Abstract
In the last 5 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.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. United States.
Anderson, S., & Meints, K. (2016). Brief Report: The effects of equine-assisted activities on the social functioning in children and adolescents with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 46(10), 3344–3352.
Ashtari, M., & Sheikh, M. (2018). The effect of swimming with dolphins on the selected balance and strength gross motor skills of eight-year old children with autism spectrum disorder. Sport Science, 11(1), 131–137.
Ávila-Álvarez, A., Alonso-Bidegain, M., De-Rosende-Celeiro, I., Vizcaíno-Cela, M., Larrañeta-Alcalde, L., & Torres-Tobío, G. (2020). Improving social participation of children with autism spectrum disorder: Pilot testing of an early animal-assisted intervention in Spain. Health & Social Care in the Community, 28(4), 1220–1229. https://doi.org/10.1111/hsc.12955
Becker, J. L., Rogers, E. C., & Burrows, B. (2017). Animal-assisted social skills training for children with autism spectrum disorders. Anthrozoös, 30(2), 307–326. https://doi.org/10.1080/08927936.2017.1311055
Beetz, A. M. (2017). Theories and possible processes of action in animal assisted interventions. Applied Developmental Science, 21(2), 139–149. https://doi.org/10.1080/10888691.2016.1262263
Burrows, K. E., Adams, C. L., & Spiers, J. (2016). Sentinels of safety: Service dogs ensure safety and enhance freedom and well-being for families with autistic children. Qualitative Health Research, 18(12), 1642–1649. https://doi.org/10.1177/1049732308327088
Byström, K., Grahn, P., & Hägerhäll, C. (2019). Vitality from experiences in nature and contact with animals-a way to develop joint attention and social engagement in children with Autism? International Journal of Environmental Research and Public Health, 16(23), 4673–4709. https://doi.org/10.3390/ijerph16234673
Carlisle, G. K., Johnson, R. A., Mazurek, M., Bibbo, J. L., Tocco, F., & Cameron, G. T. (2018). Companion animals in families of children with autism spectrum disorder: Lessons learned from caregivers. Journal of Family Social Work, 21(4–5), 294–312. https://doi.org/10.1080/10522158.2017.1394413
Carlisle, G. K., Johnson, R. A., Wang, Z., Brosi, T. C., Rife, E. M., & Hutchison, A. (2020). Exploring human–companion animal interaction in families of children with autism. Journal of Autism and Developmental Disorders, 50(8), 2793–2805. https://doi.org/10.1007/s10803-020-04390-x
Cerino, S., Borgi, M., Fiorentini, I., Correale, C., Lori, A., & Cirulli, F. (2016). Equine-assisted intervention in a child diagnosed with Autism Spectrum Disorder: A case report. Rivista Di Psichiatria, 51(6), 270–274. https://doi.org/10.1708/2596.26730
Coman, D. C., Bass, M. P., Alessandri, M., Ghilain, C. S., & Llabre, M. M. (2018). Effect of equine-assisted activities on social and sensory functioning of children with Autism. Society & Animals: Journal of Human-Animal Studies, 26(6), 551–575. https://doi.org/10.1163/15685306-12341479
De Milander, M., Bradley, S., & Fourie, R. (2016). Equine-assisted therapy as intervention for motor proficiency in children with Autism Spectrum Disorder: Case studies. South African Journal for Research in Sport, Physical Education and Recreation, 38(3), 37–49. https://hdl.handle.net/10520/EJC199894.
Fecteau, S.-M., Boivin, L., Trudel, M., Corbett, B. A., Harrell, F. E. Jr., Viau, R., Champagne, N., & Picard, F. (2017). Parenting stress and salivary cortisol in parents of children with Autism Spectrum Disorder: Longitudinal variations in the context of a service dog’s presence in the family. Biological Psychology, 123(1), 187–195. APA PsycInfo. https://doi.org/10.1016/j.biopsycho.2016.12.008.
