The Promise of Service Dogs in Autism
I was in my junior year of college at Ohio State University when my roommate roped me into joining an organization called 4 Paws for Ability, a group that trains service animals to aid children with disabilities. (All it took was “free puppy” to get me on board.) However, as I learned more about the organization based in Xenia, OH, I realized how valuable a service dog could be to a child with a disability like autism.
Autism Spectrum Disorder (ASD) was first characterized in 1943 by Leo Kanner in children who had marked impairments in their ability to relate to others. He deemed this “autistic disturbances of affective contact.” Through the years, the term autism has evolved to refer to a neurodevelopmental disorder characterized by atypical means of communication and behavioral problems. In 2000 this disorder affected approximately 1 in 150 children in the US, with the risk being 5 times higher for boys than girls. ASD has only become more pervasive – according to the CDC, prevalence has almost tripled in recent years. This is likely due to broadening of the definition and increased awareness of autism, leading to an explosion of diagnoses.3 Along with this boom in detection, we have observed that the way in which people on the autism spectrum think, learn, and problem-solve varies wildly.
“Given that autism researchers are still unsure about the etiology of this disorder, it is not surprising that the evidence for effective therapeutic treatments has been lacking.”
There are children who are extremely gifted savants, while others are severely intellectually challenged. While most people with autism are diagnosed during childhood, this is often where the similarities between patients end. The differences in origin, sub-type, and developmental impact of this disorder leads to a wide range of symptoms.
Unsurprisingly, the variety seen in symptoms cannot be traced back to one definitive source. Many genes have been found to increase predisposition to autism, but scientists have found that this can be greatly influenced by environmental factors. Specifically, 400-1000 genes have been found to be linked to ASD susceptibility, largely regulating similar physiological pathways.3 Even so, no definitive genetic cause of this neurodevelopmental condition has been found and, in fact, no genetic contribution has been identified for nearly 70% of diagnosed autism cases. For example, basic research in mice has indicated that heightened immune system activation during pregnancy could contribute to deficits in social interaction as well as the emergence of stereotyped behaviors often seen in autistic children. Additionally, human research has found that a bacterial infection during pregnancy is associated with an increased likelihood of giving birth to a child with ASD.4 Given that autism researchers are still unsure about the etiology of this disorder, it is not surprising that the evidence for effective therapeutic treatments has been lacking.
One roadblock in treatment development has been that research studies aiming to investigate ways to alleviate or manage symptoms of ASD lack empirical review. Although most autistic children undergo some type of behavioral therapy, there is limited evidence that this intervention actually works. Given the variety of symptoms and differences in patient needs, studies of treatment efficacy tend to examine highly variable sample populations, reducing potential effect sizes and making it difficult or impossible to generalize from conclusions. Additionally, only two pharmaceuticals have been approved by the FDA for ASD treatment: risperidone and aripiprazole. But these medications have so many negative side effects that the consequences of taking them may outweigh the benefits they offer. However, advocacy groups like Autism Speaks and the Association for Science in Autism Treatment have grown to support a new therapy option: the autism service dog.
“The idea to offer dogs as a companion and hopefully as a therapeutic treatment was based on evidence that social interactions increase in healthy humans when they are in the presence of a dog.”
The first autism service dog was placed with an ASD child in 1997 by National Service Dogs. The idea to offer dogs as a companion and hopefully as a therapeutic treatment was based on evidence that social interactions increase in healthy humans when they are in the presence of a dog.2 Given that ASD often has symptoms marked by inappropriate behavior towards others, it makes sense that pairing a child with a dog that is specifically trained to nurture a social bond may help autistic children transfer social skills learned with the animal to other people. Additionally, some kids with ASD become overwhelmed by stimulation from the outside world and struggle to process more than one sense at a time. Often, hugs from parents can feel suffocating or noticing a book out of place may lead to a tantrum. A dog can help integrate these sensory experiences by slowly introducing unpredictable auditory, visual, and somatosensory sensations that challenge the child’s ability to appropriately respond to external stimulation – while also associating this with the positive experience of a fluffy animal. Unfortunately, a lot of this reasoning is based on anecdotal stories and assumptions, not scientifically rigorous experiments.
However, there is a substantial amount of evidence that introducing a dog into therapy can reduce the social deficit seen in ASD. Silva and colleagues show that children with dogs included in their treatment are more likely to respond positively to therapy and display less “inappropriate behavior” compared to children without dogs.5 Additionally, Becker and colleagues were able to conclude that animal-assisted behavioral therapy led to mitigation of their social skills deficit, repetitive behaviors, and depressive symptoms.1 These data indicate that using autism service animals as a form of behavioral therapy could alleviate severe symptoms associated with the disorder. Future research needs to meticulously investigate the particular aspects of ASD improved by animal-assisted therapies in order to pinpoint which skills autism dogs need to master to effectively help symptom management.
Throughout history, animals, and dogs in particular, have evolved closely with humans, and there is something about the unique companionship of “man’s best friend” that has mutually benefited both parties. Dogs have been helping on farms, in the military, and as guides to those who are blind for many years. It is high time that we recognize their unique skills in emotional support and stress relief to aid those with mental illnesses. Hopefully, with a little bit more research and advocacy, Fido can help autistic kids around the world build happy, healthy lives.
Written by Caitlin Goodpaster. Illustrated by Gil Torten.
Edited by Desislava Nesheva and Sean Noah.
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References
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.
Harrison, K. L., & Zane, T. (2018, July 25). Is There Science Behind That? Autism Service Dogs. Retrieved from https://asatonline.org/for-parents/becoming-a-savvy-consumer/autism-service-dogs/
Masi, A., Demayo, M. M., Glozier, N., & Guastella, A. J. (2017). An Overview of Autism Spectrum Disorder, Heterogeneity and Treatment Options. Neuroscience Bulletin,33(2), 183-193. doi:10.1007/s12264-017-0100-y
Zerbo, O., Qian, Y., Yoshida, C., Grether, J. K., Water, J. V., & Croen, L. A. (2013). Maternal Infection During Pregnancy and Autism Spectrum Disorders. Journal of Autism and Developmental Disorders,45(12), 4015-4025. doi:10.1007/s10803-013-2016-3
Silva, K., Correia, R., Lima, M., Magalhães, A., & de Sousa, L. (2011). Can dogs prime autistic children for therapy: Evidence from a single case study. The Journal of Alternative and Complementary Medicine, June, 17(7), 655-659.
