Improving social participation of children with autism spectrum disorder: Pilot testing of an early animal-assisted intervention in Spain

Effectiveness of animal-assisted activities and therapies for autism spectrum disorder: a systematic review and meta-analysis

Background

Given the rising interest in complementary therapeutic strategies for autism spectrum disorder (ASD), this research aims to provide a comprehensive analysis of the impact of animal-assisted activities and therapies (AAAT) on various ASD symptoms.

Methods

A meticulous search of databases, including Scopus and PubMed, was conducted to gather relevant research on AAAT for ASD. This process led to the selection of 45 studies encompassing 1,212 participants. The chosen studies were then subjected to a meta-analysis to evaluate the efficacy of AAAT in alleviating core ASD symptoms.

Results

The meta-analysis revealed significant improvements in several core ASD symptoms due to AAAT. Notably, there were improvements in social communication (MD = -4.96, 95% CI [-7.49, -2.44]), irritability (MD = -2.38, 95% CI [-4.06, -0.71]), hyperactivity (MD = -4.03, 95% CI [-6.17, -1.89]), and different word usage skills (MD = 20.48, 95% CI [7.41, 33.55]). However, social awareness (MD = -1.63, 95% CI [-4.07, 0.81]), social cognition (MD = -3.60, 95% CI [-9.36, 2.17]), social mannerisms (MD = -0.73, 95% CI [-2.55, 1.09]), social motivation (MD = -1.21, 95% CI [-2.56, 0.13]), lethargy (MD = -1.12, 95% CI [-3.92, 1.68]), and stereotypical behaviors (MD = -0.23, 95% CI [-1.27, 0.80]) did not significantly improve.

Conclusion

The study demonstrates the potential of AAAT in improving certain core symptoms of ASD, such as social communication, irritability, hyperactivity, and word usage skills. However, the effectiveness of AAAT in other ASD symptom domains remains uncertain. The research is limited by the absence of long-term follow-up data and a high risk of bias in existing studies. Therefore, while the findings indicate the promise of AAAT in specific areas, caution is advised in generalizing its efficacy across all ASD symptoms.

Animal-assisted therapy in pediatric autism spectrum disorder: A case report

ABSTRACT

The use of therapy or service dogs to assist children with autism spectrum disorder (ASD) is increasing in clinical settings. Research studies indicate that children with ASD display enhanced prosocial behavior and emotional regulation when canines are included in therapy. Despite increased application of animal-assisted therapy in clinical and inpatient settings, healthcare providers show limited understanding of best practices for its use and require a research-based approach to incorporate animals effectively into therapeutic plans of care for pediatric patients with ASD.

How Do Children and Adolescents with ASD Look at Animals? A Scoping Review

Autism spectrum disorder (ASD) is characterized by interaction and communication differences, entailing visual attention skill specificities. Interactions with animals, such as in animal-assisted interventions or with service dogs, have been shown to be beneficial for individuals with ASD. While interacting with humans poses challenges for them, engaging with animals appears to be different. One hypothesis suggests that differences between individuals with ASD's visual attention to humans and to animals may contribute to these interaction differences. We propose a scoping review of the research on the visual attention to animals of youths with ASD. The objective is to review the methodologies and tools used to explore such questions, to summarize the main results, to explore which factors may contribute to the differences reported in the studies, and to deduce how youth with ASD observe animals. Utilizing strict inclusion criteria, we examined databases between 1942 and 2023, identifying 21 studies in international peer-reviewed journals. Three main themes were identified: attentional engagement and detection, visual exploration, and behavior. Collectively, our findings suggest that the visual attention of youths with ASD towards animals appears comparable to that of neurotypical peers, at least in 2D pictures (i.e., eye gaze patterns). Future studies should explore whether these results extend to real-life interactions.

How to Measure Human-Dog Interaction in Dog Assisted Interventions? A Scoping Review

Human-dog interaction is the working tool through which the therapeutic, educational and recreational goals of dog-assisted interventions (DAIs) are achieved. A better understanding of the characteristics of this interaction could improve the effectiveness of DAIs. This scoping review addresses the question: how has the human-dog connection been measured in the context of DAIs? After searching the Web of Science and Scopus platforms, only peer-reviewed, primary research studies reporting measures of therapy dog-human interaction, relationship and bond were included. A total of 70 included articles provided information on what was measured (interaction, relationship or bond) and how, as well as the general context (DAIs or experimental situations with therapy dogs). While the majority of the articles identified use behavioural analysis methods to analyse the interaction between the participant/recipient and the therapy dog during DAIs, it was possible to identify some more structured tools that assess the participant/recipient's interaction, relationship or bond with the therapy dog, as well as tools that consider the animal's perspective or focus on the dog-handler dyad, indicating growing areas of research. The tools and methods identified can be used by both practitioners and researchers to further explore aspects of human-dog interaction in the field of DAIs.

