Social behaviors increase in children with autism in the presence of animals compared to toys

Autistic sociality: challenging representations of autism and human-animal interactions

PURPOSE

The objective of this synthesis research was to explore representations of autism and human-animal interactions (HAI) in the health sciences literature and the implications for autistic children and their families.

METHODS

Guided by critical interpretive synthesis methods proposed by Dixon-Woods et al. (2006), we synthesized and examined how autism and HAI were described in the health sciences literature and explored assumptions and goals underlying HAI as an intervention.

RESULTS

Across 47 reviewed articles, animals were represented as therapeutic objects whose purpose from a biomedical perspective was to address "problematic" behaviours and "deficits" in social functioning and development. HAI was employed as a therapy to address improvements in these problematic behaviours in the majority of studies. Relational and social aspects of HAI were present but not explicitly discussed. An alternative perspective proposed by Olga Solomon positioned autistic sociality as one form of diverse human socialities that can be embraced, rather than held problematic and in need of being normalized.

CONCLUSIONS

Implications for HAI in rehabilitation include recognizing the multiple purposes of animals in a child's life, not only the therapeutic goal of normalizing functioning.

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.

Observation of human-animal interaction for research (OHAIRE) behavior coding in a randomized control trial of children with attention-deficit hyperactivity disorder (ADHD) and a canine-assisted intervention

Introduction

Diagnosed in about 10% of children in the United States, attention-deficit hyperactivity disorder (ADHD) is characterized by symptoms including inattention, hyperactivity, and impulsivity. Traditional interventions, such as pharmacological and psychological interventions, are often used in conjunction with integrative health options, such as animal-assisted interventions. The objective of this manuscript is to report behavior coding findings from a randomized control trial of children with ADHD.

Methods

As part of a larger randomized control trial focused on the efficacy of combining a canine-assisted intervention (live therapy dog or control stuffed dog) with cognitive behavioral therapy for children with ADHD, the current manuscript focuses on video-captured behavior observations (n = 35 children, approximately 322 minutes of data). Data were extracted and coded using the Observation of Human-Animal Interaction Research (OHAIRE) Coding System. Behavior codes are reported as summary scores for the following domains: animal social interaction and human social interaction (further separated into human-adult social interaction and human-peer social interaction). Repeated measures mixed models analyses were performed using SAS PROC GLIMMIX to evaluate group differences and change across the study period.

Results

There were no significant differences in how much children interacted with the live therapy dogs versus control stuffed dogs. With respect to human-to-human social interactions, children showed greater increases over time in human-directed social interactions in the presence of live therapy dogs compared to stuffed dogs (p = .020). Over the course of the 12-week intervention, children increased in interactions with both adults (p = .006) and their peers (p = .014); however, there were more increases over time in adult-directed social interactions in the live animal condition compared to the control stuffed animal condition (p < 0.0001).

Discussion & conclusions

Findings suggest changes in social interaction when participating in this canine-assisted intervention, specifically greater increases in human-to-human social interactions over time when a live therapy dog is present compared to a control stuffed dog. Children appear to engage relatively equally with both live and stuffed dogs; however, the impact of animals on human socialization differs based on if a live animal is present. Future studies should consider incorporating behavior coding analysis into studies of canine-assisted interventions to identify how human-animal interactions may be moderators or mechanisms for psychosocial outcomes.

The effects of service dogs for children with autism spectrum disorder and their caregivers: a cross-sectional study

Introduction

Service dogs are an increasingly popular complementary intervention for children with autism spectrum disorder. However, despite increasing demand, there remains a lack of empirical research on their potential benefits. The purpose of this study was to evaluate the effects of service dogs on children with autism and their caregivers.

Methods

A total of N = 75 families of children with autism were recruited from a non-profit service dog provider in the US, including n = 39 families previously placed with a service dog and n = 36 families engaging in usual care while on the waitlist. Caregivers completed an online survey containing both self- and proxy-report standardized measures of child, caregiver, and family functioning. Linear regressions modeled the relationship between service dog presence and survey outcomes, controlling for relevant child and caregiver covariates.

Results

Results indicated that having a service dog was associated with significantly better child sleep behaviors, including better sleep initiation and duration and less sleep anxiety/co-sleeping with medium effect sizes. However, service dog presence was not significantly related to child withdrawal, negative emotionality, emotional self-control, hyperactivity, irritability, and lethargy with small effect sizes. For caregivers, having a service dog was not significantly related to standardized measures of caregiver strain, sleep disturbance, depression, or the impact of the child's condition on family functioning with small effect sizes. Supplemental matched case-control analyses confirmed these findings.

Discussion

In conclusion, service dogs were found to positively impact sleep behaviors among children with autism, but may not uniformly relate to other areas of child and caregiver wellbeing. Prospective longitudinal designs, larger sample sizes able to detect small effects, and studies that measure sleep using objective methods are needed to build on these findings.

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.

Circumscribed interests in autism: Can animals potentially re-engage social attention?

