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Animal Therapies and Autism. Matt Colligan Caldwell College. Search Terms. PsycINFO Animal-Assisted Therapy + Autism Hippotherapy + Autism Pet Therapy + Autism Dolphin Therapy + Autism Google Search Animal-Assisted Therapy + Autism Dolphin Therapy + Autism Hippotherapy + Autism
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Animal Therapies and Autism Matt Colligan Caldwell College
Search Terms • PsycINFO • Animal-Assisted Therapy + Autism • Hippotherapy + Autism • Pet Therapy + Autism • Dolphin Therapy + Autism • Google Search • Animal-Assisted Therapy + Autism • Dolphin Therapy + Autism • Hippotherapy + Autism • Effects+Animal-Assisted Therapy + Autism • YouTube • Effects+Animal-Assisted Therapy + Autism • Animal-Assisted Therapy+Autism • Dolphin Therapy + Autism
Overview • Definitions • Common Applications • Claims • Brief History • In Practice • Hippotherapy • Dolphin Therapy • Costs • Certifications • Research • Fundamental Concerns • Conclusion
What is Animal Therapy? • Animal-Assisted Therapy (AAT)-A goal directed intervention in which an animal meeting specific criteria is an integral part of the treatment process. • Delivered and/or directed by a health/human service provider working within the scope of his/her profession. • Variety of settings (group or individual) • Documented and evaluated Arkow, P. (n.d.).Animal-Assisted Therapy and Activities. Retrieved from http://www.animaltherapy.net/
What is Animal Therapy? • An animal, such as a dog or horse becomes a basic part of a person’s day • Also referred to as: • AAT-Animal-Assisted Therapy • Pet Therapy-informal/generic • AAA-Animal-Assisted Activities • http://www.deltasociety.org/Document.Doc?id=10 Arkow, P. (n.d.).Animal-Assisted Therapy and Activities. Retrieved from http://www.animaltherapy.net/
Common Applications • Dolphin Therapy • Hippotherapy/Equine Therapy (Horse Therapy) • Bovine Therapy • Canine Therapy • Elephant Therapy • Bird Therapy • Rabbit Therapy • Lizard Therapy • Animal Assisted Therapy Equine Therapy for Children with Asperger's and Autism [Animal Assisted Therapy]. (n.d.). Retrieved from http://www.equine-therapy-programs.com/ database.
Animal Therapy to Treat Autism • Peer-mediated therapy intended to improve social behavior via the use of pets • Dogs-commonly used • Socially demanding qualities • Licking, barking, tendencies to follow • Inherently sociable
Claims • Promote improvement in human physical, social, emotional, and/or cognitive functioning. • Gain self-understanding and emotional growth • Build skills in assertiveness, self-responsibility, non-verbal communication, self-confidence, and self control Arkow, P. (n.d.).Animal-Assisted Therapy and Activities. Retrieved from http://www.animaltherapy.net/
Claims • Healing can occur when a relationship is formed between the two species • May be highly beneficial in addition to other treatments • Recognized lack of research (contrary to AAT site) • Tactile features “draw a child out” • Stimulates development of verbal communication and other objects • Increases self confidence • Leads to increase in willingness to learn skills at school/home Equine Therapy for Children with Asperger's and Autism [Animal Assisted Therapy]. (n.d.). Retrieved from http://www.equine-therapy-programs.com/ database.
Claims • Effects of Animal-Assisted Therapy on Autism (Video 1 of 5) • Effects of Animal Assisted Therapy on Autism (Video 2 of 5) • Effects of Animal Assisted Therapy on Autism (Video 3 of 5) • Effects of Animal Assisted Therapy on Autism (Video 4 of 5) • Effects of Animal Assisted Therapy on Autism (Video 5 of 5)
History • World War II • Corporal William Wynn • Wounded in Philippines • Smoky-Yorkshire Terrier • Dr. Charles Mayo • Commanding Officer of Hospital • Mayo Clinic, Rochester, MN • Smoky-12 years as therapy dog Animal-assisted therapy. (2010, November 10). Retrieved from http://en.wikipedia.org/wiki/Animal-assisted_therapy
History • Elaine Smith • American nurse working in England • Observed therapeutic effect of dogs in hospital • 1976-Created training program for dogs • Nancy Stanley • TLZ (Tender Loving Zoo)- non-profit • Noticed responses of disabled individuals to animals while working at San Diego Zoo Animal-assisted therapy. (2010, November 10). Retrieved from http://en.wikipedia.org/wiki/Animal-assisted_therapy
What Does Animal Therapy Look Like? • Hippotherapy • Horse may choose child • If horse “dips it’s head” or “nuzzles” child in passing • No standard therapeutic protocol • Golden Retriever Helps Boy Come Out of Autism - Friend Like Henry Equine Therapy for Children with Asperger's and Autism [Animal Assisted Therapy]. (n.d.). Retrieved from http://www.equine-therapy-programs.com/ database.
