Background: Autism spectrum disorder (ASD) is diagnosed in early childhood and affects 1 in 68 children in the United States. ASD often creates deficits in social functioning making it difficult for children with ASD to socialize and communicate with others.

Purpose: The purpose of this review paper is to examine the effectiveness of therapeutic horseback riding (THR) on communication and social skills in children with ASD.

Methods: Articles were selected from the databases CINAHL and PubMed and were published within the last 10 years in the United States and Europe. Search terms included ASD, children, and THR. Studies with samples sizes of ten or less were excluded.

Results: Inconsistent results were found for two of the studies that used the Social Responsiveness Scale; one study found statistically significant results for improved social motivation when compared to the control group (p = .038) while another study found a significant improvement for social cognition compared to the control group (p= 0.05). The remaining outcomes tested amongst the studies were not significant.

Conclusion: Current research does not fully support the efficacy of THR on communication and social skills for children with ASD. Therefore nurses do not have enough evidence to recommended this approach to families that have a child with ASD. Future studies should be conducted using larger sample sizes so the ASD population is well represented. With more research, the findings will hopefully serve to facilitate the assimilation of this population into society.