BACKGROUND

Circumscribed interests (CI) in autism are highly fixated and repetitive interests, generally centering on non-social and idiosyncratic topics. The increased salience of CI objects often results in decreased social attention, thus interfering with social interactions. Behavioural, biomarker and neuroimaging research points to enhanced social functioning in autistic children in the presence of animals. For instance, neuroimaging studies report a greater activation of reward systems in the brain in response to animal stimuli whereas eye-tracking studies reveal a higher visual preference for animal faces in autistic individuals. This potentially greater social reward attached to animals, introduces the interesting and yet unexplored possibility that the presence of competing animal stimuli may reduce the disproportionately higher visual attention to CI objects.

METHOD

We examined this using a paired-preference eye-tracking paradigm where images of human and animal faces were paired with CI and non-CI objects. 31 children (ASD n = 16; TD n = 15) participated in the study (3391 observations).

RESULTS

Autistic children showed a significantly greater visual attention to CI objects whereas typical controls showed a significantly greater visual attention to social images across pairings. Interestingly, pairing with a CI object significantly reduced the social attention elicited to human faces but not animal faces. Further, in pairings with CI objects, significantly greater sustained attention per visit was seen for animal faces when compared to human faces.

CONCLUSIONS

These results thus suggest that social attention deficits in ASD may not be uniform across human and animal stimuli. Animals may comprise a potentially important stimulus category modulating visual attention in ASD.

The effectiveness of animal-assisted therapy for children and adolescents with autism spectrum disorder: A systematic review

BACKGROUND

and purpose Individuals with autism spectrum disorder (ASD) experience difficulty with communication, learning, behaviour, and social interactions. Animal-assisted therapy (AAT) is a growing alternative and complementary therapy for ASD. This review aims to investigate the effectiveness of AAT for children and adolescents with ASD in the domains of cognitive, social, emotional, behavioural, and physical.

METHODS

A systematic search of databases (Medline, Emcare, Embase, Cochrane Library, PsycINFO, PsycARTICLES, Scopus, ERIC and OTseeker) was conducted in March 2022. Grey literature was also explored which included searching Trove database and the first 10 pages of Google, as well as pearling reference lists of included studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The methodological quality of the included studies was assessed using a modified Joanna Briggs Institute Review Form for Randomised Controlled Trials. A descriptive synthesis was undertaken due to heterogeneity within the evidence base.

RESULTS

Seven randomised controlled/clinical controlled trials with moderate methodological quality were included in this review. Overall, participation in AAT identified positive trends in the cognitive, social, emotional, behavioural, and physical domains. Despite the positive outcomes, implementation of AAT should be taken with caution as there are currently no standardised frameworks due to heterogeneity within the intervention protocols and outcome measures.

CONCLUSION

AAT may have positive effects across a multitude of outcomes in the management of ASD for children and adolescents. However, the current literature has considerable methodological concerns which should be addressed by future research.

Brief Report: Above and Beyond Safety: Psychosocial and Biobehavioral Impact of Autism-Assistance Dogs on Autistic Children and their Families

Autism-Assistance Dogs (AADs) are highly-skilled service animals trained primarily to ensure the safety of an autistic child by preventing elopement and mitigating 'meltdowns'. Although anecdotal accounts and case-studies have indicated that AADs confer benefits above and beyond safety, empirical support anchored in validated clinical, behavioral, and physiological measures is lacking. To address this gap, we studied children and their families before and after receiving a well-trained AAD using a within-subject, repeated-measures design. Notably, this study is the first to assess change in a biomarker for chronic stress in both autistic children and their parents. Final analyses included pre-/post-AAD data from 11 triads (parent/handler-dog-child) demonstrating significantly positive psychosocial and biobehavioral effects of AADs.

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.

Calm with horses? A systematic review of animal-assisted interventions for improving social functioning in children with autism

LAY ABSTRACT

Children with autism typically experience difficulties interacting socially with others when compared to their non-autistic peers. Establishing how effective interventions are for improving social functioning is important to help inform what should be offered to children with autism. This study reviewed how effective interventions that involved interaction with a live animal, known as animal-assisted interventions, are in improving social functioning in children with autism. A systematic search of the evidence on this topic found nine studies, which were explored for the effectiveness of animal-assisted interventions and the quality of methods used. Overall, these studies showed improvements in social functioning following equine-assisted or therapeutic horse-riding interventions, with initial evidence showing improvements are sustained in the short and medium term. However, several issues were identified, which limit the strength of any conclusions that can be drawn from this evidence. For example, in many studies people assessing the children were aware that they received the intervention or were in a control group. There was also not enough evidence available to draw conclusions on the effectiveness of other animal-assisted interventions. Future research should address the limitations that were common in the designs of these studies and investigate the potential benefit of other animal populations, such as dogs and cats.

Preliminary Efficacy of Occupational Therapy in an Equine Environment for Youth with Autism Spectrum Disorder

The purpose of this study was to identify appropriate outcome measures and assess preliminary efficacy of occupational therapy in an equine environment (OT^ee HORSPLAY) for youth with autism spectrum disorder (ASD). Twenty-four youth with ASD aged 6-13 were randomized to 10 weeks of OT^ee HORSPLAY or to a waitlist control condition, occupational therapy in a garden. Youth demonstrated significantly improved goal attainment and social motivation, and decreased irritability after OT^ee HORSPLAY. When compared to the subset of participants who completed the waitlist control condition, the OT^ee HORSPLAY group still demonstrated significant improvements in goal attainment. This study provides preliminary evidence that horses can be integrated into occupational therapy for youth with ASD to improve social and behavioral goals.

