Honors Undergrad Thesis

7/31/2019 Honors Undergrad Thesis

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Running head: A REVIEW OF ANIMAL-ASSISTED THERAPY

A Review of Animal-Assisted Therapy

Sara H. Tischler

Michigan State University

Honors Capstone Paper

2011


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Abstract

Despite increasing interest in alternative therapies, there is insufficient research in the area

of animal-assisted therapy. Much of the current research has had similar results: that there is

not enough solid evidence to make an accurate conclusion and that more research needs to be

done. However, there have been several studies that show some promising results. Through this

literature review, it can be concluded that there are definite benefits to the use of animal-assisted

therapy, but that more work needs to be done in order to reach a more definite conclusion.

Animal-assisted therapy can be particularly beneficial to individuals on the autism spectrum,

but it is unclear how or why this works and the amount of empirical evidence is relatively low.

This literature review will cover the effects of animal-assisted therapy in a variety of context, but

focus mainly on autism spectrum disorders.

Keywords: animal-assisted therapy, autism, developmental disorders


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Introduction

Alternative medicine is defined as any practice that is used with the intention of healing

and that is not currently within the realm of traditional medicine. The World Health Organization

defines traditional medicine as:

The health practices, approaches, knowledge and beliefs incorporating plant, animal and

mineral-based medicines, spiritual therapies, manual techniques and exercises, applied

singularly or in combination to treat, diagnoses and prevent illnesses or maintain well-

being. (Fact sheet no. 134)

With the passing of time, enormous advances in medical technology have been made, and many

interesting ideas for alternative medicine have come about as a result. Some of these have been

controversial and perhaps even potentially dangerous, while others have been tested and retested

with promising results. One fascinating example of an alternative therapy is animal-assisted

therapy, or AAT. AAT involves the use of an animal (typically a dog but horses, dolphins,

birds, and other animals can be used) to promote the physical and psychological well-being of

a patient. AAT can constitute therapy in the traditional sense of the word but can also include

pet ownership. It can be provided on an individual or group basis. The animals must possess

a specific set of characteristics, such as good temperament and lower energy levels, which are

beneficial to the well-being of the patient and can be smoothly integrated into the individual or

groups treatment plan.

Animal-assisted therapy has been widely praised for its ability to help patients with a

large variety of disabilities, illnesses, and physiological conditions. Most of the information of

the effect of AAT has been patient, family, or therapist testimonies. There have been relatively


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few empirically-based studies conducted on AAT and many of these have been inconclusive.

Perhaps this is because AAT is a fairly new and ever-growing field. Isolated incidents of using

animals for therapeutic purposes occurred during World War II but it wasnt until the 1970s that

the use of animals for therapeutic purposes was not fully established, and the first non-profit

organization dedicated to this endeavor was founded in 1977. The Delta Society is a national

non-profit that incorporates therapy and companion animals into the lives of patients. To become

fully trained in AAT and work for the Delta Society, students must take a course taught by a

certified healthcare professional. Practical applications are taught and the students engage in role-

plays and exercises with the animals. To be sponsored by the Delta Society, therapists must

register with the organization and make an effort to keep up with the latest research through

conferences and additional courses (Delta Society, 2009).

There are many hypothesized benefits of animal-assisted therapy, mostly dealing with

autism spectrum symptoms, medical problems, behavioral issues, and emotional and

psychological well-being. In the 19th century, Florence Nightingale hypothesized that the

presence of a bird in a hospital units kept the patience occupied and happy (Nimer & Lundahl,

2007). Animals have been thought to promote human well-being and physical health for years.

For example, patients get much needed exercise when walking or playing with an animal, and

caring for animals can lead to increased responsibility. Interaction with the animals can give

patients a feeling of companionship, which leads to increased overall happiness.

The following is a review of the current literature on animal-assisted therapy and pet

ownership. The results of each study will be discussed at length, and the potential positive and

negative consequences of AAT will be extensively detailed. While there is likely not enough

evidence at this point to make a solid conclusion as to the potential benefits or risks of AAT, this


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review will attempt to cover as much of the information currently available as possible. This

should aid the field in reaching a fuller understanding of AAT and promote further research.