What Does Animal Therapy Look Like? • Specially trained animal and handler teams work in close connection with patient's, doctors, and therapists to accomplish specific, targeted and measurable treatment goals Animal-Assisted Therapy. (2010). Retrieved from http://www.mahalo.com/animal-assisted-therapy
What Does Animal Therapy Look Like? • Therapist teaches child to engage in the care and handling of domestic animals within a classroom or home • May be taught care-taking responsibilities as daily routines Freeman, S. K., Ph.D. (2007). Miscellaneous Therapies: Pet-facilitated Therapy. In The Complete Guide to Autism Treatments (pp. 327-333). Lynden, WA: SKF Books USA, Inc.
Hippotherapy • Hippotherapy is a physical, occupational, and speech-language therapy treatment strategy that utilizes equine movement as part of an integrated intervention program to achieve functional outcomes • Rhythmic and repetitive movement American Hippotherapy Association. (n.d.). Retrieved 2007, from The American Hippotherapy Association, Inc. website: http://www.americanhippotherapyassociation.org/aha_hpot_tool.htm
Hippotherapy • No actual hippotherapists • Trained “therapy professionals” evaluate appropriateness of hippotherapy on individual basis • Therapy professionals work closely with horse handler • Manipulate aspects of horse’s movement to promote favorable outcomes pertaining to a particular therapy American Hippotherapy Association. (n.d.). Retrieved 2007, from The American Hippotherapy Association, Inc. website: http://www.americanhippotherapyassociation.org/aha_hpot_tool.htm
Hippotherapy • Physical Therapists-Address motor needs of each patient • Sitting, standing, walking • Occupational Therapists-Combines effects of equine movement with effects of equine movement • fine motor control, sensory integration, feeding skills, attentional skills, and functional daily living skills • Speech/Language Pathologists-uses equine movement to facilitate the physiologic systems that support speech and language American Hippotherapy Association. (n.d.). Retrieved 2007, from The American Hippotherapy Association, Inc. website: http://www.americanhippotherapyassociation.org/aha_hpot_tool.htm
Hippotherapy • Rowan Isaacson • 7-year-old boy with autism • Autism Therapy On Horseback, The Horse Boy, CNN Dr. Sanjay Gupta Talks With Rupert Isaacson • Riding Out Of Autism's Darkness
Dolphin Therapy • Ten day treatment plan (except Mondays) • Half-hour sessions, followed by dolphin show • http://www.dolphintherapy.eu/article.php?artic=Tedavi Dolphin Therapy. (n.d.). Retrieved from http://www.dolphintherapy.eu
Dolphin Therapy • “…people who spend thousands of dollars for DAT don't just lose out financially, but they put themselves, and the dolphin, at risk of injury or infection.” (Marino, Lori; 2007) • Dolphin "Therapy" a Dangerous Fad, Researchers Warn • Video: The Harmony Program
Temple Grandin • Insights from an Autistic: Autism and Animals • Temple Grandin • Diagnosed with autism in 1950 • Ph.D. in Animal Science from the University of Illinois • 2005-Animals in Translation
Temple Grandin • Autism and Animal Relationships • Argues that language is not a requirement for consciousness • The normal human brain filters out environmental details that animals and individuals with autism do not • The worst thing you can do to an animal is make it feel afraid • Most animals have “super-human skills” or “animal genius” • In comparison to savants in individuals with autism • Animals Make us Human Grandin, T. (n.d.). Animals in Translation. Retrieved from http://www.grandin.com/inc/animals.in.translation.html
Animal Therapy Testimonials • “….It was completely geared towards my child. I even forgot to bring my sons PECS and visuals and the staff had a visual schedule and pictures to help with his program and help with his language. It was amazing.” • “Exceeded my expectations. If anything, staff helped me see that my son was on an even higher level than I thought.” • “The experience makes him happy, builds confidence, fosters independence, positive emotional impact, and motivates use of language.”
