Dr. Caiti Peters of Colorado State University joins the Broadcast Retirement Network to discuss how horse-assisted therapy is linked to lower stress in children with autism. She explains why horses make uniquely effective therapy partners, shares published research showing reduced cortisol levels after equine-assisted sessions, and highlights how these services are becoming more accessible nationwide—including Colorado Medicaid’s new coverage for horse-integrated therapies.
Transcript:
Jeffrey Snyder, Broadcast Retirement Network
Dr. Peters, it’s so great to see you. Thanks for joining us on the program this morning.
Caiti Peters, PhD., Colorado State University
Thank you for having me. It’s a pleasure to be here.
Jeffrey Snyder, Broadcast Retirement Network
And I really appreciate you coming on. As I was telling you in the virtual green room, we have a love, our family has a love of horses. And this is a very important topic for us.
But also, I think there are many family members out there looking for alternatives and therapeutics that may help their loved ones. So let’s I want to start with that kind of a basic question about neurodivergence and autism. Can you talk talk about some of the stresses that individuals who are neurodivergent may may feel and what that exhibits as?
Caiti Peters, PhD., Colorado State University
Absolutely. Sure. I’ll speak specifically about autism because that’s my area of expertise.
But I think it probably applies across a lot of different areas of neurodivergence. But autism is really defined by differences in social communication, as well as difficulties regulating behavior. And so what that can look like is autistic individuals.
Many do verbally communicate. Some are minimally verbal. But even when they do have that verbal communication, it can be difficult to communicate with peers, which can then make it difficult to create relationships that are long lasting.
And so I think that’s a big part of the difficulty is is with that social communication, which then ends up creating difficulties in in everyday life in a lot of different contexts within their relationships, within their ability to participate in school, to participate in maybe recreational activities. It can it can affect a lot of different areas of life. And then the differences in behavior also kind of compound those difficulties where it can.
The diagnostic term is restricted and repetitive behavior, and that looks very different across participants. But maybe it includes body rocking in order to help calm themselves down, or maybe it includes difficulty changing in a routine. So if something doesn’t go the way they expected, then it can be really difficult to to pivot and change.
And so, again, those are skills that we use all the time in our daily lives. And so it can can make just daily life a little bit more complicated.
Jeffrey Snyder, Broadcast Retirement Network
And I have to think for the parents, or at least for those that are children, the loved ones who are trying to support this, the individual or individuals, it can be stressful for them as well. Even though I think they probably have learned over the years to cope, they’re probably dealing with their own internal stresses to their system. Absolutely.
Caiti Peters, PhD., Colorado State University
Yeah. I think that parenting is always a challenge, regardless of if we’re parenting a neurodivergent child or a typically developing child. But there are added layers of complexity.
And I know that a lot of parents think really hard about how can they best support their child. And luckily, there are a lot of different services out there for autistic children. But choosing which one is also part of the difficulty is what’s going to be the best fit for my child.
And, you know, nobody really wants their child spending their entire life in therapy. So, you know, you probably need to pick and choose which services are worth the time and investment.
Jeffrey Snyder, Broadcast Retirement Network
So one of the therapies that you wrote about and you’ve studied is horse therapy or horse assisted therapy. Can you describe what that may be and what that looks like? Sure.
Caiti Peters, PhD., Colorado State University
So equine assisted services is really an umbrella term to describe a lot of different services where we incorporate horses into services to help improve human outcomes. So human health and well-being. The therapy that I’ve looked at in particular is occupational therapy, integrating horses.
There’s also physical therapy or speech therapy or mental health therapy. So within that piece of our industry, those are therapy services that are provided by licensed therapists who are working within their scope of practice. But they integrate horses into the therapy in order to improve outcomes for the person participating.
So occupational therapy oftentimes looks at improving social skills or self-regulation skills with autistic children. We work on those same skills, but we do that in the context of interacting with horses.
Jeffrey Snyder, Broadcast Retirement Network
And what makes the horse, as I said before, our family has a close connection with horses. I think I don’t understand them, but I know them to be very intelligent and intuitive. What makes the horse the right partner in these types of therapies?
Caiti Peters, PhD., Colorado State University
We have thought a lot about that, and I think it really comes down to three main ideas. The first is motivation. So getting an autistic child to engage with you in the therapy intervention is really the most important piece to making that intervention effective.
If the child is not willing to engage and participate, then you’re probably not going to get great outcomes. But kids are oftentimes very excited to interact with their horse. And so boosting that motivation and engagement is a really key piece.
And I think horses in particular, given how large they are and that you can ride them, can be particularly motivating in comparison to other animals. But then beyond that motivation factor, I also think that the movement of the horse can be really regulating, particularly for autistic children. So when you’re riding the horse, that movement that you’re receiving is actually providing sensory input.