Effects of Animal-Assisted Therapy and Pet Ownership on Physiological Health

Research has examined the relationship between pet ownership, animal-assisted therapy,

and physiological health. A study by Friedmann et al. (Friedmann, Katcher, Lynch, & Thomas,

1980) focused on the effects of pet ownership on patients with cardiovascular illnesses after

being released from the coronary unit of a hospital. 92 patients with a diagnosis of myocardial

infarction or angina pectoris were first interviewed in the hospital using an inventory of social

data and psychological mood status. Pet ownership was included in the interview. After a year,

fourteen of the patients had died. The physiological health of the remaining patients was

evaluated. Of the 39 patients who had reported owning pets, 11 died. Only 3 of the 52 pet

owners died within the year. After a year, the average physiological severity score of pet owners

was a 2.0 on a 6 point scale. These results suggest that animal affiliation and companionship has

important health effects.

In Australia, a study was conducted in which the health of pet owners was screened in

comparison to individuals without pets. It was found that the risk factors related to

cardiovascular health were noticeably lower in pet owners (Anderson, Reid, & Jennings, 1992).

A follow-up study, however, found no correlation between decreased risk and pet ownership

(Headey, 1999). One reason for this discrepancy could be the different methodologies of the

studies. A later study found that pet owners tended to be in better health than those without pets

(Jorm & Parslow, 2003). This information was obtained from records of physician visits and

medication history. These studies could potentially aid in the understanding of AAT, but the

results are so varied that it is difficult to reach a conclusion. More research needs to be done, and


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it needs to be carried out carefully and methodically in order to obtain meaningful results.

Effects of Animal-Assisted Therapy on Psychological Well-Being

Research has examined the relationship between animal-assisted therapy and human

psychological well-being. It has shown to improve self-esteem and feelings of security, reduce

stress and anxiety, and increase the rate of social interaction and communications (Barba, 1995).

While animal-assisted therapy does lead to better psychological functioning, it is questionable as

to whether or not this is a benefit exclusive to AAT. In a study by Sandra Barker, Ph.D. and

Kathryn Dawson, Ph.D., 313 adult psychiatric patients were referred for therapeutic recreation

over an eight-month period and attended both an animal-assisted therapy group session and a

therapeutic recreation group session. At the beginning and the end of each session, the therapists

administered the State-Trait Anxiety Inventory. The decrease in anxiety after AAT was twice as

great for patients with mood disorders, psychotic disorders, and other disorders than after other

forms of recreational therapy. The researchers suggested that this was due to the heavier

demands of traditional recreational therapy. AAT was easier on patients with psychotic disorders

and was therefore more effective. The researchers also emphasized the importance of repeated

studies. Their methods included only one day per week of AAT, and it is recommended that

more frequent exposure be studied, as it may have a greater impact on participants (Barker &

Dawson, 1998).

Animal-assisted therapy and pet ownership have also shown promising results among the

aging population. For example, married white females were found to be happier when they rated

their level of animal attachment at a five (very attached) (Banks, 2002). 45 residents were

administered the Demographic and Pet History Questionnaire and the UCLA Loneliness Scale.

They were randomized into three groups with varying levels of AAT. One of these groups


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received no AAT whatsoever. The participants were then retested at the end of the study. An

interesting finer point of this study was that those of lower socio-economic status (SES) were

unhappier having pets than those of higher SES. In a follow-up study, it was found that, at the

end of a one-hour AAT session, participants in a long-term care facility for the elderly were

restless and tired. However, all of the residents interviewed had a strong desire for more animal

interaction in their lives, and their feelings of loneliness decreased as a result of the therapy.

