Good afternoon. My name is Madison Kraft. I'm a current fourth-year medical student at Edward Valley College of Osteopathic Medicine, Carolina's campus. Today, I will be presenting on effects of equine-assisted services on parental stress scores of children with autism spectrum disorder on behalf of our research team, including myself and the authors listed on the poster. For some background, Healing and Learning Through Therapeutic Writing, HALTR, is an organization that specializes in therapeutic writing and equine-assisted services, EAS, for children with special needs. We have an understanding of how EAS and other services provide benefits to children, but we don't have a great deal of research characterizing how EAS impacts the health of parents, and in particular regards their psychosocial health. Parents of children with chronic disease or disability have previously reported higher levels of stress, burnout, and depression symptoms compared to parents of children without a child who suffers from a chronic illness or disability. There's currently minimal evidence for how EAS affects parents' psychosocial health, and this research and our team wanted to better illuminate that subject on behalf of our patients and our community. For our methods, we recruited 13 parents of children with an autism spectrum disorder, ASD diagnosis, through their participation at Therapeutic Writing Center, HALTR, which can be seen here in Figure 1. While this is currently a photo of a participant at HALTR, it is not one of the participants within our study. We want to preserve anonymity. We utilized a mixed-method study comprising the depression, anxiety, and stress score, also known as the DAS-21 questionnaire, as a pre- and post-test measure given to parents at the beginning and end of the 16-week writing semester for our quantitative portion. The pre- and post-depression anxiety and stress scores were then analyzed to determine mean, median, standard deviations, median change score, and interquartile range. To test for statistically significant changes, given the small sample size within the study, we used the Wilcoxon-signed rank test. For our qualitative arm, we conducted one-time interviews during the 16-week writing semester with one of the parents to better understand parent perspectives, their emotions, and lived experiences, and eventually conduct a thematic analysis of their responses. The interviews were semi-structured, and the questions were standardized and reviewed to ensure minimal bias. The interviews were recorded, transcribed, and de-identified, and we're currently working on our thematic analysis of that material. So, moving to our results. Our thematic analysis, as I stated, remains ongoing, but we do want to display some of the quotes from our participants seen in Table 1, which highlight their perspectives, among which many were echoed among multiple participants. Parents mentioned stress regarding how their child is perceived, both by family and within the public sphere, difficulty getting access to resources for their child, minimal support groups and resources for parents or other caregivers of children with special needs, and stress regarding allocation of time and resources for their child while balancing the interests and welfare of other children and family within their life. Moving to our statistical data, we've displayed the pre- and post-median scores and the changes seen across the depression, anxiety, and stress scores here in Figure 2. In our statistical analysis, the mean pre-intervention stress scores were 12.77, with a standard deviation of 9.95, and post-intervention stress scores were 8.62, with a standard deviation of 10.98, as seen here in the far right of Figure 2. Using a two-tailed Type 1 error rate of 0.05, we observed a statistically significant decrease with a p-value of 0.03 in the stress scores post-intervention. However, while you may see on the graph that depression and anxiety scores showed a reduction from the pre- to post-test, there was no identifiable statistically significant decrease post-intervention. The pre-intervention depression scores were 4.31, with a standard deviation of 6.92, with subsequent post-intervention depression scores of 2.31, with a standard deviation of 4.49. Our pre-intervention anxiety scores were 5.54, with a standard deviation of 5.84, with a subsequent post-intervention anxiety score of 4.0, with a standard deviation of 4.47. So this is quite a bit of data we've worked through, and it remains ongoing, but we do feel that we were able to successfully capture a statistical impact of stress and its reduction in parents of children with autism spectrum disorder, and better characterize the perspectives of those caring for children with special needs living in our community. EAS has demonstrated an effect on reducing the stress scores in this sample, and we hope we can translate the methodology to other parents and more caregivers of children with special needs utilizing equine-assisted services. We'd like to hopefully expand the study to other equine-assisted services centers across the United States and provide standardized templates so we can better collect a larger sample of data. We as osteopathic physicians, and future physicians and medical students, we frequently identify our patients are more than their diagnoses, and they're largely impacted by the health systems and factors around them. We hope that this study has better characterized how these services impact the health not only of those participating, but the health of those who care for them and participate directly in their life.

equine-assisted services

autism spectrum disorder

parental stress

therapeutic riding

caregiver support