Vocal-friend: internet of social-things framework to aid verbal communication

PURPOSE

Deficits in social verbal communication in individuals with Social Communication Disorder (SCD) is of concern and SCD in the human community is prevalent in large population throughout the globe. Deficits in verbal social communication are prevalent in a large population. This paper aimed to propose internet connected multi-system architecture which is capable to support verbal communication in a social environment for individuals with social communication deficits.

MATERIAL AND METHODS

Implementation methodology was included with corpus collection for specific communication, deep learning based machine training for intelligent communication, and implementation of the trained algorithm on internet connected electronic multiple social communication devices. The implemented system is smart enough to initiate and maintain two types of communication; the first type includes communication between multiple individuals on the remote location and the second type includes communication with the individual present in the physical listening range.

RESULTS

The system was investigated in terms of its algorithmic parameters and found 97% to 100% in terms of training and testing accuracy with negligible mean squared error. Vocal-Friend analysed results based on audio-bot simulative conditions provide more than 91% accuracy, interaction rate and fallback rate. On the basis of the satisfaction analysis, above average results were noticed.

CONCLUSION

In terms of technical implementations and satisfaction analysis, results found acceptable with above average score.IMPLICATION FOR REHABILITATIONProposed framework is easy to use by caregivers with even having little knowledge.Support individual with deficit to learn social verbal communication skill to survive in society.Aiding parents, caregivers and professionals to understand the communication needs of individuals with communication deficits.Since technology is also grooming in the domain of rehabilitation, so this system could be used in various future applications such as social robots, social virtual assistants etc.

Animal-Assisted Interventions for Autism Spectrum Disorder: A Systematic Review of the Literature from 2016 to 2020

In the last five years, the literature on animal-assisted intervention (AAI) for Autism Spectrum Disorder (ASD) has doubled in size from 42 studies prior to 2015 to 85 studies (cumulative total assessed in 2020). Horses remain the most commonly researched animal for AAI, followed by dogs. The most commonly researched outcome was social interaction, across 21 studies. Though the quantity of studies has increased, issues with methodological rigor remain. Results highlight the need for a continued focus on methodological rigor as well as refining the structure of animal-assisted interventions, addressing the welfare needs of the animals involved, and continuing to establish an evidence base of both significant and nonsignificant findings for AAI for individuals with ASD.

Animal-Assisted Green Care Farming for Patients With Mental and Physical Disorders: A Narrative Review

Green care is an umbrella term that includes numerous therapeutic interventions that immerse the patient into nature and natural environments. Animal-assisted therapy (AAT) with farm animals is a component of green care that may benefit patients with mental health disorders. While the majority of research exploring farm AATs originated in Europe, interest in this therapeutic intervention is emerging in the United States. While there are green care farms utilizing animal therapies in the United States, these therapeutic interventions have not been reported in the scientific literature. Further exploration of this topic in the United States may benefit various patient populations and contribute to overall better health care. A literature review found that farm AATs may be beneficial for patients with mental health disorders, but did not identify any studies addressing AAT with farm animals in the context of physical health disorders. This may be a desirable direction for future research.

How Autism Assistance Canines Enhance the Lives of Autistic Children

The primary objective of this qualitative study was to examine the emerging phenomenon regarding the use of autism assistance canines to support the development of autistic children. Following an evaluation and analysis of literature and national educational policies, it became apparent that, to date, little research has been conducted regarding the concept of animal assisted education within Irish society. Therefore, this qualitative research study aimed to increase the body of research in order to inform future policy makers. Data were gathered using 9 semi structured interviews which explored the attitudes, experiences and perceptions of parents, canine handlers and teachers. Thematic analysis was used to assess, analyse, code and identify themes. The results clearly indicated that an autism assistance canine can positively enhance the life experience of an autistic child in Irish society. More specifically, this study found that an autism assistance canine can positively influence the behavior, safety, social interaction, independent functioning, companionship, language development, educational experience and the family life of an autistic child.