Levinson, seen as the father of animal-assisted therapy, conducted studies on young

children in educational contexts. He found that the presence of a therapy animal, in this case a

dog, stimulated social interaction between the child and the human therapist, making for a more

relaxed environment (Levinson, 1969). Levinson discussed the use of a companion animal as a

therapeutic adjunct, finding that an animal decreases the shock of beginning the therapeutic

process and helps the participant become more comfortable with the human therapist. Levinson

also found, however, that the presence of an animal has negative consequences as well. The

patient, especially a child, may feel resentment at having to share the animal with the therapist,

or may feel that the animal has unwillingly been imposed upon him or her.

The most well-known incorporation of animals into the learning environment is the

Reading Education Assistance Dogs program in Salt Lake City, Utah. The program was founded

in 1999 by Intermountain Therapy Animals, who found that all of the students who participated

for 13 months gained at least two grade levels. The researchers suggested that this was due to the

comfort level of the children. The dogs seemed to be a catalyst to reading aloud, something the

children were afraid to do before the implementation of the program. The presence of the dog

also added an element of fun, which promoted relaxation and helped the children forget their

perceived limitations (Bueche, 2003). Similar results were obtained in the Carolina Canines for


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Service program. A group of children who tested below grade level for reading ability were

paired up with a therapy dog once a week for the entire school year. Most of these children

improved their reading level by at least two grade levels (Newlin, 2003). The results of this

particular study, however, are questionable at best, due to the lack of a control variable.

Effects of Animal-Assisted Therapy on Children with Autism Spectrum Disorders and other

Developmental Disabilities

The current literature on the use of animal-assisted therapy and animal-assisted activities

(including pet ownership) on children with autism spectrum disorders (ASD) and other

developmental disabilities shows promising results. A study on 68 children found that nearly half

of them named their pets as a source of emotional support (Melson & Schwartz, 1994). The

children reported that they could tell their pets when they were sad, angry, happy or wanting to

share a secret. Their parents stated that the children were less anxious and withdrawn than other

children as a result of having an animal in the home. Another study found that children who

reported that they had intimate talks with their pets had more empathy toward their peers

(Bryant, 1985). Thus, pet ownership has shown to be particularly useful for children on the

autism spectrum, as a lack of empathy is a common characteristic of the disorder.

While children, especially those with developmental disorders, can be reluctant to open

up to adults and discuss their feelings and problems, and animal-assisted therapy may ease

their stress and anxiety and help them to open up (Fine, 2000). Children might observe the

amount of care the therapist gives to the therapy animal and feel more comfortable and cared

for themselves. In addition, research has shown that the mere presence of a therapy animal can

support inclusion in classrooms. In one study, children without disabilities were ten times more


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likely to interact with a disabled peer if that peer was accompanied by their therapy animal

(Katcher, 1997). This gives support to the idea that therapy animals are an effective social

lubricant.

It is possible that animal-assisted therapy may help children on the autism spectrum

increase attachment and establish bonds with others (George, 1988). The children may transition

from an attachment with the animal to an attachment with a human being, typically their

caregiver (Winnicott, 1986). Because of the difficulties children with developmental disabilties

may have with social interaction, AAT could prove highly effective for them. Children in

particular could benefit from the use of animals as an alternative therapy. Triebenbacher found

that animals are a key part of social development in children (Triebenbacher, 2000). Because

pharmacological methods and many educational therapies have not been effective for all, many

parents and caregivers have turned to alternative treatments. Early research supports using AAT

as a treatment; it was found to increase the rate of pro-social behaviors in children on the autism

spectrum, as well as decrease self-absorption (being in their own world or obsession with

narrow interests) (Redefer & Goodman, 1989).

School is a large part of a childs day, and it also has perhaps the biggest influence on

children, particularly those with developmental disabilities. While it is likely that school staff

and administrators may not be fully supportive of animals in the school setting, AAT is possible

for children in school and can also be helpful not just for the child but for his or her peers. The

children can learn about the animals and about how to treat them, as well as how much they can

help people. While AAT can help the participant with discipline and self esteem, it can do the

same for the children observing these interactions. AAT teaches responsibility in many forms;

children learn to care for an animal and treat it with kindness as well as to work on their therapy


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goals and gain motivation and knowledge (Chandler, 2001).

