perroud N, Alda M, et al. Prevalence of attention‐deficit/hyperactivity disorder in people with mood disorders: a systematic review and meta‐analysis. Acta Psychiatr Scand, 2021, 143(5): 380-391.
48. Schuck SEB, Johnson HL, Abdullah MM, et al. The role of animal assisted intervention on improving self-esteem in children with attention deficit/hyperactivity disorder. Front Pediatr, 2018, 6: 300.
49. Schuck SE, Emmerson NA, Fine AH, et al. Canine-assisted therapy for children with ADHD: preliminary findings from the positive assertive cooperative kids study. J Atten Disord, 2015, 19(2): 125-137.
50. Gilboa Y, Helmer A. Self-management intervention for attention and executive functions using equine-assisted occupational therapy among children aged 6-14 diagnosed with attention deficit/hyperactivity disorder. J Altern Complement Med, 2020, 26(3): 239-246.
51. Aviv TM, Katz YJ, Berant E. The contribution of therapeutic horseback riding to the impr-ovement of executive functions and self-esteem among children with ADHD. J Atten Disord, 2020, 25(12): 1743-1753.
52. White E, Zippel J, Kumar S. The effect of equine-assisted therapies on behavioural, psychological and physical symptoms for children with attention deficit/hyperactivity disorder: a systematic review. Complement Ther Clin Pract, 2020, 39: 101101.
53. Lentini JA, Knox M. A qualitative and quantitative review of equine facilitated psychotherapy (EFP) with children and adolescents. Open Complement Med J, 2009, 1(1): 51-57.
54. Yoo JH, Oh Y, Jang B, et al. The effects of equine-assisted activities and therapy on resting-state brain function in attention-deficit/hyperactivity disorder: a pilot study. Clin Psychopharmacol Neurosci, 2016, 14(4): 357-364.
55. Luman M, Oosterlaan J, Sergeant JA. Corrigendum to “the impact of reinforce-ment contingencies on AD/HD: a review and theoretical appraisal” [Clinical Psychology Review 25 (2005) 183-213]. Clin Psychol Rev, 2005, 25(4): 533.

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