Costs • Dolphin Therapy • Five 40 min sessions=$2,600 • $11,800 for three weeks • Prices do not include travel expenses and accommodations • Hippotherapy • One 45 min session=$135 at Special Strides Therapeutic Riding Center in Monroe, NJ Brakes and Williamson. (2007). Research Autism. Retrieved from Research Autism website: http://www.researchautism.net/ autism_treatments_therapies_intervention.ikml?ra=64&infolevel=4&info=costimplications
Costs • Pet Therapy may consist of purchasing a goldfish for $5 • Dolphin Therapy may cost nearly $12,000
Certifications • Hippotherapy Certification Requirements According to American Hippotherapy Association • Mostly OT’s, PT,s and Speech/Language Pathologists • AHA Credentials - HPCS • Animal Assisted Therapies and Activities • Certification Programs • Harcum College in Brym Mawr, PA-Online Courses • Requirements • $875 • No prior credentials necessary • 30 hr online course • 10 hrs clinical observation time • 1 text book
Research • The Effects of Animal-Assisted Therapy in Children with Autism (Farrell, Erin; 2006)-Hamline University • The Effects of Animal Assisted Therapy in Children with Autism • Purpose: to investigate AAT and autism and to see if AAT can be used to help facilitate social communication in autistic students in a school setting • Rationale: by using AAT to capture the attention and motivate each child, AAT will address the core impairments of autism by facilitating social interaction, social communication, and social understanding. By measuring evidence of each of these elements when each child is receiving the AAT, and measuring in a non-AAT environment, there will be evidence of higher social interaction, understanding, and communication in the AAT environment.
Research • Dependent Variables • Social Interaction • Assessed willingness to participate via 1-5 scale • Social Communication • Assessed non-verbal or verbal communication: touching, pulling, throwing a ball, etc… • Social Understanding • Assessed facial gazing, eye contact (Farrell, Erin; 2006)
Research • Measurement Procedure in Regular Classroom • Social Understanding: Facial gazing or eye contact with adult or peer • Social Communication: ASL signals, via PECS, or verbal communication • Initiation of communication with adult or peer • Social Interaction • Willingness to participate teacher/observer rating • 1-Will not participate even with direction by teacher • 2-Will not participate until teacher direction • 3-Participates partially on own, partially with teacher direction • 4-Participates mostly on own, very little teacher direction • 5-Participates entirely on own, no teacher direction needed (Farrell, Erin; 2006)
Research • Measurement Procedure with Claire (dog) • Social Understanding • Facial gazing or eye contact with adult or Claire • Social Communication • Initiation of communication with adult or Claire • Social Interaction • Willingness to participate teacher/observer rating • 1-Will not participate even with direction by teacher • 2-Will not participate until teacher direction • 3-Participates partially on own, partially with teacher direction • 4-Participates mostly on own, very little teacher direction • 5-Participates entirely on own, no teacher direction needed (Farrell, Erin; 2006)
Research • Sessions videotaped in classroom and AAT environment • 6 participants • Videotapes reviewed multiple times • Averaged scores of each tally • t-test conducted to measure each category for statistical significance • Results • Statistically significant results suggested increase in initiations of communication with adults • Mean score of communication with adult without AAT=6.0833 • Mean score of communication with adult with AAT=11.9167 • Difference=5.8333 (Farrell, Erin; 2006)
Research • Willingness to participate without AAT=2.417 • Willingness to participate with AAT=3.5417 • Mean difference=1.0000 • Discussion • Students in a school setting are more willing to participate and initiate communication with AAT • AAT can be used to help students with autism in many areas • There was not much room for experimental control because of the school setting and lack of resources • More research is needed in AAT and autism, this is a beginning • Future research can use more experimental control • Confounds??? (Farrell, Erin; 2006)