In a study done by Griess in 2010 on participants with learning disabilities, the children

stated that they were more motivated to read and had positive feelings about interacting

with the therapy dog. Children with autism who may feel unmotivated due to ridicule or a

misunderstanding of their disability may gain some encouragement from the use of a therapy

animal, and perhaps an increase in self-esteem that naturally will lead to greater success.

Animal-assisted therapy can provide children with a source of unconditional love and an outlet

for the expression of emotions (Griess, 2010). A study by Sams et al. in 2006 compared the

effects of AAT on children with autism to those of traditional occupational therapy techniques.

The researchers hypothesized that AAT would have more of an impact in the areas of social

interaction and language use. They found that, when children participated in AAT, they

exhibited greater use of language and social interaction than they did when exposed to traditional

occupational therapy practices. The authors of this particular study even went as far as to say that

AAT should be standard practice for children and families living with autism spectrum disorders.

Another characteristic of autism is stereotypical, repetitive behavior. These are often

referred to as self-stimulating behaviors, or stims. Examples of stimming include hand

gestures, humming, and rocking back and forth. Some of these, such as head banging, can be

dangerous to the child. In a study by Redefer and Goodman, a therapy dog was introduced to

sessions with children on the autism spectrum. It was found that the rate of stereotypical

behaviors decreased after the introduction of the dog, and the rate of socially appropriate

behaviors increased (Redefer & Goodman, 1989). Children with autism can also have deficits in

motor and language skills, as well as emotional control.


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One pilot study in the realm of occupational therapy examined the amount of social

interactions and language use when animals were incorporated into therapy (Sams, Fortney, &

Willenbring, 2006). Twenty-two children with autism participated in the study, and they

received school-based therapy twice per week; once with animals and once without for control

purposes. The children were observed by trained research assistants, who recorded each instance

of social interaction and language use. These instances were classified as either spontaneous

or prompted. The results of the study were obtained using paired-samples t-tests and indicated

that both use of language and social interactions were significantly more common in the sessions

which incorporated an animal. This seems to support the idea that AAT is a beneficial addition

to the lives of children with autism, particularly those that are struggling with deficits in the

areas of language and social interaction.

A study by Martin and Farnum focused on ten children with ASD between the ages of 3

and 13. The children were assessed using the Psycho-educational Profile-Revised, a highly

reliable and valid measure. The PEP-R measures imitation, perception, fine motor control, gross

motor control, hand-eye coordination, cognitive performance, and verbal performance. These

combined measures are used to pinpoint a childs developmental age, and are related to a typical

autism diagnosis. When AAT was incorporated into the childrens treatment, scores on this

assessment increased. In addition, the children laughed more and appeared to be happier and

more relaxed when the therapy dog was present. This study, while lacking in generalizability due

to the smaller sample size, lends support to AAT and its usefulness for children with ASD and

developmental disabilities (Martin & Farnum, 2002).

In another study, fourteen students on the severe end of the spectrum of developmental

disabilities were exposed to animal-assisted therapy in addition to their regular treatment plan at


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a residential facility (Heimlich, 2001). The students were seen for a half an hour each, twice per

week, with a trained animal handler and therapy dog. After evaluating the behavioral outcomes

of the participants using the Measurement of Pet Intervention (created specifically for this

study), it was evident that the data indicated a positive effect in the areas of cognitive

functioning and positive behavior. However, the research team was still unable to draw a solid

conclusion due to a number of confounding variables. Inter-rater reliability was relatively low, as

the opinions of the three research assistants as to the success of the therapy varied.

