Review on The Animal Assisted Therapy of Autism Spectrum Disorder (asd)

Autism Spectrum Disorder (ASD) encompasses a wide range of social and mental afflictions that are difficult to treat. Due to a lack of established treatments for ASD, alternative therapies have been the primary form of intervention. One of these alternatives is animal-assisted therapy, a field that has experienced growing interest and has recently accumulated studies that investigate its efficacy.

The majority of research on ASD and animal-assisted therapy has examined children and has primarily used dogs and horses for therapy. Studies have shown positive effects of the therapy, including high satisfaction rates among the participants' families. Over the last few decades, there has been increasing interest in, as well as research on, the health benefits of pet ownership, animal visitation (such as in a hospital or nursing home setting), and animal-assisted therapy (AAT). Investigations of the potential benefits have focused on a variety of groups, from Alzheimer's patients to children recovering from surgery.

More recently, some researchers have turned their attention to animal-assisted therapy for children on the autism spectrum, as well as the use of service dogs with these children. Children with Autism Spectrum Disorder (ASD) often experience rejection and victimization by their peers, which could result in social isolation, anxiety and problem behaviors at home (O'Haire, McKenzie, McCune, & Slaughter, 2014). Over time, these experiences could impact the physical and mental health of the child (O'Haire et al., 2014).

Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ASD is characterized by persistent impairment in social functioning and restricted, repetitive pat¬terns of behavior (American Psychiatric Association, 2013). These symptoms are present from early childhood and have the potential to impair everyday functioning (American Psychiatric Association, 2013). Animal-assisted intervention is a term used to encompass both animal-assisted therapy and animal-assisted activities. While animal-assisted therapy refers to an interventional strategy that involves an animal, is goal-directed and is facilitated by a trained professional, animal-assisted activities are activities with animals that create opportunities for educational, recreational or therapeutic benefits without being goal-directed or facilitated by a professional (O’Haire et al., 2014).

According to the human-animal interaction social support theory, animals have the ability to enhance social support as they act as a source of comfort and facilitate social interactions (McNicholas & Collis, 2006). Additionally, the human-animal interaction attachment theory suggests that animals can act as a source of comfort and safety for children, which could alleviate distress and reduce problem behaviours (Kruger & Serpell, 2006). While these theoretical underpinnings have led researchers to theorise that animals offer a unique outlet for social engagement (O’Haire, 2013), others have contended that social aversion amongst individuals with ASD may be specific to the human species and may not extend to animals (Johnson, 2003).Improving Quality of Life of Autistic Kids or Adults by Animal-Assisted TherapyIndividuals with ASD often suffer from difficulty in focusing, responding to sensory stimuli, and communicating with others, all of which have been shown to improve after the use of pet therapy. A variety of studies support the concept that animals can be particularly effective with children who have ASD.

For example, research has shown that such children tend to prefer pictures of animals to those of humans and are less responsive to the sound of the human voice as opposed to other stimuli. Introducing a dog to children with ASD can result in a reduction of stress, anxiety, and irritation and can also promote a more relaxed environment for those children. Caitlin Siewertsen; Emma French; Masaru Teramoto, Ph.D., MPH AND is a neuro-developmental disorder with a diagnosis based upon repetitive stereotypic behaviors and impaired abilities in communication and social interaction. The latter may be presented by difficulties establishing and sustaining relationships, a lack of eye contact, and deficiencies in social reciprocity and Theory of Mind. Symptoms of ASD can be socially disruptive at times, and the general public has limited knowledge or understanding of ASD. Research using US longitudinal data has shown that young adults with ASD are significantly more prone to social isolation than young adults with other intellectual, emotional or behavioural disabilities , with negative implications for their quality of life.

Working with animals can have some really positive benefits for an individual with ASD for eg:

• Promote positive emotions and improve the mood.
• Support the development or expression of empathetic skills
• Boost confidence.
• Ease anxiety
• Reduce feelings associated with loneliness, insecurity, sadness, social isolation and anger
• Improves communication
• Teaches boundaries and respect for one’s private space
• Helps improve social skills.
• Teaches one to have greater control over impulses and emotions
• Helps develop trust not only with animals but human beings as well.