Fine, A. H., Tedeschi, P., & Elvolve, E. (2015). Forward thinking: The evolving field of human-animal interactions. In A. H. Fine (Ed.), Handbook on animal-assisted therapy: Foundations and guidelines for animal-assisted interventions (4th ed., pp. 21–36). Elsevier Inc.
Fine, A. H., Beck, A. M., & Ng, Z. (2019). The state of animal-assisted interventions: Addressing the contemporary issues that will shape the future. International Journal of Environmental Research and Public Health, 16(20), 3997–4016. https://doi.org/10.3390/ijerph16203997
Fine, A. H., & Andersen, S. J. (2021). A commentary on the contemporary issues confronting animal assisted and equine assisted interactions. Journal of Equine Veterinary Science, 103436.
Gabriels, R. L., Zhaoxing, P., DeChant, B., Agnew, J. A., Brim, N., & Mesibov, G. (2015). Randomized controlled trial of therapeutic horseback riding in children and adolescents with Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 55(7), 541–549. https://doi.org/10.1016/j.jaac.2015.04.007
Gabriels, R. L., Pan, Z., Guérin, N. A., Dechant, B., & Mesibov, G. (2018). Long-term effect of therapeutic horseback riding in youth with Autism Spectrum Disorder: A randomized trial. Frontiers in Veterinary Science, 5, 156. https://doi.org/10.3389/fvets.2018.00156
Germone, M. M., Gabriels, R. L., Guerin, N. A., Pan, Z., Banks, T., & O’Haire, M. E. (2019). Animal-assisted activity improves social behaviors in psychiatrically hospitalized youth with Autism. Autism, 23(7), 1740–1751. https://doi.org/10.1177/1362361319827411
Grandgeorge, M., Gautier, Y., Brugaillères, P., Tiercelin, I., Jacq, C., Lebret, M.C., & Hausberger, M. (2017). Social rivalry triggers visual attention in children with Autism Spectrum Disorders. Scientific Reports, 7(1). https://doi.org/10.1038/s41598-017-09745-6.
Grandgeorge, M., Dubois, E., Alavi, Z., Bourreau, Y., & Hausberger, M. (2019). Do animals perceive human developmental disabilities? Guinea pigs’ behaviour with children with Autism Spectrum Disorders and children with typical development A Pilot Study. Animals, 9(8), 522.
Grandgeorge, M., Gautier, Y., Bourreau, Y., Mossu, H., & Hausberger, M. (2020). Visual attention patterns differ in dog vs. cat interactions with children with typical development or Autism Spectrum Disorders. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.02047.
Grandin, T., Fine, A. H., O’Haire, M. E., Carlisle, G. K., & Bowers, C. M. (2015). The role of animals for individuals with Autism Spectrum Disorder. In A. H. Fine (Ed.), Handbook on animal-assisted therapy: Foundations and guidelines for animal-assisted interventions (4th ed., pp. 225–236). Academic Press.
Griffioen, R., van der Steen, S., Cox, R. F. A., Verheggen, T., & Enders-Slegers, M. J. (2019). Verbal interactional synchronization between therapist and children with Autism Spectrum Disorder during dolphin assisted therapy: Five case studies. Animals: an Open Access Journal from MDPI, 9(10), 716–731. https://doi.org/10.3390/ani9100716
Hall, S. S., Wright, H. F., Hames, A., & Mills, D. S. (2016). The long-term benefits of dog ownership in families with children with Autism. Journal of Veterinary Behavior: Clinical Applications and Research, 13(1), 46–54. https://doi.org/10.1016/j.jveb.2016.04.003
Harris, A., & Williams, J. M. (2017). The impact of a horse riding intervention on the social functioning of children with Autism Spectrum Disorder. International Journal of Environmental Research and Public Health, 14(7), 776–795. https://doi.org/10.3390/ijerph14070776
Hart, L. A., Thigpen, A. P., Willits, N. H., Lyons, L. A., Hertz-Picciotto, I., & Hart, B. L. (2018). Affectionate interactions of cats with children having Autism Spectrum Disorder. Frontiers in Veterinary Science, 5(1). https://doi.org/10.3389/fvets.2018.00039.