Administrative support at the residential facility was not as high as the researchers would have

liked. A major issue that came up during the course of the study was the health and well-being of

the therapy animal. Cody, a black Labrador retriever, suffered from a weakened immune system

due to the stress of the therapy sessions and eventually fell ill. He was responsible for all

fourteen sessions and had very little time in between sessions. This brings to light the importance

of having multiple trained and certified therapy animals available. While it is perhaps more

beneficial to have one animal per participant, this does not rule out the possibility of having

different animals for different participants. An additional concern that the researchers had was an

ethical one. They did not find it appropriate to separate the animal and participant as soon as the

therapy sessions were terminated. It is probable that each participant will develop some sort of

emotional bond or relationship with their therapy animal, and the research team suggests that

meetings be planned on an intermittent basis and in a less structured and formal environment

A more unique example of the use of animals in therapy for children with developmental

disabilities is to use them to help with debilitating shyness. A common symptom of autism is

social anxiety and the inability to read social cues. Children with autism can have a large amount

of difficulty in school because of this. The use of therapy animals has been shown to help people


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overcome their shyness. The children can interact with the animal, perhaps by speaking or

reading to it, and use it as practice for communicating with other human beings.

Dogs are not the only viable option for animal-assisted therapy. Other animals,

particularly horses have proven effective therapeutic tools for children with autism. A study by

Bass, et al. worked with existing research to determine the effects therapeutic horseback riding

had on children with autism spectrum disorders, particularly in the social domain of functioning

(Bass, et al., 2009). Therapeutic horseback riding has been defined as using horseback riding to

improve the participants posture, balance, and mobility while helping them to form a

therapeutic bond with the animal, potentially leading to improved social skills (All & Loving,

1999). It is best suited for children with a combination of motor, cognitive, and social difficulties.

Research in the area of therapeutic horseback riding is limited, just as it is for AAT with

a canine. It consists mostly of case studies and anecdotal evidence, as opposed to empirical

studies. Bizub and Bizub (2003) studied the effect of horseback riding therapy on five adult

patients with psychiatric disabilities. The therapy, which was divided into animal bonding

activities, riding skills, and post-ride processing activities with the group, resulted in an increase

in the participants self-esteem, as well as their levels of social engagement and self-efficacy.

This was measured through interviews conducted with both participants and guardians before

and after the therapy took place. They were scored for thematic content such as social skills and

self-esteem by a team of trained researchers.

Macauley and Guiterrez in 2004 studied the effect of horse-assisted therapy on

children with language impairments. The goals of each participant were increase their receptive

and expressive language skills. After the therapy sessions, the parents of the participants reported

that there was an increase in speech and language abilities in their children. When compared to


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traditional therapies, the researchers found that horse-assisted therapy was more successful in

improving the self-concept of the participants. They formed relationships with each other as a

group, as well as with their therapy animal. They also became increasingly confident in their

riding abilities as the therapy progressed, challenging their initial doubts about their abilities.

The riders were able to recognize that they had met their early fears of riding head on, which

seemed to please them. They developed a sense of respect and empathy for animals throughout

the course of therapy, and reported feeling encouraged by the staff and volunteers. Despite these

promising results, this study was conducted on only three young boys, which is obviously not an

accurate representation of the population of children with language impairments or

developmental disabilities.

In regards to motor functioning, an area in which some children on the autism spectrum

have difficulty, Sterba et al. (2002) ran an eighteen-week study to determine if horse-assisted

therapy would have any effect. The researchers split gross motor functioning into five domains

including lying and rolling, sitting, crawling and kneeling, standing and walking/running, and

jumping. It was determined through this study that horse-assisted therapy had a significant

positive impact on all five of these domains

The aforementioned study done by Bass et al. examined the effects of a twelve-week

therapeutic horseback riding program on the social functioning of children with autism. It was

hypothesized that these children would exhibit improvements in their social functioning when

compared to participants who did not receive this particular therapy. A highly trained staff at a

therapeutic riding center was responsible for administering the therapy and sessions were held

one hour per week for a period of 12 weeks. Horse assignments were randomized except in cases

were height and weight adjustments had to be made. Participants engaged in mounting and


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dismounting exercises, riding skills, horsemanship, and playing games while on the horse.