How it's done

Typically animals used for therapy are horses also known as Equine-Assisted therapy, dogs also know as Canine-Assisted therapy and sometimes Dolphins are also used also known as Dolphin-assisted therapy. In a typical session, the therapist works with an ASD person on how to properly engage the horse or a canine in positive interaction. For e.g.. with a horse, a child may lead the horse around in an encloses space without using physical contact. In this way, the child must learn how to appropriately communicate with the horse. In sessions, horses or canines essentially teach the recovering person how to treat them. This type of interaction is a gentle way of teaching ASD child to communicate in a more sensitive manner.

In addition, the improved communication paves the way for building trust. Communication is the foundation of trust; although this simple thing may not be so obvious after a few sessions animal-assisted therapy can have in long-term benefits for kids with ASD which includes building social skills and the relationship between the therapist and the therapy animals can also model for a healthy relationship. Uyemura, B. (Dec. 16, 2011). “The Truth About Animal-Assisted Therapy.” Psych Central. Accessed Dec. 7, 2015. Research Behind the Intervention Research presented by interactive Autism network (IAN) on Animal-assisted therapies (AAT)Of the more than 8,000 families participating in the IAN Research project who have reported on treatments, 514 (or about 6%) has reported using an animal-assisted therapy or AAT. Some were trying more than one, so that information about 568 AATs was submitted. Of all AATs, therapeutic horseback riding, also known as equine therapy or hippotherapy, was most frequently used, with 349 children taking part. In addition, 168 families were using “animal" or "pet" therapy. Only 51 were using canine therapy or a service dog, although it is likely some "dog therapy" families listed their treatment under "animal" or "pet" therapy. No one reported using dolphin therapy. Families shared experiences involving all kinds of child-animal bonds and interactions.

For example, some children were involved in programs where a dog was made available to children in a school or therapeutic setting. Some families had brought animals into their homes and their lives, hoping for regular interaction with a loving pet would help their child. Dogs were mentioned most often, but so were snakes, rabbits, and cats. One mother described her son's bond with the family felines and his empathy for them: "Mark cares for the kitties and worries about them. He loves to interact with them and he will sing to them to help them ‘feel safe.' He gives us glimpses into what he is feeling by telling us when he thinks the kitties are scared or nervous."

A number of families were enthusiastic about equine therapy, saying it had been a wonderful experience for their child on the autism spectrum. "This is the therapy where I have seen the most improvement with Suzie," one mother declared. "She seems to enjoy horseback riding because it not only feels good in a sensory way, but it creates a sense of competency and confidence. In the past couple of months, she has graduated to steering the horse all by herself and trotting (without complaint, which is new to her) in a 2 point stance. She was all smiles during her recent horseback riding sessions."There were stories of disappointment, as well. Some families found their child was indifferent to an animal they tried to introduce, and that the hoped-for bond didn't form. One mother said, "At a very young age Adam had a fascination with water. We had 3 pounds at the time. It only took one time for him to take off to a pond to throw a rock into it and I had to run to all three ponds to find him... I decided to purchase a Labrador and train it myself to find all children when asked. The dog was very successful at this job but because of the lack of response from my child, she would rather not find him. She was very willing to find any other child but the child I wanted her to find.”A fairly small number of families reported having a service dog.

These specially trained animals were in the home as a constant presence, like a pet, but also were able to perform functions no untrained dog could. They explained how the dog's presence often smoothed the way socially, giving people an excuse to approach and interact and also giving them some idea that the child might have some issues. (Parents of children with ASD often comment that people give critical looks, thinking their children "bratty" rather than disabled because they appear so physically normal.)One grateful mother explained the many ways she felt their service dog had helped her son: "When we have the dog, and Sean has a tether, we do not experience stimming or self-injurious behavior. Sean is quite excited to take his dog to the store or the movies. He naturally responds to questions about his dog and it also helps him with eye contact and restricts his repetitive body movements...