Harwood, C., Kaczmarek, E., & Drake, D. (2019). Parental perceptions of the nature of the relationship children with Autism Spectrum Disorders share with their canine companion. Journal of Autism and Developmental Disorders, 49(1), 248–259. https://doi.org/10.1007/s10803-018-3759-7
Hill, J. R., Ziviani, J., & Driscoll, C. (2020a). “The connection just happens”: Therapists’ perspectives of canine-assisted occupational therapy for children on the Autism spectrum. Austrailian Occupational Therapy Journal, 67(6), 550–562. https://doi.org/10.1111/1440-1630.12680
Hill, J. R., Ziviani, J., & Driscoll, C. (2020b). Canine-assisted occupational therapy for children on the Autism spectrum: Parents’ perspectives. Australian Occupational Therapy Journal, 67(5), 427–436. https://doi.org/10.1111/1440-1630.12659
Hill, J., Ziviani, J., Driscoll, C., Teoh, A. L., Chua, J. M., & Cawdell-Smith, J. (2020c). Canine assisted occupational therapy for children on the Autism spectrum: A pilot randomised control trial. Journal of Autism and Developmental Disorders, 50(11), 4106–4120. https://doi.org/10.1007/s10803-020-04483-7
Höfer, J., Hoffmann, F., & Bachmann, C. (2017). Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review. Autism, 21(4), 387–402.
Johnson, S. C. (2003). Detecting agents. Philosophical Transactions of the Royal Society of London. Series b, Biological Sciences, 358, 549–559. https://doi.org/10.1098/rstb.2002.1237
Jorgenson, C. D., Clay, C. J., & Kahng, S. (2020). Evaluating preference for and reinforcing efficacy of a therapy dog to increase verbal statements. Journal of Applied Behavior Analysis, 53(3), 1419–1431. https://doi.org/10.1002/jaba.668
Julius, H., Beetz, A., Kotrschal, K., Turner, D., & Uvnäs-Moberg, K. (2013). Attachment to pets: An integrative view of human-animal relationships with implications for therapeutic practice. Hogrefe Publishing.
Kalmbach, D., Wood, W., & Peters, B. C. (2020). Parental perspectives of occupational therapy in an equine environment for children with Autism Spectrum Disorder. Occupational Therapy in Health Care, 34(3), 230–252. https://doi.org/10.1080/07380577.2020.1751903
Kazdin, A. E. (2017). Strategies to improve the evidence base of animal-assisted interventions. Applied Developmental Science, 21(2), 150–164. https://doi.org/10.1080/10888691.2016.1191952.
Klinger, L. G., Cook, M. L., & Dudley, K. M. (2020). Predictors and moderators of treatment efficacy in children and adolescents with Autism Spectrum Disorder. Journal of Clinical Child & Adolescent Psychology, 0(0), 1–8. https://doi.org/10.1080/15374416.2020.1833735.
Kregiel, A., Zaworski, K., & Kolodziej, E. (2019). Effects of animal-assisted therapy on parent-reported behaviour and motor activity of children with Autism Spectrum Disorder. Health Problems of Civilization, 13(4), 273–278. https://doi.org/10.5114/hpc.2019.90013
Kwon, S., Sung, I. Y., Ko, E. J., & Kim, H. S. (2019). Effects of therapeutic horseback riding on cognition and language in children with autism spectrum disorder or intellectual disability: A preliminary study. Annals of Rehabilitation Medicine, 43(3), 279–288. https://doi.org/10.5535/arm.2019.43.3.279
LaB NioHNH. (2021). Study Quality Assessment Tools. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.
Levinson, B. (1983). In B. Katcher, & A. Beck (Eds.), New perspectives on our lives with companion animals (p. 283). Philadelphia University of Pennsylvania Press.
