Are Autism Assistance Dogs suitable for children of all ages?

When should an Autism Assistance Dog be introduced to a child with autism?

 

Answer:

These questions, coupled with an increase in interest by families in acquiring a dog for their child and ASD researchers attempting to assess the effectiveness of dogs in support of a child and family. However, it is not yet possible to conclusively state that assistance dogs (also called service dogs) are effective companion for a child with ASD, let alone make recommendations as to the desired characteristics and training of dogs or suitable child and family characteristics (e.g., child age, level of functioning, behavioural issues; family type and dynamics). This is because the studies published to date have many limitations.

• Many studies rely on parental reports of child behaviour and functioning and family wellbeing rather than direct observation or objective assessment with reliable scales. This increases the possibility that reported changes to child behaviour and functioning and family wellbeing after the introduction of an assistance dog are perceived rather than real (the Placebo Effect). The expectation, belief or hope that an intervention will be beneficial can lead to a perception that it is effective when in reality it may not be. Therefore, it is always best to back up parents’ judgements with objective measures of changes, such as structured observation and/or assessments of the child and/or family. Many funding organisations ask for this kind of evaluation before they commit themselves to funding an intervention, such as assistance dogs.
• Many of the studies include only a small number of children or families, and given the variability of children with ASD, they often find inconclusive results which can’t be interpreted easily. This is not helped by the large age range of the children included in the studies (for example, 8-18 years; 3-15 years, 4.5-14 years and so on) and by the fact that all studies only include children with high-functioning ASD. Therefore, we cannot say for which children/family a dog would be helpful and for which it would be ineffective or, worse, too risky. We also don’t know at what child-age a dog should be introduced to a family, or indeed, whether a young dog is better than an older one.
• Few studies have included a control group (child/family without a dog) or control condition (same child/family before introduction of a dog). Also the length of time a dog has been in the family is usually not reported. This makes it difficult to know whether any changes in the child’s behaviour and function and family’s wellbeing is because of the dog or something else, including the child’s natural developmental progression.
• Some studies do not discriminate between trained assistance dogs and pet dogs and to our knowledge nobody has investigated whether one is more effective than the other. We also don’t have any evidence for what abilities an assistance dog should be trained for to best be able to support children with ASD and their families. Considering that a trained dog may not be easily obtainable and expensive, this is a research project that is desperately needed.

Preliminary findings to date

There are, however, some preliminary findings that can be gleaned from the available studies.

Attachment to dog

It seems that children with ASD can get attached to dogs and that the presence of a dog can lead to reduced stress and anxiety levels in the child. Their tendency to ‘escape’ from home may also be reduced, because the dog may be trained to watch out for escape attempts and prevent them. Further, if the dog is allowed to sleep in the same room as the child and if the child can tolerate it, it may lead to better sleep for the child (and consequently the family). All these benefits are of great help to the child’s family and contribute to their wellbeing.

However, not all children with ASD get attached to dogs; some remain fearful or worse, if they have aggressive tendencies, may hurt the dog, which of course may lead to the dog defending itself by hurting the child. Some children also have sensory issues with a dog (being sensitive to the fur, the noises a dog makes, its smell etc). Therefore the child and dog need to be supervised closely, especially in the beginning. There is some evidence that a small dog may be better than a large dog, and a dog with a calm and patient temperament is better that a boisterous dog. In one study it was found that a dog may be an additional burden to a family already experiencing increased stress due to having to care for a child with ASD.

Changes in behavior

Some studies report that social interactions, play behaviour and communication improves when the child has developed a good relationship with a dog. However, these findings remain to be corroborated by independent observations or assessments. Only one study (Carlisle, 2014) to date has compared two groups of children with ASD, one that had dogs and the other without. There were very few differences in the level of social skills and number of problem behaviours in the two groups. But there was some evidence that the longer the dog was in the family, the better the child’s social skills and behaviour.

Encouraging indications that the presence of other animals (guinea pigs) can increase positive social behaviours in children with ASD come from another recent study by O’Haire, McKenzie, Beck and Slaughter (2013). They observed children with ASD during play sessions in school either with toys or with guinea pigs. Their social behaviour with their peers during these sessions was scored by independent observers on standardised scales. Participants with ASD were found to show more talking, looking at faces, and making tactile contacts and received more social approaches from their peers in the presence of animals, compared to toys. They also displayed more smiling and laughing, as well as less frowning, crying, and whining in the presence of animals.

Conclusion

The results of our recent studies are encouraging and we await further well-designed studies. Given of the scarcity of reliable evidence to date we are unable to make recommendations either for or against dog ownership in families with a child with ASD.

Further readings

For those who wish to read more about the effectiveness of Autism Assistance Dogs (or other animals) we recommend the following articles:

1. Berry, A., Borgi, M., Francia, N., Alleva, E., & Cirulli, F. (2013). Use of assistance and therapy dogs for children with Autism Spectrum Disorders: A critical review of the current evidence. The Journal of Alternative and Complementary Medicine, 19, 73–80. http://online.liebertpub.com/doi/pdf/10.1089/acm.2011.0835
2. Carlisle, G.K. (2014). The social skills and attachment to dogs of children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45, 1137-1145. http://link.springer.com/article/10.1007/s10803-014-2267-7/fulltext.html
3. O’Haire, M.E. (2013). Animal-assisted intervention for Autism Spectrum Disorder: A systematic literature review. Journal of Autism and Developmental Disorders, 43, 1606-1622. http://link.springer.com/article/10.1007/s10803-012-1707-5/fulltext.html
4. O’Haire M.E. (2013). Review of current evidence and future directions in animal-assisted intervention for children with autism. OA Autism, Mar 10; 1(1):6. http://www.oapublishinglondon.com/article/445
5. O’Haire, M.E., McKenzie, S.J., Beck, A.M. & Slaughter, V. (2013). Social behaviors increase in children with autism in the presence of animals compared to toys. PLoS ONE, 8 (2): e57010. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584132/