At home when Sean is experiencing difficulties, the dog applies deep pressure by lying on or leaning against Sean.” IAN Research Findings: Animal-Assisted Therapies Critical Thinking and evaluation of the Research The notion that bonding with an animal can improve physical, mental, and social difficulties are appealing, but evidence that specific interventions with specific animals accomplish specific goals with specific groups of patients is still quite sparse. Although many AAT studies or programs claim that they provide substantial benefits, a great deal of the research so far has been done on a small scale, across a wide array of varied settings, and with people with all kinds of conditions and needs. This makes animal-assisted therapy seem too much of a cure-all and lessens its legitimacy.

Despite the belief in the therapy on the part of patients or practitioners, it has therefore been suggested that insurance companies are unlikely to pay for it until better science consistently shows precisely what type of AAT, done in what setting, and for how long, benefits which type of patient. The evidence is needed to support more widespread acceptance in use of animal-assisted therapy.

The programs that are most prone to criticism are those supported by very little research, but very big claims. Dolphin-assisted therapy, or DAT, is a good example of this. Writing for the Washington Post, Katherine Ellison comments: “Do you or does your child suffer from cerebral palsy? Down syndrome? Autism? A knee injury? If you do -- and you have a week or two and a few thousand dollars to spare  a growing and controversial group of global entrepreneurs claims it can help you feel better by putting you in close contact with dolphins.” A major critique of dolphin-assisted therapy research set forth some of the challenges of animal-assisted therapy research more generally. These included the influence of participants’ expectations (as stoked by provider’s advertising and claims), the fact that the experience with the dolphins may have been “nonspecific” (that is, a platypus or cat might have done just as well), and “novelty effects” (that is, a person may have been energised by a new experience, but the results would have been the same for any equally fun and new experience).

Studies that are conducted by those who will provide and market the therapy, of course, suffer from inherent bias. It is often a problem that those most motivated to test a therapy, whatever it might be, are those who already believe in it, hope to prove it works, and then market it, train people to provide it, etc. Teresa Foden IAN Assistant Editor; Connie Anderson, Ph.D.IAN Community Scientific Liaison January 21, 2011Future Directions Despite the potential pitfalls, the field of AAT is maturing, and it is likely more research into specific therapies for specific populations will be conducted in the future. Again, the notion that human-animal interaction leads to “bonding” or “attachment” – something people with ASD often need help with – may make AAT especially attractive to families with a child on the autism spectrum.

This notion may be especially relevant when the animal is not encountered briefly, as in a therapy visit, but is spending more time with the child as a pet. There is a great deal of research still needed to provide families guidance about the effectiveness of animal-assisted therapies. Studies which focus in on specific AATs directed at improving specific ASD-associated challenges will be most useful, as will studies that help demonstrate if children on the autism spectrum with certain characteristics are especially likely to benefit. If social aspects of ASD, from mere interest in social interaction to actual “bonding,” are a goal, it will be important to find a way to characterize and measure these concepts in concrete ways.

The idea that the unconditional love and the simpler social give-and-take offered by dogs and other animals can coax children with ASD into social interaction, and then make them more likely to seek interaction with other people, is intuitive and attractive. Whether this is truly the case, and when, still needs to be put to the test. Teresa Foden IAN Assistant Editor; Connie Anderson, Ph.D.IAN Community Scientific Liaison January 21, 2011My personal view on the Animal-assisted therapy Being an animal lover and pet owner myself I do understand how animals can be great companions and fulfill a lot of emotional needs. So as I greatly agree that as a human- companion animal bond promotes many physiological and psychological benefits more research needs to be done in the field to confirm the benefits of using animals for occupational therapy. Having said that I very strongly believe that animal-assisted therapy can definitely enhance the emotional well being of children with special needs to have a friend and a companion as they often feel lonely and isolated. Research or no research all kids whether special needs or neuro-typical must have animal and pet interaction as it definitely makes them more humble and humane and those are definitely two qualities we all need to possess to grow as a more tolerant society.