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. British Medical Journal, 339, b2700. https://doi.org/10.1136/bmj.b2700
Llambias, C., Magill-Evans, J., Smith, V., & Warren, S. (2016). Equine-assisted occupational therapy: Increasing engagement for children with Autism Spectrum Disorder. American Journal of Occupational Therapy, 70(6). https://doi.org/10.5014/ajot.2016.020701.
London, M. D., Mackenzie, L., Lovarini, M., Dickson, C., & Alvarez-Campos, A. (2020). Animal assisted therapy for children and adolescents with Autism Spectrum Disorder: Parent perspectives. Journal of Autism and Developmental Disorders, 50(12), 4492–4503. https://doi.org/10.1007/s10803-020-04512-5
Malcolm, R., Ecks, S., & Pickersgill, M. (2018). ‘It just opens up their world’: Autism, empathy, and the therapeutic effects of equine interactions. Anthropology & Medicine, 25(2), 220–234. https://doi.org/10.1080/13648470.2017.1291115
McNicholas, J., & Collis, G. M. (2000). Dogs as catalysts for social interactions: Robustness of the effect. The British Journal of Psychology, 91(1), 61–70. https://doi.org/10.1348/000712600161673
Michelotto, A. L. L., Anater, A., Guebert, M. C. C., Borges, T. D., Michelotto, P. V., Jr., & Pimpao, C. T. (2019). Animal-assisted activity for children with Autism Spectrum Disorder: Parents’ and therapists’ perception. Journal of Alternative and Complementary Medicine, 25(9), 928–929. https://doi.org/10.1089/acm.2019.0196
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group TP. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLOS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
O’Haire, M. E. (2013). Animal-assisted intervention for Autism Spectrum Disorder: A systematic literature review. Journal of Autism and Developmental Disorders, 43(7), 1606–1622. https://doi.org/10.1007/s10803-012-1707-5
O’Haire, M. E. (2017). Research on animal-assisted intervention and Autism Spectrum Disorder, 2012–2015. Applied Developmental Science, 21(3), 200–216. https://doi.org/10.1080/10888691.2016.1243988
O’Haire, M. E., Germone, M. M., Daigle, C. L., Gabriels, R. L. (2015). Development and initial validation of the OHAIRE-M1. International Society for Anthrozoology (ISAZ) Conference.
Ozyurt, G., Ozcan, K., Elikucuk, C. D., Odek, U., & Akpinar, S. (2020). Equine assisted activities have positive effects on children with Autism Spectrum Disorder and family functioning. Montenegrin Journal of Sports Science and Medicine, 9(2), 51–58. https://doi.org/10.26773/mjssm.200909
Palley, L. S., O’Rourke, P. P., & Niemi, S. M. (2010). Mainstreaming animal-assisted therapy. ILAR Journal, 51(3), 199–207. https://doi.org/10.1093/ilar.51.3.199
Pan, Z., Granger, D. A., Guérin, N. A., Shoffner, A., & Gabriels, R. L. (2019). Replication pilot trial of therapeutic horseback riding and cortisol collection with children on the Autism spectrum. Frontiers in Veterinary Science, 5, 312. https://doi.org/10.3389/fvets.2018.00312
Peters, B. C., Wood, W., Hepburn, S., & Bundy, A. (2020). Pilot study: Occupational therapy in an equine environment for youth with Autism. OTJR : Occupation, Participation and Health, 40(3), 190–202. https://doi.org/10.1177/1539449220912723
Petty, J. D., Pan, Z., Dechant, B., & Gabriels, R. L. (2017). Therapeutic horseback riding crossover effects of attachment behaviors with family pets in a sample of children with Autism Spectrum Disorder. International Journal of Environmental Research and Public Health, 14(3). https://doi.org/10.3390/ijerph14030256.