Balancing the Risks and Benefits of Pet Ownership in Pediatric Transplant Recipients

In recent decades, the number of pediatric transplantations and their survival rates have increased. Psychological problems and poorer quality of life are notable among children undergoing transplantation and can have long-lasting consequences and affect immunosuppressive therapy adherence. Pet ownership and animal contact have been associated with physical, mental, and social health benefits. Despite these potential benefits, however, companion animals are known to be a source of infection, which is one of the main concerns for clinicians. Because of immunosuppression, these children are particularly vulnerable to infections. Zoonoses comprise a long list of infectious diseases and represent a major public health problem. Nevertheless, many families and most healthcare providers are unaware of these potential risks, and there is a worrisome lack of recommendations to manage the risk-benefit balance, which could pose a risk for acquiring a zoonosis. Furthermore, no data are available on the number of transplanted patients with pets, and this risk-benefit balance is difficult to adequately evaluate. In this document, we review the currently available evidence regarding the epidemiology of zoonotic infections in patients undergoing transplantation, focusing on pediatric patients from a risk-benefit perspective, to help inform decision-making for clinicians. Families and healthcare professionals should be aware of the risks, and clinicians should actively screen for pets and offer comprehensive information as part of routine clinical practice. A multidisciplinary approach will ensure proper care of patients and pets and will establish preventive measures to ensure patients are safe living with their pets.

Emotion Facial Processing in Children With Autism Spectrum Disorder: A Pilot Study of the Impact of Service Dogs

Processing and recognizing facial expressions are key factors in human social interaction. Past research suggests that individuals with autism spectrum disorder (ASD) present difficulties to decode facial expressions. Those difficulties are notably attributed to altered strategies in the visual scanning of expressive faces. Numerous studies have demonstrated the multiple benefits of exposure to pet dogs and service dogs on the interaction skills and psychosocial development of children with ASD. However, no study has investigated if those benefits also extend to the processing of facial expressions. The aim of this study was to investigate if having a service dog had an influence on facial expression processing skills of children with ASD. Two groups of 15 children with ASD, with and without a service dog, were compared using a facial expression recognition computer task while their ocular movements were measured using an eye-tracker. While the two groups did not differ in their accuracy and reaction time, results highlighted that children with ASD owning a service dog directed less attention toward areas that were not relevant to facial expression processing. They also displayed a more differentiated scanning of relevant facial features according to the displayed emotion (i.e., they spent more time on the mouth for joy than for anger, and vice versa for the eyes area). Results from the present study suggest that having a service dog and interacting with it on a daily basis may promote the development of specific visual exploration strategies for the processing of human faces.

Changes in social functioning and engagement during canine-assisted intervention for children with neurodevelopmental disorders in the context of an early intervention service

PURPOSE

The objectives were to evaluate the feasibility of early implementation of a canine-assisted intervention (CAI) for children with neurodevelopmental disorders, and to determine the changes in social functioning and in engagement experienced by the participants.

MATERIALS AND METHODS

A CAI consisting of 24 sessions was piloted in an intra-subject quasi-experimental longitudinal design. The outcome measures were the Assessment of Communication and Interaction Skills (ACIS) and Individual Child Engagement Record-Revised (ICER-R).

RESULTS

No adverse events or side-effects were noted. The sample consisted of 44 participants (median age 37 months). A total of 33 children (75%) attended all sessions. Main results showed that after completing the intervention, the overall ACIS score improved significantly (p < 0.001); the effect size was large. There was a significant improvement in the scales of the ICER-R from baseline to the final assessment: overall engagement (p < 0.001), frequency of repetitive behaviours (p < 0.001), frequency of interaction between the child and adults (p < 0.001), and the quality of this interaction (p < 0.001); the effect sizes ranged from medium to large.

CONCLUSIONS

The early application was feasible. The results in the areas of social functioning and engagement suggest that this CAI may be a useful complementary strategy in early therapeutic intervention with these children. WHAT THIS PAPER ADDS?: The results of implementation of a canine-assisted intervention (CAI) at an early therapeutic intervention unit for children with neurodevelopmental disorders are not known. This research supported the feasibility and positive impact of a CAI in a population consisting of children with neurodevelopmental disorders in the earliest stages of their life, with similar proportions of participants with global developmental delay and autism spectrum disorder. The study was pioneering in the development of this form of actions in an early intervention service for children with these health conditions. The intervention appears feasible and the results extend the existing evidence base for this intervention modality. The findings suggest significant improvements of a medium to large size in the domains of communication skills and social relations, engagement levels, frequency and quality of interaction with adults and repetitive behaviours after 12 and 24 weekly CAI sessions.

Improving the Emotional Distress and the Experience of Hospitalization in Children and Adolescent Patients Through Animal Assisted Interventions: A Systematic Review

Introduction

Animal Assisted Interventions (AAIs) are increasingly common in pediatric care settings as a means to promote the physical, mental, and emotional well-being of hospitalized children and adolescents.