Zoonotic Risk of Encephalitozoon cuniculi in Animal-Assisted Interventions: Laboratory Strategies for the Diagnosis of Infections in Humans and Animals

The involvement of animals for therapeutic purposes has very ancient roots. To date, it is clear that animal-assisted interventions (AAIs), in addition to ensuring the replacement of missing or deficient affects, improves psychophysiological parameters connected to human health. However, AAI could potentially present risks related to the transmission of infectious agents from animals to humans. Among these microorganisms, E. cuniculi is a microspore which induces pathological effects (fever, headache, nausea, vomiting, diarrhea, breathlessness, respiratory symptoms, and weakness) in both humans and animals. Consequently, an accurate and fast diagnosis of E. cuniculi infection, as well as the identification of new diagnostic approaches, is of fundamental importance. This literature review was carried out to provide an extensive and comprehensive analysis of the most recent diagnostic techniques to prevent and care for E. cuniculi-associated risks in the AAI field.

Animal assisted intervention for oncology and palliative care patients: A systematic review

INTRODUCTION

Animal assisted interventions (AAI) have been used in different contexts including oncology/palliative care and can improve mood, quality of life and wellness. The goal of this review was to evaluate studies about AAI and its effects on oncological/palliative care patients.

METHODS

The search was conducted on PubMed, Scopus and Lilacs databases. The inclusion criteria were original articles that measured quantitatively the health-related outcomes of an AAI on oncological/palliative care patients.

RESULTS

Ten studies fulfilled the inclusion criteria. Benefits related to the AAI were described. Mood, pain perception and quality of life seemed to be the variables that had improvement with the intervention. Due to the small sample sizes/heterogeneous methodologies, additional analyses could not be performed.

CONCLUSIONS

AAI can be an important tool for improving psychosocial/physiological parameters in cancer/palliative care patients. Further well designed studies are needed to provide a better knowledge of the AAI benefits in this setting.

Animal Interaction Affecting Core Deficit Domains Among Children with Autism: A Meta-Analysis

Animal-assisted intervention (AAI) has garnered public interest and has been implemented for youth with autism spectrum disorders-a practice supported by anecdotal evidence. While investigations of AAI for children with autism have been conducted, the extant literature is characterized by significant variability in methodology and practice. The present meta-analysis examines the aggregated effects of equine AAI on adaptive functioning among children with autism. Results indicated that interacting with an equine specifically during AAI produced small-to-medium effects (g = 0.40) on the adaptive functioning of children with autism. Recommendations are made for future research on this topic.

Exploring Human-Companion Animal Interaction in Families of Children with Autism

The study goal was to explore companion animal (CA) ownership in families of children with autism spectrum disorder (ASD), including parents' beliefs about benefits and burdens of CAs, as well as parent stress. Participants (N = 764) completed online survey instruments anonymously. Findings revealed that parents with lower incomes perceived more benefits of CAs and their children were more strongly bonded with their CAs. Parents owning both a dog and cat perceived more benefits than those with only a dog or cat. Dog owners perceived more benefits than cat owners. Parents who perceived their CAs as providing more benefits had less stress. Provider implications are to consider recommending CAs to families of children with ASD for family benefits including lower parental stress.

Predictors of performance on the Reading the Mind in the Eyes Test

We explored factors associated with performance on the Reading the Mind in the Eyes Test (RMET). 180 undergraduate students completed the human RMET requiring forced-choice mental state judgment; a control human Age Eyes Test (AET) requiring age judgment; a Cat Eyes Test (CET) requiring mental state judgment; and measures of executive function, empathy and psychopathology. Versions of the CET and AET were created that matched the RMET for difficulty (accuracy 71%). RMET and CET performance were strongly correlated after accounting for AET performance. Working memory, schizotypal personality and empathy predicted RMET accuracy but not CET scores. Liking dogs predicted higher accuracy on all eyes tasks, whereas liking cats predicted greater mentalizing but reduced emotional expression. Importantly, we replicated our core findings relating to accuracy and correlations between the CET and RMET in a second sample of 228 students. In conclusion, people can apply similar skills when interpreting cat and human expressions. As RMET and CET performance were found to be differentially affected by executive function and psychopathology, the use of social cognitive measures featuring non-human animals may be of particular use in future clinical research.

Do Animals Engage Greater Social Attention in Autism? An Eye Tracking Analysis

BACKGROUND

Visual atypicalities in autism spectrum disorder (ASD) are a well documented phenomenon, beginning as early as 2-6 months of age and manifesting in a significantly decreased attention to the eyes, direct gaze and socially salient information. Early emerging neurobiological deficits in perceiving social stimuli as rewarding or its active avoidance due to the anxiety it entails have been widely purported as potential reasons for this atypicality. Parallel research evidence also points to the significant benefits of animal presence for reducing social anxiety and enhancing social interaction in children with autism. While atypicality in social attention in ASD has been widely substantiated, whether this atypicality persists equally across species types or is confined to humans has not been a key focus of research insofar.