Politte, L. C., Howe, Y., Nowinski, L., Palumbo, M., & McDougle, C. J. (2015). Evidence-based treatments for Autism Spectrum Disorder. Current Treatment Options in Psychiatry, 2(1), 38–56. https://doi.org/10.1007/s40501-015-0031-z
Protopopova, A., Matter, A. L., Harris, B. N., Wiskow, K. M., & Donaldson, J. M. (2020). Comparison of contingent and noncontingent access to therapy dogs during academic tasks in children with Autism Spectrum Disorder. Journal of Applied Behavior Analysis, 53(2), 811–834. https://doi.org/10.1002/jaba.619
Rodriguez, K. E., Greer, J., Yatcilla, J. K., Beck, A. M., & O’Haire, M. E. (2020). The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PloS one, 15(12). https://doi.org/10.1371/journal.pone.0243302.
Schulz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMC Medicine., 8(1), 18. https://doi.org/10.1136/bmj.c332
Specialist Unit for Review Evidence. (2021). Critical appraisal checklists. https://www.cardiff.ac.uk/specialist-unit-for-review-evidence/resources/critical-appraisal-checklists.
Silva, K., Lima, M., Santos-Magalhães, A., Fafiães, C., & de Sousa, L. (2018). Can dogs assist children with severe Autism Spectrum Disorder in complying with challenging demands? An exploratory experiment with a live and a robotic dog. Journal of Alternative and Complementary Medicine, 24(3), 238–242. https://doi.org/10.1089/acm.2017.0254
Silva, K., Lima, M., Santos-Magalhães, A., Fafiães, C., & de Sousa, L. (2019). Living and robotic dogs as elicitors of social communication behavior and regulated emotional responding in individuals with Autism and severe language delay: A preliminary comparative study. Anthrozoös, 32(1), 23–33. https://doi.org/10.1080/08927936.2019.1550278
Souza-Santos, C., dos Santos, J. F., Azevedo-Santos, I., & Teixeira-Machado, L. (2018). Dance and equine-assisted therapy in Autism Spectrum Disorder: Crossover randomized clinical trial. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 15(5), 284–290.
Tan, V.X.-L., & Simmonds, J. G. (2018). Parent perceptions of psychosocial outcomes of equine-assisted interventions for children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 48(3), 759–769. https://doi.org/10.1007/s10803-017-3399-3
van der Steen, S., Heineman, M. M. P., & Ernst, M. J. A. (2019). Evaluating animal-assisted interventions: An empirical illustration of differences between outcome measures. Animals: An Open Access Journal from MDPI, 9(9). https://doi.org/10.3390/ani9090645.
Vitztum, C., & Urbanik, J. (2016). Assessing the dog: A theoretical analysis of the companion animal’s actions in human-animal interactions. Society & Animals, 24(2), 172–185. https://doi.org/10.1163/15685306-12341399
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., et al. (2014). The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Wijker, C., Steen, S. van der, Spek, A., Leontjevas, R., & Enders-Slegers, M.-J. (2020a). Social development of adults with Autism Spectrum Disorder during dog-assisted therapy: A detailed observational analysis. International Journal of Environmental Research and Public Health, 17(16). https://doi.org/10.3390/ijerph17165922.
Wijker, C., Leontjevas, R., Spek, A., & Enders-Slegers, M.-J. (2020b). Effects of dog assisted therapy for adults with Autism Spectrum Disorder: An exploratory randomized controlled trial. Journal of Autism and Developmental Disorders, 50(6), 2153–2163. https://doi.org/10.1007/s10803-019-03971-9
Wilson, E. O. (1984). Biophilia. Cambridge, MA: Harvard University Press.
Funding
This publication was made possible in part by Grant TL1TR002531 (T. Hurley, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Nieforth, L.O., Schwichtenberg, A.J. & O’Haire, M.E. Animal-Assisted Interventions for Autism Spectrum Disorder: A Systematic Review of the Literature from 2016 to 2020. Rev J Autism Dev Disord 10, 255–280 (2023). https://doi.org/10.1007/s40489-021-00291-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40489-021-00291-6