Children with Autism Spectrum Disorder (ASD) have difficulty engaging in activities. Based on the literature, the unique features of horses may be beneficial to children with ASD. There is limited research supporting the use of horses in occupational therapy interventions. This study examined the effects of equine-assisted occupational therapy for 7 children with ASD ages 4 to 8 years. A multiple baseline design was used. For each child, there were 9 to 11 baseline assessments (gross and fine motor play activities), 9 to 12 intervention sessions, and 4 follow-up sessions (gross and fine motor play activities). Intervention sessions were 40 to 60 minutes long and consisted of time spent on the horse and in horse related activities. Children were videorecorded in all conditions. Trained coders scored randomly selected segments of the video recording. Inter-rater reliability was good.