METHODS

We attempted a comprehensive examination of the differences in visual attention to static images of human and animal faces (40 images; 20 human faces and 20 animal faces) among children with ASD using an eye tracking paradigm. 44 children (ASD n = 21; TD n = 23) participated in the study (10,362 valid observations) across five regions of interest (left eye, right eye, eye region, face and screen).

RESULTS

Results obtained revealed significantly greater social attention across human and animal stimuli in typical controls when compared to children with ASD. However in children with ASD, a significantly greater attention allocation was seen to animal faces and eye region and lesser attention to the animal mouth when compared to human faces, indicative of a clear attentional preference to socially salient regions of animal stimuli. The positive attentional bias toward animals was also seen in terms of a significantly greater visual attention to direct gaze in animal images.

CONCLUSION

Our results suggest the possibility that atypicalities in social attention in ASD may not be uniform across species. It adds to the current neural and biomarker evidence base of the potentially greater social reward processing and lesser social anxiety underlying animal stimuli as compared to human stimuli in children with ASD.

Examining the Effects of Rabbit-Assisted Interventions in the Classroom Environment

Simple Summary

At the beginning of the first grade of elementary school, children generally show higher levels of anxiety, which continually decreases due to interactions with teachers. However, anxiety levels in children can also be decreased by using additional methods such as animal-assisted interventions in class. In this study, the efficiency of a rabbit-assisted intervention was examined in two first-grade classes with different backgrounds. In one of the classes, most of the pupils had special education needs. It could be concluded that rabbit-assisted interventions were particularly efficient where the anxiety levels of the children were high. This method seems to be useful in improving the efficacy of the educational ability of teachers.

Abstract

The effect of rabbit-assisted interventions on the anxiety levels of first-grade children at a primary school was analyzed. At the beginning of our research, no rabbit-assisted intervention was applied for 6 weeks in order to establish the level of stress caused by the start of the education period. We then alternated 6-week-long periods with and without rabbit-assisted intervention. The level of anxiety in children was assessed every three weeks both in the assisted and non-assisted periods, using the State–Trait Anxiety Inventory for Children, STAI-C. One of the examined classes did not apply the integrating policy while the other class contained pupils with special education needs (called the integrating class). Rabbit-assisted interventions proved to be efficient, as anxiety level scores were significantly lower during the animal-assisted periods. The rabbits actively initiated encounters with humans, not only in the framework of animal-assisted interventions, but also at other occasions. In cases of discomfort, the rabbit retreated to the cage and stayed inside for a short time. The children displayed signs of pleasure when the rabbits approached them. The favorable effect of animal assistance was more apparent in the integrating class. It could be concluded that rabbit-assisted interventions were suitable for decreasing the anxiety levels of elementary school children, improving the efficacy of the educational ability of teachers.

Verbal Interactional Synchronization between Therapist and Children with Autism Spectrum Disorder during Dolphin Assisted Therapy: Five Case Studies

Synchronizing behaviors in interactions, such as during turn-taking, are often impaired in children with Autism Spectrum Disorder. Therapies that focus on turn-taking generally lead to increased social skills, less interruptions, and silent pauses, however a positive non-demanding environment is therefore thought to be beneficial. Such an environment can be achieved by incorporating animals into therapy. Our study was guided by the following research questions: (1) How can we characterize the interaction between child and therapist during dolphin-assisted therapy, with regard to synchrony in verbalizations (turn-taking) and (2) does synchrony change over the course of six sessions of therapy? To answer these questions, we performed a cross-recurrence quantification analysis on behavioral data of five children, to give a detailed view of the interaction between therapist and child in the context of dolphin-assisted therapy. We were able to detect synchrony (i.e., adequate turn-taking) in all dyads, although not all children improved equally. The differences might be explained by a delayed reaction time of some children, and their level of language development.

The Animal in Me: Enhancing Emotion Recognition in Adolescents with Autism Using Animal Filters

People with autism are often characterized as having difficulties with theory of mind abilities such as emotion recognition. However, rather than being a pervasive deficit of ‘mindblindness,’ a number of studies suggests these difficulties vary by context, and when people with autism mindread non-human agents, such as animals or cartoons, these abilities improve. To replicate this effect, 15 adolescents with both autism and intellectual disability participated in a test of facial emotion recognition, with both human and animal faces. Participants performed significantly better on the animal version of the assessment compared to the human version, and human rather than animal scores were the strongest predictor of symptom severity. These results were shown to be primarily driven by improvement in recognition of the emotions happiness and anger in animal rather than human faces. Implications with regards to social motivation and theory of mind interventions are discussed.

Observing Live Fish Improves Perceptions of Mood, Relaxation and Anxiety, But Does Not Consistently Alter Heart Rate or Heart Rate Variability

Although fish and other aquatic species are popular privately-kept pets, little is known about the effects of watching live fish on the perceptions of arousal and the link between those perceptions and physiological measures of arousal. In two separate experiments, participants were asked to watch identically-equipped fish tanks for five minutes in each of three conditions: (1) Live fish, (2) plants and water, and (3) empty tank. Linear mixed models used across both experiments revealed similar results: Greater perceptions of relaxation and mood, and less anxiety during or after viewing the live fish condition, compared with the other conditions. Heart rate and heart rate variability responded to the arousal associated with a math task, but did not differ consistently across viewing conditions. These results suggest that the link between perceptions of arousal, and the physiological measures associated with arousal, may not be strong or immediate, or that heart rate and heart rate variability may not be appropriate measures for the test population. Implications of these results for the biophilia hypothesis and the biopsychosocial model are discussed.