Objectives

The aim of this work was to review published studies implementing AAIs in hospital settings and to assess the effects of AAIs on the biobehavioral response to stress and pain, social behavior, quality of life and level of satisfaction with hospitalization in children and adolescents. Stress and burden, quality of life, mood and level of satisfaction with hospitalization in parents/caregivers as well as stress and burden, perception of the work environment and job satisfaction in hospital staff were also reviewed.

Methods

All published studies reporting quantitative assessments were systematically searched using PubMed, Scopus, ProQuest and Web of Science databases in accordance with PRISMA guidelines. The aim was to identify studies examining the effects of AAIs on behavioral, psychological and physiological responses to stress in children and adolescents (0-18 years) formally admitted to a hospital for a stay, as well as in those undergoing a visit for treatments or medical examinations.

Results

Of the 350 studies screened, 21 were eligible for inclusion. Most of them focused on stress, pain, and anxiety reduction in pediatric patients, and used both physiological parameters and behavioral and psychological observations/scales. All studies employed dogs. Results show the potential of AAIs to reduce anxiety and behavioral distress in pediatric patients while acting on physiological measures associated with arousal.

Conclusion

Although further, more rigorous studies are still needed, the findings of this review may have implications for clinical practices suggesting appropriate planning of AAIs by pediatric healthcare professionals.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=178993], identifier [CRD42020178993].

Dog training intervention improves adaptive social communication skills in young children with autism spectrum disorder: A controlled crossover study

LAY ABSTRACT

There is some evidence that using therapy dogs for children with autism spectrum disorder generally results in improved social communication skills and reduced behavioral problems. However, well-controlled studies that examine its effectiveness are scarce. This study examined the effectiveness of a "Dog Training Intervention." The study included 73 participants diagnosed with autism spectrum disorder (61 males, 12 females) with age range of 2:10-7:6 years (M = 4:10 ± 1:0) who attend autism spectrum disorder-specific special education schools. The study population was divided into two groups. Each group received the dog training intervention during one part of the school year (first half or second half) in addition to the standard interventions provided by the special education school settings. The dog training intervention was given twice weekly for 4 months within the school setting. The group that received the dog training intervention first showed a significant increase in adaptive social and communication skills in comparison to the second group that did not receive the intervention in this period. This improvement was maintained after the dog training intervention. The second group, which received intervention at the second half of the year, showed improvement in communication and socialization adaptive skills only during the period in which they received the dog training intervention. The positive impact on social communication adaptive skills of the dog training intervention among young children with autism spectrum disorder suggests that dogs may serve as an effective model for establishing social interaction. Dog training intervention appears to be an effective adjunct treatment to the interventions provided in special education schools for young children with autism spectrum disorder.

Assessing the Outcomes of an Animal-Assisted Intervention in a Paediatric Day Hospital: Perceptions of Children and Parents

Simple Summary

Scientific evidence of the effects of intervention with dogs as a non-pharmacological distraction strategy in child hospital care is still small. In addition, the results of implementation of animal-assisted programmes at a paediatric day hospital are not known. Thus, in this pilot study, we conducted preliminary research on the efficacy of an intervention based on the use of therapy dogs at a Spanish day hospital. An intra-subject quasi-experimental longitudinal design was used. The study showed that implementation of an animal-assisted programme at a paediatric day hospital is feasible. Children and parents both gave this programme their highest satisfaction rating. The results portray a significant improvement in the child’s self-assessment of their emotional well-being. In parallel, the parents confirmed this significant improvement in the child’s mood. The research suggests that conducting an animal-assisted session just before an outpatient medical procedure is an effective approach in the promotion of emotional welfare, a compromised area for a high percentage of paediatric patients during hospitalisation periods.

Abstract

There is a growing interest in the use of animal-assisted intervention (AAI) as a non-pharmacological strategy to improve child welfare in hospitals. However, the efficacy of implementation of programmes based on activities with dogs in a paediatric day hospital is not known. An intra-subject quasi-experimental longitudinal design was used for the purpose of assessing the feasibility of such an intervention, as well as exploring the perceptions of its outcomes by children and parents/guardians. A total of 55 children in outpatient care at a paediatric day hospital participated in an AAI session. The application of this intervention was feasible. Self-assessment by the paediatric patients revealed a statistically significant improvement in their emotional state after the session, which was large in size. Parents confirmed this improvement in their child, perceiving significant changes in their mood, which were large in size. This study suggests that AAI is an effective approach when it comes to promoting the emotional welfare of children during their stay in hospital care environments. Participating in recreational occupations with dogs could contribute in a relevant and efficient way to the development of significant and gratifying experiences and to a more positive perception of healthcare centres on the part of children.