Research on animal-assisted intervention and autism spectrum disorder, 2012-2015

Animal-assisted activity improves social behaviors in psychiatrically hospitalized youth with autism

There is preliminary research suggesting that animal-assisted activities can improve social interactions of children with autism spectrum disorder. This pilot study sought to investigate the benefits of animal-assisted activities with dogs and psychiatrically hospitalized youth with autism spectrum disorder. Participants were recruited from a specialized inpatient psychiatric hospital unit for youth with autism spectrum disorder and other developmental disabilities. Utilizing a crossover design, participants served as their own control by engaging in two 10-min conditions: an experimental dog and handler interaction (animal-assisted activities) and a novel toy and handler control (control). Of the 142 youth aged 6--8 years screened for participation, 47 completed both conditions. Participants' behavioral data were captured via video and coded using the Observation of Human-Animal Interaction for Research, a tool specifically developed to capture human behavioral interactions in the presence of animals. Overall, social-communication behaviors significantly improved in the animal-assisted activities experimental condition compared to the control condition (p = 0.0001). Specifically, participants in the animal-assisted activities experimental condition displayed more positive emotional facial expressions (p ⩽ 0.0001), talking (p = 0.0408), use of gestures (p = 0.032), and looking at both adults and peers (p ⩽ 0.0001). In addition, a higher frequency of constant motion (p = 0.003) was observed in the animal-assisted activities experimental condition. Results suggest that animal-assisted activities with a dog may promote social-communication behaviors in psychiatrically hospitalized youth with autism spectrum disorder. Given the fact that social and communication behaviors can facilitate treatment engagement for this population, we recommend future studies examine how such improvements can positively affect the psychiatric treatment of this population.

Replication Pilot Trial of Therapeutic Horseback Riding and Cortisol Collection With Children on the Autism Spectrum

We aimed to determine whether results of our prior randomized control trial [RCT; NCT02301195, (1)] of Therapeutic Horseback Riding (THR) for children and adolescents with autism spectrum disorder (ASD) could be replicated at a different riding center and if treatment effects also included differences in the expression of associations between problem behavior and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants with ASD (N = 16) ages 6-16 years were randomized by nonverbal intelligence quotient to either a 10-week THR group (n = 8) or no horse interaction barn activity (BA) control group (n = 8). Outcome measures were a standard speech-language sample and caregiver-report of aberrant and social behaviors. Participants' saliva was sampled weekly at a consistent afternoon time immediately pre- and 20 min' post-condition (later assayed for cortisol). Intent-to-treat analysis revealed that compared to controls, THR participants had significant improvements in hyperactivity, and social awareness, and significant improvements at the 0.1 significance level in irritability and social communication behaviors. There were no significant improvements in number of words or new words spoken during the standard language sample. Linear mixed effects model analysis indicated that greater weekly pre-lesson irritability levels were associated with smaller post-lesson reduction in salivary cortisol levels, and greater weekly pre-lesson hyperactivity levels were associated with smaller cortisol reduction in the THR group, but not in the BA control group. The findings represent a partial replication of prior results (1), extend prior observations to include THR effects on biobehavioral relationships and suggest that cortisol could be a target mediator for THR effects on irritability and hyperactivity behaviors in youth with ASD. Clinical Trial Registration: Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov, identifier: NCT02301195.

Reliability and Validity Assessment of the Observation of Human-Animal Interaction for Research (OHAIRE) Behavior Coding Tool