Do Animals Perceive Human Developmental Disabilities? Guinea Pigs' Behaviour with Children with Autism Spectrum Disorders and Children with Typical Development. A Pilot Study

Some cues used by humans and animals during human-animal interactions may have significant effects, modulating these interactions (e.g., gaze direction, heart rate). This study aimed to determine whether an animal in human-animal interactions is capable of "perceiving" its human partner's potential developmental "disabilities". To test this hypothesis, we studied guinea pigs (GP) behaviours in the presence of 44 6-to-12-year-old children with either typical development (TD children) or with autism spectrum disorders (ASD children). Thus, we recorded the GP behaviours during the entire session (to establish their time budget) and focused in particular on the onset and end of physical interactions. The GP behaviours (e.g., feeding, resting, self-grooming, exploring) were not significantly different between the two groups of children during the whole session. GP behaviours in the presence of children differed slightly when encountering ASD children versus TD children: more positive behaviours toward ASD children at the onset, more feeding and resting in the presence of TD children toward the end of an interaction. TD children showed longer-lasting interactions. One could explain this by GP curiosity toward ASD children behaviours (e.g., no marked behaviours such as attempts to touch), whereas GPs seemed calmer at the end with TD children (i.e., interacting with ASD children may be a little stressful). This partly gave support to our study's hypothesis. GPs seemed to perceive developmental disabilities during a first encounter with children and to adjust their behaviours to that of children. We discuss the issues of animal training, animals' well-being and acute stress, whether they are pets or used in animal-assisted interventions. Further studies (on pets or animal-assisted interventions) are warranted.

Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial

Animal-assisted therapy (AAT) is increasingly used to address impaired social competence in patients with acquired brain injury. However, the efficacy of AAT has not been tested in these patients. We used a randomised, controlled within subject trial to determine the effects of AAT on social competence in patients undergoing stationary neurorehabilitation. Participants received both AAT sessions and paralleled conventional therapy sessions. The patients’ social behaviour was systematically coded on the basis of video recordings of therapy sessions. Moreover, mood, treatment motivation and satisfaction was measured during each therapy session. We analysed 222 AAT and 219 control sessions of 19 patients with linear mixed models. Patients showed a significantly higher amount of social behaviour during AAT. Furthermore, patients’ positive emotions, verbal and non-verbal communication, mood, treatment motivation and satisfaction were increased in the presence of an animal. Neutral emotions were reduced but no effect was found regarding negative emotions. Our results show that AAT increases aspects of social competence and leads to higher emotional involvement of patients with acquired brain injury, reflected in higher social engagement, motivation and satisfaction during a therapeutic session.

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.

A One Health Research Framework for Animal-Assisted Interventions

BACKGROUND

The integration of animals into healthcare, referred to as animal-assisted intervention, is a rapidly growing research field and was previously related to One Health. However, the assessment of synergistic effects of animal-assisted interventions (AAI) has been poorly addressed to date.

METHOD

We discuss experiences in integrated human and animal assessments in AAI and provide a methodical framework for One Health approaches in AAI research. We propose theoretical consideration of an integrated human and animal health assessment, as well as the use of such an integrated approach in research. Based on the existing research, we argue that, for a deeper understanding of AAI mechanisms, parallel research designs are needed.

RESULTS AND CONCLUSION

Our paper shows that a One Health study design is necessary to ensure that a tradeoff in health of animals is prevented and that an added value, or synergistic benefit, can be achieved on both sides during animal-assisted interventions.

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.

What am I thinking? Perspective-taking from the perspective of adolescents with autism

Autistic people are often described as being impaired with regard to theory of mind, though more recent literature finds flaws in the theory of mind deficit paradigm. In addition, the predominant methods for examining theory of mind often rely on "observational" modes of assessment and do not adequately reflect the dynamic process of real-life perspective taking. Thus, it is imperative that researchers continue to test the autistic theory of mind deficit paradigm and explore theory of mind experiences through more naturalistic approaches. This study qualitatively examined theory of mind in 12 autistic adolescents through a series of semi-structured interviews. Interpretive phenomenological analysis of the data revealed four core themes in participants' theory of mind experiences and strategies, all of which highlighted how a more accurate representation of autistic theory of mind is one of difference rather than deficit. For instance, data showed that autistic heightened perceptual abilities may contribute to mentalizing strengths and that honesty in autism may be less dependent on systemizing rather than personal experience and choice. Such findings suggest that future research should reexamine autistic characteristics in light of their ability to enhance theory of mind processing. Understanding how an autistic theory of mind is uniquely functional is an imperative step toward both destigmatizing the condition and advocating for neurodiversity.