Research • The Effect of Therapeutic Horseback Riding on Social Functioning in Children with Autism (Bass, Margaret M.; Duchowny, Catherine A; Llabre, Maria M.; 2009) • Journal of Autism and Developmental Disorders • Purpose: Examine the effects of a 12-week therapeutic horseback riding intervention on social functioning in children with ASD. • Participants: 34 participants diagnosed with ASD • All participants met criterion of DSM-IV • Selected via Agency of Persons with Disabilities and University of Miami’s Center for Autism Related Disabilities • No prior exposure to equine therapy • Randomly assigned to control or experimental group • Prior exposure to conventional therapies
Research • Experimental Group • 2 girls and 17 boys ranging from 5-10 years old • Control Group • 3 girls and 12 boys ranging from 4-10 years old • Measurement Procedure • Social Responsiveness Scale (SRS)-65 item questionnaire that measures the severity of ASD symptoms • Social Awareness-the ability to pick up on social cues • Social Cognition-expressive social communication • Social Communication • Social Motivation-the extent to which a respondent is generally motivated to engage in social-interpersonal behavior • Autistic Mannerisms-the ability to pick up on social cues • Administered to parents and teachers • Examples: “Seems much more fidgety in social situations than when alone” and “doesn’t recognize when others are trying to take advantage of him or her” (Bass, Duchownly, Llabre; 2009)
Research • Sensory Profile (SP) • 125-item questionnaire • Addresses degree to which children exhibit problems in: • Sensory Processing • Modulation • Behavior and Emotional Responses • Procedure • Treatment Group • Therapeutic riding sessions: 1hr per week for 12 weeks (Bass, Duchownly, Llabre; 2009)
Research • Activities • Mounting/Dismounting: verbal, step-by-step instructions • 5 min sessions • Aimed at stimulating verbal communication, proprioception, and vestibular processing • Exercises • 10 min warm-up exercises • Aimed at conditioning participants for physical demands of intervention • Riding Skills • 15 min sessions • Aimed at stimulating sensory seeking, gross, and fine motor domains (Bass, Duchownly, Llabre; 2009)
Research • Mounting • 20 min sessions • Individual/group games on horse focusing on communication and social skills • e.g., “Simon Says” and “Red Light, Green Light” • Horsemanship Activities • 1 hr sessions • Learned care-taking and grooming skills • Learned to identify tools • e.g., body brush, face brush • “Physical” and “verbal” reinforcement (Bass, Duchownly, Llabre; 2009)
Research • Post Session Questionnaire Follow-up • Parents completed measurements following 12-weeks of intervention • Results • Sensory Profile-T-tests revealed that experimental group significantly increased from pre-test to post-test • Control group slightly increased • Social Responsiveness Scale-T-tests revealed that experimental group significantly increased from pre-test to post-test • The Effect of Therapeutic Horseback Riding on Social Functioning in Children with Autism
Research • Discussion • experimental group improved in critical areas such as sensory integration and directed attention • improved social motivation and sensory sensitivity, as well as decreased inattention and distractibility • No change in fine motor, social cognition, and social awareness • Longer treatment may have influenced these areas • Explanations • The horse was reinforcing • The horse, a novel stimulus, may have caused participants to break away from previously sedentary routines • “Highly structured event” may have increased focus (Bass, Duchownly, Llabre; 2009)
Research • Findings are compatible with view that cerebellum plays role in both motor and social domains • “It is possible that therapeutic horseback riding, an activity that demands motor learning skills, motor control, and social engagement is linked to cerebellar functioning” • “Although no measurements were used to directly ascertain the degree of cerebellar movement, the literature above lends support to this interpretation.” • “It is reasonable to suggest that significant treatment effects…may be, in part, attributed to cerebellar stimulation.” (Bass, Duchownly, Llabre; 2009)
Research • No info regarding medications • No info regarding other therapy schedules • Could not ascertain if “change” can be attributed to horseback riding or confounds • Six participants dropped out of experimental group and three dropped out of control group • A more comprehensive study is necessary to assess the influence of the intervention on social functioning (Bass, Duchownly, Llabre; 2009)
Research • Equine Assisted Growth and Learning Association (EAGALA) • Encourage all members to submit research • EAGALA Equine Assisted Growth and Learning Association, Inc. (2009). eagala. Retrieved from Equine Assisted Growth and Learning Association, Inc website: http://www.eagala.org/