In occupational therapy, we call it vestibular and proprioceptive sensory input. We have evidence to show that can be very regulating. So if a child shows up and they’re a little maybe irritable or hyperactive, which is common difficulties for autistic children, then during the process of riding the horse, you can almost see it.
You can see them kind of go from that state of hyper arousal where they might be having a difficult time engaging to like it’s like a sigh of relief. Just the movement of the horse and interacting with that animal can really help promote a calm sense of alertness. So, again, they’re better able to participate and engage because they’re in that more calm and alert stage rather than irritable or hyperactive.
Jeffrey Snyder, Broadcast Retirement Network
And the horse is pretty intuitive, right? I mean, they’re very intelligent. Very much so.
Caiti Peters, PhD., Colorado State University
Yeah, I think that’s the third. Sorry, go ahead.
Jeffrey Snyder, Broadcast Retirement Network
No, no, you finish your thought. I interrupted you.
Caiti Peters, PhD., Colorado State University
No, you’re fine. I think that’s the third really key element is that human equine interaction. And particularly with horses, because by nature, horses are prey animals, which means that they are always very alert to their environment because that’s how they’ve evolved.
They have to be alert and in tune with what’s going on in their environment. And what’s going on with the person in their environment is a big piece of that. So they they react to human emotions and they react to human social communication.
And so we can integrate that into therapy because, say, a child is working on their social communication. The horse, if you’re yelling and screaming, is probably not going to react very well to you. But if you have a confident and assertive communication style that’s still calm and engaged, then you’re going to get a much better reaction from that horse.
And so we can really practice those social communication skills, those emotion regulation skills in the context of interacting with horses.
Jeffrey Snyder, Broadcast Retirement Network
You’re based in Colorado. Great state. Beautiful state.
You can see some of the background behind you. Does this type of therapy exist across the 50 states in the district in terms of access? So will someone living in Virginia or Maryland or Utah have access to a similar service?
Be able to or do they need to come specifically to Colorado in order to partake?
Caiti Peters, PhD., Colorado State University
Great question. I believe we’re in all 50 states. It is definitely across the country.
There are over 700 centers that are accredited by PATH International and several more who, for various reasons, are not accredited. But so hundreds and hundreds of these centers across the U.S. that provide services, that’s for equine assisted services generally. So the particular service we provide, which is occupational therapy, is available at many of those centers.
But, yes, there’s a lot of equine assisted services centers that serve individuals with autism and a variety of other disabilities across the U.S. And, you know, in terms of the is something like this.
Jeffrey Snyder, Broadcast Retirement Network
I don’t I don’t you know, I think as we’ve kind of evolved as a society, there are all different types of therapies. And these therapies tend to be covered by insurance or things like Medicaid. Are you seeing these services covered by those types of those types of enterprises?
Caiti Peters, PhD., Colorado State University
Yes, that is really a state by state question. I will say here in Colorado, we recently had a bill passed so that starting in 2024, Medicaid does cover therapies integrating horses. And that was that bill actually included a lot of the research we do at Colorado State University as support for the bill.
So because people are starting to recognize that these are services that are still within the scope of practice of the licensed therapist that’s providing it. And that integrating horses into that practice can can really enhance how beneficial the therapies are. But there are some states where it’s not covered by insurance yet.
And that’s part of why what we do at CSU is to research the efficacy of these services so that we can demonstrate they are effective and improve access to people who could benefit.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, I mean, I don’t even have to look at the data. I can just tell you that my own interactions, I think it’s very therapeutic. And I’ve always had positive experiences.
I’m sure others have well have as well. How do you follow up on this? You’re always doing research.
You’re always doing advocacy. How do you follow up on this type of research? What’s next in the in the docket, so to speak?
Caiti Peters, PhD., Colorado State University
Sure. Well, so this particular study was that was published demonstrated that participants demonstrate decreased cortisol after interacting with the horse during therapy compared to in a traditional clinic environment. We’re actually digging further into that to better understand what is happening physiologically.
Cortisol is one indicator of what’s happening, but there’s a lot of other things we can measure. So we’re looking at participants electrodermal activity, which is an indicator of their nervous system activity, as well as heart rate variability, which is another indicator of our nervous system activity in order to better understand. OK, so cortisol is decreasing.
We’re not distressing the children. And in fact, they’re calmer. But what’s happening in the nervous system that can also help us better understand how human equine interaction can benefit autistic children?
Jeffrey Snyder, Broadcast Retirement Network
Well, it’s certainly great research. There’s certainly a bond that the child or the individual feels with the horse. And I bet you the parents and the loved ones also have a bond as well.
Dr. Peters, it’s great to see you. Thanks for joining us on the program. Great research.
And we look forward to having you back on the program again very soon.
Caiti Peters, PhD., Colorado State University
Thank you so much for having me.