Juvenile stress induces behavioral change and affects perineuronal net formation in juvenile mice

Background

Many neuropsychiatric disorders develop in early life. Although the mechanisms involved have not been elucidated, it is possible that functional abnormalities of parvalbumin-positive interneurons (PV neurons) are present. Several previous studies have shown that juvenile stress is implicated in the development of neuropsychiatric disorders. We aimed to clarify the effects of juvenile stress on behavior and on the central nervous system. We investigated behavioral abnormalities of chronically-stressed mice during juvenilehood and the effect of juvenile stress on PV neurons and WFA-positive perineuronal nets (PNNs), which are associated with vulnerability and plasticity in the mouse brain.

Results

Due to juvenile stress, mice showed neurodevelopmental disorder-like behavior. Juvenile stressed mice did not show depressive-like behaviors, but on the contrary, they showed increased activity and decreased anxiety-like behavior. In the central nervous system of juvenile stressed mice, the fluorescence intensity of WFA-positive PNNs decreased, which may signify increased vulnerability.

Conclusion

This study suggested that juvenile stressed mice showed behavioral abnormalities, resembling those seen in neuropsychiatric disorders, and increased brain vulnerability.

Seeing More Than Human: Autism and Anthropomorphic Theory of Mind

Theory of mind (ToM) is defined as the process of taking another's perspective. Anthropomorphism can be seen as the extension of ToM to non-human entities. This review examines the literature concerning ToM and anthropomorphism in relation to individuals with Autism Spectrum Disorder (ASD), specifically addressing the questions of how and why those on the spectrum both show an increased interest for anthropomorphism and may even show improved ToM abilities when judging the mental states of anthropomorphic characters. This review highlights that while individuals with ASD traditionally show deficits on a wide range of ToM tests, such as recognizing facial emotions, such ToM deficits may be ameliorated if the stimuli presented is cartoon or animal-like rather than in human form. Individuals with ASD show a greater interest in anthropomorphic characters and process the features of these characters using methods typically reserved for human stimuli. Personal accounts of individuals with ASD also suggest they may identify more closely with animals than other humans. It is shown how the social motivations hypothesized to underlie the anthropomorphizing of non-human targets may lead those on the spectrum to seek social connections and therefore gain ToM experience and expertise amongst unlikely sources.

Affectionate Interactions of Cats with Children Having Autism Spectrum Disorder

Mental and physical benefits of dogs have been reported for adults and children with special needs, but less is known about benefits of cats for children. A cat that can be held by a child could provide important therapeutic companionship for children with severe or less severe autism spectrum disorder (ASD) who otherwise may lack prosocial behaviors. Because relatively little is known about the behavior of cats around children, we conducted this study. Phase 1 gathered web-survey data from families having an adult cat and a child with ASD (n = 64). In Phase 2, there were direct telephone interviews of parents having a child with severe ASD (n = 16) or less severe ASD (n = 11), or typical development (n = 17). From the Phase 1 web survey of families with ASD children (full range of severities), affectionate interactions of the cats with children were common. Most parents with ASD children volunteered positive comments regarding the cat, such as calming the child, being a soothing protector or a guardian. In the interviews in Phase 2, for all three groups, most parents characterized cats as at least moderately affectionate toward the child. However, cats living with severe ASD children were reported to exhibit less affection than those living with typically developing children or children with less severe ASD. A minority of cats in each group showed some aggression to the specified child; this was not elevated with ASD children. Responses suggested that the cats adopted as kittens were more affectionate and less aggressive to all categories of children than those adopted as adults. Overall, participants reported that ASD children's behaviors indicated that they valued the relationship with the cat, similar to typically developing children, pointing to the importance and potential usefulness of selecting affectionate and compatible cats for ASD children.

Measuring the Effects of an Animal-Assisted Intervention for Pediatric Oncology Patients and Their Parents: A Multisite Randomized Controlled Trial

Objective: This multicenter, parallel-group, randomized trial examined the effects of an animal-assisted intervention on the stress, anxiety, and health-related quality of life for children diagnosed with cancer and their parents. Method: Newly diagnosed patients, aged 3 to 17 years (n = 106), were randomized to receive either standard care plus regular visits from a therapy dog (intervention group), or standard care only (control group). Data were collected at set points over 4 months of the child’s treatment. Measures included the State-Trait Anxiety Inventory™, Pediatric Quality of Life Inventory, Pediatric Inventory for Parents, and child blood pressure and heart rate. All instruments were completed by the child and/or his/her parent(s). Results: Children in both groups experienced a significant reduction in state anxiety ( P < .001). Parents in the intervention group showed significantly decreased parenting stress ( P = .008), with no changes in stress among parents in the control group. However, no significant differences between groups over time on any measures were observed. Conclusions: Animal-assisted interventions may provide certain benefits for parents and families during the initial stages of pediatric cancer treatment.

Social rivalry triggers visual attention in children with autism spectrum disorders

Visual social attention is central to social functioning and learning and may act as a reinforcer. Social rivalry, which occurs when an individual is excluded from dyadic interactions, can promote interspecific learning by triggering attention. We applied it to an animal-assisted intervention, where the behaviour of ASD children was compared between an experimental (attention shift of the animal trainer from the dog-child to the dog only) and a control (attention maintained on the dyad) groups (study 1). The results show that ASD children are sensitive to the direction of (visual) social attention and may act, physically and visually, in order to regain it. When the animal trainer concentrated on the dog, the overall visual attention of the ASD children increased, suggesting a heightened awareness towards their environment. They oriented more towards the animal trainer and the dog, contrarily to the control group. The repetition of the procedure was even associated with increased joint attention with the animal trainer (study 2). Thus, ASD children do care about and seek human visual attention. They show an ability to adapt their social behaviour, which questions whether their known deficits in social competencies are hard wired or whether the deficits are in their expression.

