The Experiences of Females with an Autism Spectrum Condition Undertaking Equine Assisted Therapy

Abstract

Background: Autism Spectrum Conditions (ASC) are described in the literature as a set of neurodevelopmental conditions characterised by early difficulties in social communication and interactions across multiple settings (Meng- Chuan, Lombardo & Baron- Cohen, 2014). Since the first cases of ASC were outlined in the literature, there has been a higher rate of diagnosis of ASC in males compared with females. In 2013, it was reported that the estimated prevalence for an ASC diagnosis was four males to one female (Werling & Geschwind, 2013). Numerous explanations have been proposed for the variance in diagnoses; however, it has been acknowledged that females with an ASC present with wholly different characteristics to males, such as the ability to ‘mask’ their difficulties (Tierny, Burns & Kierby, 2013). Furthermore, it has been evidenced that screening and diagnostic instruments do not accurately discriminate between male and female presentations of ASC (Kopp & Gillberg, 2011). As a consequence, females often receive an untimely diagnosis, or may never meet the clinical thresholds to receive a diagnosis. This has a detrimental impact on education, relationships, emotional wellbeing and mental health. Moreover, many of the interventions employed for people with an ASC are inappropriate for females, as the evidence base for intervention is centred upon the male phenotype (Koenig & Tsatsanis, 2005). Evidence regarding the use of animals in therapy has gradually been established in the fields of both mental health and neurodevelopmental difficulties (Fine, 2006). Equine Therapy is one such branch of animal therapy, and is based upon the premise of the horse as a focus of delivering therapy. Equine Therapy is an experiential process, and is typically centred around learning new skills, and honing an understanding of oneself and others through the use of the horse (Romaniuk, Evans & Kid, 2018). Aim: The aim of this project was to explore how females with an ASC experienced Equine Assisted Therapies, to gain a detailed understanding of the individual experiences underlying this particular intervention. Method: Five female participants, aged between fifteen and thirty years old, with a diagnosis of ASC were recruited from two Equine Therapy centres in the UK. Each participant undertook a semi-structured interview, and the resultant transcripts were analysed using Interpretive Phenomenological Analysis (IPA). Results: The analysis produced three superordinate themes. The first superordinate theme was conceptualised as ‘the toxic experience of living in the social world’, which indicated the detrimental, emotional impact of peers, school and authority figures on participants. ‘The process of Equine Assisted Therapy’ was a further superordinate theme, which explored the benefits of distance in indirect intervention, and highlighted the challenges associated with equine therapy. Finally, ‘the emotional impact of horses on my world’ was considered as important to participants. This theme referred to the impact of EAT on participants’ sense of self, and the fostering of their confidence and leadership skills. Conclusion and Recommendations: The results of this study gave rise to clinical implications and services for females with an ASC, including the consideration of non-verbal therapeutic interventions, undertaken in a community setting. In conjunction to this, this study drew attention to the distribution of where financial resources may be ideally placed for this clinical population.