Dr. Barry Coughlan:

I thank members for the invitation to come before the committee. I will build on what Mr. Hegarty said and give a brief overview of autism spectrum disorder, ASD, and the work St. Joseph's Foundation does in this regard.

As committee members will be aware, autism or autism spectrum disorder is a life-long developmental disability that can cause a wide range of challenges in social interaction, communication and behaviour. In our most recent diagnostic framework, it is defined as a spectrum condition that impacts upon all areas of functioning and has significant implications in the lives of those living with the condition. A diagnosis of autism not only impacts the child, but it has significant implications from a systemic family perspective, affecting parents, siblings and extended family members.

I am sure committee members will be aware that the prevalence figures are increasing. Many of our prevalence rates come from the Centers for Disease Control and Prevention in the United States. That figure currently stands at one in 44 children. The previous prevalence rates were one in 59 in 2018 and one in 68 in 2016. Therefore, the prevalence figures are increasing and there is significant international evidence to indicate that. Unfortunately, few data are available from an Irish perspective, and there is not a specific autism register. The prevalence rate is one in 65.

Autism is a complex condition with many comorbidities or co-existing conditions, such as emotional regulation, aggression, anxiety, mental health difficulties, cognitive difficulties and sensory motor difficulties, to name but a few. St. Joseph's Foundation offers services to both children and adults. From a clinical perspective, we are seeing increased levels of complexity among children and adults. There is considerable evidence that suggests there are significant differences in terms of gender. The current rates suggest that more males than females have autism, but that is under review.

There are many evidence-based strategies for autism, one of which is equine therapy, an alternative multi-modal intervention that involves utilising a horse to enhance the core impairments of autism. It involves activities in the presence of a horse, including mounted activities such as horse riding and hippotherapy, as well as non-mounted equine-focused activities, such as caring for the horse and grooming, etc. While existing research evidence is somewhat in its infancy, it is growing substantially. We now have a body of growing evidence that suggests its effectiveness. Evidence from existing literature indicates that equine therapy and equine-assisted interventions for individuals with autism are very promising. The same premise could be applied to other more complex cognitive behaviour therapies. The evidence is growing in that area. Even though equine therapy or equine-assisted interventions can be considered complex interventions, the volume of systematic reviews and other methodologically sound research on equine therapy is growing. Much of the research, involving systematic reviews, is reporting positive outcomes in a range of difficulties presented under the autism spectrum.

Liskennett Farm was officially opened in Granagh, County Limerick, in 2015. It is a horse-boy hub designed to enable children and adults with autism or intellectual disability to learn, play and express themselves in a stress-free, non-judgmental environment. It provides residential, respite and day services for adults with autism and intellectual disabilities and a range of equine activities for children with autism and intellectual disabilities, including accredited training, equine-assisted learning, equine care, animal therapy, horse riding and occupational work-like therapy.

I hope this briefing was of interest to committee members and we are happy to address any questions they may have.