Equine Facilitated Therapy for Complex Trauma (EFT-CT)

Emerging research suggests that Equine Facilitated Psychotherapy (EFP) may be beneficial for traumatized youth. In addition, complex trauma (i.e., multiple and/or prolonged developmentally adverse traumatic events which are typically interpersonal in nature) treatment research is still growing and there is a need for the development and examination of novel treatments for youth with complex trauma histories. The current article describes a promising EFP model for this population called Equine Facilitated Therapy for Complex Trauma (EFT-CT). EFT-CT embeds EFP practices within Attachment, Regulation and Competency (ARC), an extant evidence-based complex trauma treatment framework for children and adolescents. The authors provide three case studies using both observational data provided by clinicians, as well as longitudinal measures of psychosocial functioning, to illustrate the potential promise of EFT-CT. The article concludes with a discussion about implications for EFP treatment and research.

The Impact of a Horse Riding Intervention on the Social Functioning of Children with Autism Spectrum Disorder

This paper reports a case-control study of a horse riding intervention for children with autism spectrum disorder (ASD). A sample of 26 children, aged 6 to 9 years, were assigned to either the intervention (n = 12) or control group conditions (n = 14). Pre- and post-tests were carried out using the Childhood Autism Rating Scale, Second Edition (CARS2) and the Aberrant Behaviour Checklist-Community Edition (ABC-C). An observational measure of compliance and behaviour during the horse riding sessions was completed for the intervention group. There was a significant reduction in the severity of ASD symptoms and hyperactivity from pre- to post-test for the intervention group only. These results indicate that the intervention improves some aspects of social functioning for children with ASD.

Assessing Preferences for Animals in Children with Autism: A New Use for Video-Based Preference Assessment

The inclusion of animals into interventions for children with autism spectrum disorder (ASD) is a growing practice known as animal-assisted intervention (AAI). The choice of the animal to include in an intervention is often solely up to the interventionist and depends on their experience, subjective judgment, and ease of access to different animals. For individuals with ASD who are non-verbal and unable to indicate preferred stimuli or activities, incorporating preference into interventions has been linked to increases in positive behaviors and enhanced quality of life. We propose that animal choice based on a participant's preference may enhance the experience of AAI and maximize its outcomes. A common technique used to reliably determine preferred interactions and activities in interventions for children with ASD is a stimulus preference assessment. The video-based multiple-stimulus without replacement (MSWO) procedure, in particular, allows for discrimination of complex stimuli that could not feasibly be presented all at once, which is the case when choosing an animal. Based on the well-documented reliability of this technique in the field of applied behavior analysis, we propose that a future direction in AAI is utilizing video-based MSWO to guide animal selection.

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

Including animals in autism intervention is growing in both research and practice. A systematic literature review was conducted to collate and synthesize all empirical research on animal-assisted intervention (AAI) for autism published from 2012 to 2015. Findings from 28 included studies revealed that AAI programs generally include one animal per participant with a total contact time of approximately 10 hours over the course of 8 to 12 weeks. Research methodology is diverse and though limited in many cases, has improved over the last few years. The most commonly reported outcome was increased social interaction, which was unanimously significant across 22 studies. The need for further research is highlighted, calling for a focus on refining AAI techniques, identifying optimal circumstances for positive change as well as individuals who may not benefit, and independent replication of high quality studies to move AAI from an enrichment activity to an evidence-based practice for autism.

Social-emotional adjustment and pet ownership among adolescents with autism spectrum disorder

Adolescents with Autism Spectrum Disorder (ASD) often experience poor social-emotional adjustment and interactions with peers, but taking care of a family pet may serve as a buffer. This study utilized 81 parent-adolescent dyads to examine how dimensions of pet ownership (responsibility, comfort, companionship) may be associated with social-emotional adjustment (depression, loneliness, friendship quality) among adolescents with ASD, as well as how social impairments may influence these relations. Results revealed that adolescents who took more responsibility for their pet exhibited fewer depressive symptoms. Additionally, parents of more socially impaired adolescents reported better friendship quality than less socially impaired adolescents. Findings suggest taking care of a pet may facilitate better social-emotional adjustment among adolescents with ASD.

Capturing Experiences of Youth With ASD via Photo Exploration: Challenges and Resources Becoming an Adult

Youth with autism spectrum disorder (ASD) experience significant challenges transitioning to adulthood, but we have few firsthand accounts of these issues due to youth’s limited participation in research. In this study, we utilized a qualitative methodology, Photovoice, to understand youth’s perspectives on becoming adults. We recruited 11 youth with ASD, aged 18 to 25, from urban and rural counties in Missouri. Youth described their experiences of becoming adults with pictures; attended group, individual, and discussion photo-sharing sessions; and exhibited their work publicly. This methodology facilitated dialogue and the collection of an array of data including 201 transcription pages and 184 pictures. Thematic analysis identified important topics and patterns. Youth’s discussions and photos captured difficulties transitioning out of school, socialization challenges, and their connection with animals. Five themes emerged: (a) difficulty transitioning into adulthood, (b) desires for and problems with relationship building, (c) feeling different from peers and family, (d) animals as a coping mechanism for negative feelings, and (e) animals as a source of companionship. This study is the first to elicit experiences of youth with ASD during the transition to adulthood and coping techniques. Although youth described many challenges, they showed resilience and used animals as a source of support and socialization.