Research • Bizubet al. (2003) • Examined the effect of a therapeutic horseback riding program on five adults with longstanding histories of psychiatric disabilities • Three men and two women participated in a 10-week equine therapy program consisting of one session per week for 2 hrs. • Each session was divided into three parts: bonding activities, mounting skills, and post-processing group activities. • At the end of intervention, participants showed higher levels of self-esteem, social engagement, and self-efficacy • No quantitative results available
Research • Macauley and Guiterrez (2004) • Investigated the effect of animal-assisted therapy versus traditional therapies on three young boys with language learning disabilities • Hippotherapy intervention lasted for 6 weeks with each weekly session occurring for 1 hr • Each participant had specific goals that focused on increasing receptive and expressive language, reading, and writing skills • Parents in the hippotherapy group reportedan increase in their child’s overall speech and language abilities • Results indicated that hippotherapy was more successful than traditional therapy in improving participants’ self-concept
Fundamental Concerns • The fact that animals are used does not make an activity a “therapy • We use an array of materials • Are materials therapeutic or techniques?? • Example- “toy therapy” • Animals may be reinforcers…Why??? • Animals have predictable routines Freeman, S. K., Ph.D. (2007). Miscellaneous Therapies: Pet-facilitated Therapy. In The Complete Guide to Autism Treatments (pp. 327-333). Lynden, WA: SKF Books USA, Inc.
Fundamental Concerns • “My child has a dog. In fact she’s had a well-trained dog for the last ten years and has a good relationship with her dog. That said, do I think that the dog has improved her ability to socially interact with other people and would I purchase the dog with this expectation? Of Course not. One thing that I’ve noticed is that having a dog makes people more likely to approach us and ask her questions about her dog. In that respect, the dog indirectly provides her with social opportunities. In addition, I would use the dog as a reinforcer if I thought that would help her learning…” Freeman, S. K., Ph.D. (2007). Miscellaneous Therapies: Pet-facilitated Therapy. In The Complete Guide to Autism Treatments (pp. 327-333). Lynden, WA: SKF Books USA, Inc.
Conclusion • Not inherently dangerous • Dolphin therapy may increase exposure to infections • May be reinforcing to some children • May be able to teach care-taking skills • Not scientifically validated as treatment for autism
References Arkow, P. (n.d.).Animal-Assisted Therapy and Activities. Retrieved from http://www.animaltherapy.net/ Equine Therapy for Children with Asperger's and Autism [Animal Assisted Therapy]. (n.d.). Retrieved from http://www.equine-therapy-programs.com/ database. Animal-assisted therapy. (2010, November 10). Retrieved from http://en.wikipedia.org/wiki/Animal-assisted_therapy Animal-Assisted Therapy. (2010). Retrieved from http://www.mahalo.com/animal-assisted-therapy American Hippotherapy Association. (n.d.). Retrieved 2007, from The American Hippotherapy Association, Inc. website: http://www.americanhippotherapyassociation.org/aha_hpot_tool.htm Freeman, S. K., Ph.D. (2007). Miscellaneous Therapies: Pet-facilitated Therapy. In The Complete Guide to Autism Treatments (pp. 327-333). Lynden, WA: SKF Books USA, Inc. Emory University (2007, December 24). Dolphin 'Therapy' A Dangerous Fad, Researchers Warn. ScienceDaily. Retrieved December 2, 2010, from http://www.sciencedaily.com /releases/2007/12/071218101131.htm Grandin, T. (n.d.). Animals in Translation. Retrieved from http://www.grandin.com/inc/animals.in.translation.html Brakes and Williamson. (2007). Research Autism. Retrieved from Research Autism website: http://www.researchautism.net/ autism_treatments_therapies_intervention.ikml?ra=64&infolevel=4&info=costimplications The American Hippotherapy Association. (2007). Retrieved from http://www.americanhippotherapyassociation.org/aha_edu_credentials.htm Brakes and Williamson. (2007). Research Autism. Retrieved from Research Autism website: http://www.researchautism.net/ autism_treatments_therapies_intervention.ikml?ra=64&infolevel=4&info=costimplications
References Equine Assisted Growth and Learning Association, Inc. (2009). eagala. Retrieved from Equine Assisted Growth and Learning Association, Inc website: http://www.eagala.org/ Dolphin Therapy. (n.d.). Retrieved from http://www.dolphintherapy.eu