The Observation of Human-Animal Interaction for Research (OHAIRE) is a coding tool developed to capture the behavior of children when interacting with social partners and animals in naturalistic settings. The OHAIRE behavioral categories of focus are emotional displays, social communication behaviors toward adults and peers, behaviors directed toward animals or experimental control objects, and interfering behaviors. To date, the OHAIRE has been used by 14 coders to code 2,732 min of video across four studies with a total of 201 participants ages 5 to 18 years (M = 10.1, SD = 2.5). Studies involved animal-assisted intervention with three species (i.e., dogs, horses, and guinea pigs) and three populations (i.e., autism spectrum disorder, attention-deficit hyperactivity disorder, and typically developing children) in a school, a therapeutic horseback riding program, a group therapy program, and the hospital setting. We explored the psychometric properties of the OHAIRE through analyses of its inter-rater reliability, intra-rater reliability, convergent and divergent validity, and internal structure, using data from these four human-animal interaction studies. The average inter-rater reliability was excellent (kappa = 0.81), with good reliability in most of the behavioral categories coded. Intra-rater reliability was consistently excellent (0.87 ≤ kappa ≤0.96). Internal structure analyses with Cronbach's alpha supported the exploratory use of subscales to measure social communication behaviors toward peers (α = 0.638) and adults (α = 0.605), and interactions experimental control objects (α = 0.589), and the use of a subscale to measure interactions with animals (α = 0.773). Correlation analyses with multiple questionnaires showed a convergence between positive emotional display and social behaviors as assessed by the OHAIRE and social skills as assessed by the Social Skills Rating System (SSRS) and the Social Communication Questionnaires (SCQ). Little concordance was found between the OHAIRE and the Social Responsiveness Scale (SRS) or the Aberrant Behavior Checklist-Community (ABC). The OHAIRE shows promise for wider use in the field of Human-Animal Interaction, with a need for generalization across more settings and ages.

Long-Term Effect of Therapeutic Horseback Riding in Youth With Autism Spectrum Disorder: A Randomized Trial

This paper presents 6-month follow-up data of 44% (N = 64/116) of participants (ages 6-16 years) with a diagnosis of autism spectrum disorder, who participated in a previously-published randomized controlled trial of therapeutic horseback riding (THR) compared to a no-horse contact active control. The objective of this study was to examine whether significant improvements of irritability, hyperactivity, social, and communication behaviors observed in participants randomized to receive a 10-week manual-based THR intervention were sustained 6 months after the intervention conclusion. Participants' caregivers from both the THR (n = 36) and active control (n = 28) groups completed a measure of irritability and hyperactivity behaviors (primary outcome variables). Additionally, only the THR group participants completed the full battery of study outcomes assessments. Between group comparisons examining the extended interval from baseline (1-month pre-intervention assessment) to 6-months after the intervention revealed that the THR group maintained reductions in irritability behavior at a 0.1 level (effect size = 0.32, p = 0.07). (Effect size = 0.32, p = 0.07), which was 73% of efficacy preserved from the primary post-intervention endpoint (within 1-month post-intervention). Hyperactivity behaviors did not sustain this same trend. Comparisons from baseline and 6-months after the intervention revealed that the THR group sustained significant initial improvements made in social and communication behaviors, along with number of words and different words spoken during a standard language sample. This is the first known study to examine and demonstrate the longer-term effects of THR for individuals with ASD and warrants a more thorough evaluation of whether the effects of THR are maintained for at least 6-months after the intervention compared to a control.

CLINICAL TRIAL REGISTRATION INFORMATION

Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195.

Effects of Equine Therapy on Individuals with Autism Spectrum Disorder: A Systematic Review

Literature on effects of equine therapy in individuals with autism spectrum disorder (ASD) has grown in recent times. Equine therapy is an alternative multimodal intervention that involves utilizing a horse to enhance core impairments in ASD. Recent systematic reviews in this area have several limitations including inclusion of populations other than ASD, assessment of a variety of animal-assisted interventions other than equine therapy, and a failure to conduct quantitative analyses to provide accurate effect size estimates. We conducted a focused systematic review to address these limitations. Our review suggested that equine therapy has beneficial effects on behavioral skills and to some extent on social communication in ASD. The evidence for positive effects of equine therapy on perceptuo-motor, cognitive, and functional skills is currently limited.

Therapeutic Horseback Riding Crossover Effects of Attachment Behaviors with Family Pets in a Sample of Children with Autism Spectrum Disorder

The unique needs of individuals with autism spectrum disorder (ASD) have implications for animal welfare. This nested pilot study examined the effects of a randomized trial of 10-week therapeutic horseback riding (THR) intervention versus a no-horse barn activity (BA) control group on children's behaviors with family pets. Sixty-seven (THR n = 31; BA n = 36) participants with ASD (ages 6-16 years) with one or more family pet, were enrolled from a larger trial (n = 116) following their randomization to intervention groups, stratified by nonverbal intellectual ability. A consistent caregiver completed questionnaires about participants' interactions with their household pets pre- and post-intervention. Caregivers of THR group participants reported significant improvements in participants' caring actions with the family pet compared with the BA group (p = 0.013; effect size = 0.74). Engaging with horses during a standard THR intervention protocol may generalize to improving caring actions toward family pets in children and adolescents with ASD.