Pet Face: Mechanisms Underlying Human-Animal Relationships

Accumulating behavioral and neurophysiological studies support the idea of infantile (cute) faces as highly biologically relevant stimuli rapidly and unconsciously capturing attention and eliciting positive/affectionate behaviors, including willingness to care. It has been hypothesized that the presence of infantile physical and behavioral features in companion (or pet) animals (i.e., dogs and cats) might form the basis of our attraction to these species. Preliminary evidence has indeed shown that the human attentional bias toward the baby schema may extend to animal facial configurations. In this review, the role of facial cues, specifically of infantile traits and facial signals (i.e., eyes gaze) as emotional and communicative signals is highlighted and discussed as regulating the human-animal bond, similarly to what can be observed in the adult-infant interaction context. Particular emphasis is given to the neuroendocrine regulation of the social bond between humans and animals through oxytocin secretion. Instead of considering companion animals as mere baby substitutes for their owners, in this review we highlight the central role of cats and dogs in human lives. Specifically, we consider the ability of companion animals to bond with humans as fulfilling the need for attention and emotional intimacy, thus serving similar psychological and adaptive functions as human-human friendships. In this context, facial cuteness is viewed not just as a releaser of care/parental behavior, but, more in general, as a trait motivating social engagement. To conclude, the impact of this information for applied disciplines is briefly described, particularly in consideration of the increasing evidence of the beneficial effects of contacts with animals for human health and wellbeing.

Animal-Assisted Intervention for trauma: a systematic literature review

Animals have a long history of inclusion in psychiatric treatment. There has been a recent growth in the empirical study of this practice, known as Animal-Assisted Intervention (AAI). We conducted a systematic review of the empirical literature on AAI for trauma, including posttraumatic stress disorder (PTSD). Ten studies qualified for inclusion, including six peer-reviewed journal articles and four unpublished theses. Participants were predominantly survivors of child abuse, in addition to military veterans. The presentation of AAI was highly variable across the studies. The most common animal species were dogs and horses. The most prevalent outcomes were reduced depression, PTSD symptoms, and anxiety. There was a low level of methodological rigor in most studies, indicating the preliminary nature of this area of investigation. We conclude that AAI may provide promise as a complementary treatment option for trauma, but that further research is essential to establish feasibility, efficacy, and manualizable protocols.

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

OBJECTIVE

This study expands previous equine-assisted intervention research by evaluating the effectiveness of therapeutic horseback riding (THR) on self-regulation, socialization, communication, adaptive, and motor behaviors in children with autism spectrum disorder (ASD).

METHOD

Participants with ASD (aged 6-16 years; N = 127) were stratified by nonverbal IQ standard scores (≤85 or >85) and randomized to 1 of 2 groups for 10 weeks: THR intervention or a barn activity (BA) control group without horses that used similar methods. The fidelity of the THR intervention was monitored. Participants were evaluated within 1 month pre- and postintervention by raters blinded to intervention conditions and unblinded caregiver questionnaires. During the intervention, caregivers rated participants' behaviors weekly.

RESULTS

Intent-to-treat analysis conducted on the 116 participants who completed a baseline assessment (THR n = 58; BA control n = 58) revealed significant improvements in the THR group compared to the control on measures of irritability (primary outcome) (p = .02; effect size [ES] = 0.50) and hyperactivity (p = .01; ES = 0.53), beginning by week 5 of the intervention. Significant improvements in the THR group were also observed on a measure of social cognition (p = .05; ES = 0.41) and social communication (p = .003; ES = 0.63), along with the total number of words (p = .01; ES = 0.54) and new words (p = .01; ES = 0.54) spoken during a standardized language sample. Sensitivity analyses adjusting for age, IQ, and per protocol analyses produced consistent results.

CONCLUSION

This is the first large-scale, randomized, controlled trial demonstrating efficacy of THR for the ASD population, and findings are consistent with previous equine-assisted intervention studies.

CLINICAL TRIAL REGISTRATION INFORMATION

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

Animals may act as social buffers: Skin conductance arousal in children with autism spectrum disorder in a social context

Children with autism spectrum disorder (ASD) experience high rates of social stress and anxious arousal. Preliminary evidence suggests that companion animals can act as buffers against the adverse effects of social stress in adults. We measured continuous physiological arousal in children with ASD and typically developing (TD) children in a social context during four conditions: (a) a baseline of reading silently, (b) a scripted classroom activity involving reading aloud, (c) free play with peers and toys, and (d) free play with peers and animals (guinea pigs). Our results confirmed heightened arousal among children with ASD compared to TD children in all conditions, except when the animals were present. Children with ASD showed a 43% decrease in skin conductance responses during free play with peers in the presence of animals, compared to toys. Thus, animals may act as social buffers for children with ASD, conferring unique anxiolytic effects.