During the course of these activities, the children were expected to form a therapeutic bond with

their assigned horse. At the end of the program, there was an observed increase in social

functioning, as coded by trained researchers, but this may have been due to a number of different

factors. First, exposure to a horse, a relatively novel creature for most children, could have been

what stimulated the children. The introduction of a novel stimulus may have encouraged children

to move away from the more rigid and routine lifestyle that typically comes with autism

spectrum disorders and become more active both physically and socially. Riding a horse is a

multisensory experience, and children with sensory-processing difficulties that are often

associated with autism may have found this particularly stimulating. The environment of the

sessions was highly structured (participants were instructed to listen and follow directions, speak

to and give instruction to their horse, and identify parts of the horse) and this may have

encouraged children to become actively engaged in the activities and maintain this involvement

for extended periods of time. The treatment effects in the areas of fine motor and perceptual

skills, social cognition, and social awareness, however, were not statistically significant. It is

possible that, had the therapy lasted longer than 12 weeks, these results would have improved. It

is also important to note that no information on medication regimens was collected, nor was

parent therapy information, and thus there were some possible confounding variables that could

not be controlled for.

Dolphins have also been used in animal-assisted therapy, but this is an area in which

there is very little research. The use of wild animals such as dolphins is fairly rare as it is, for the

most part, inaccessible, expensive, and highly unpredictable. The major exception to this is the

use of the dolphin. Swimming with dolphins is not as dangerous and has become more feasible


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and accessible to families (Capaldo, 1989). Using dolphins to help people with psychological

disorders dates back to the 1970s, when people realized the healing potential of swimming with

the animals (Cochrane & Callen, 1992). In Betsy Smith, PhDs book, Between Species:

Celebrating the Dolphin-Human Bond(2003), she discussed her work with dolphin-assisted

therapy and children with autism. She reported that the attention spans of the children increased,

and in her 1980s writings, reported that children with autism began reaching out and touching

the dolphins spontaneously within minutes of therapy beginning. Interactive play behavior was

also observed more frequently after the introduction of dolphin-assisted therapy (Smith, 1987).

Dave Nathanson was the first to coin the term dolphin human therapy and he had some

intriguing findings. He studied both verbal and nonverbal children with developmental

disabilities and observed their behavior before and after dolphin-assisted therapy sessions.

Nathanson developed a series of controlled language experiments using dolphins as the teachers.

The goal was to increase sensory stimulation and attention, leading to increased rates of learning.

He found that nonverbal children were four times more likely to respond in some way to the

dolphin than to a parent, and that verbal children improved their vocabulary by up to 13% after

therapy (Nathanson, 1980). When attempting to replicate these results several years later, he

found that children were able to learn information 2 to 10 times faster with greater retention as

compared to the classroom (Nathanson, 1989). This was a six-month study with the same goal of

improved functioning among the children. It was a one-group, reverse-treatment design with

both a pretest and a posttest, and involved interactions with the dolphins from both the dock and

in the water. Parent surveys were collected before and after treatment. It validated the original

study and served as the basis for a treatment program involving dolphins. In 1997, Nathanson

and his colleagues conducted a study involving more children with autism among other


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disabilities. It was very similar in design to the study done in 1989, except this time behaviors

were charted from direct observations and more precautions were taken. For example, the water

temperature was repeatedly measured and the same dolphin and therapist was used every time.

The goal was to see if dolphin-assisted therapy could achieve the same or better results than six

months of traditional therapy. The results showed significantly greater improvement amongst the

children when DAT was utilized, and they also concluded that it was a more cost-effective

option (Nathanson, deCastro, Friend, and McMahon, 1997). Marino and Lilienfeld argued that

there were flaws in the previous studys data and thus their conclusion was premature. They

claimed that the validity of the study was threatened by the natural maturation of the participants,

and thus that Nathanson and his colleagues misinterpreted the results of their study and their data

could not be properly interpreted (Marino and Lilienfeld, 1998).

Other studies have had less promising results. Research done by Servais assessed the

interactions between children with autism and therapy dolphins. The Autidolfijn project was

designed to see if simply swimming with dolphins caused increased learning in children with a

diagnosis of autism. The project consisted of two pretest and posttest designs with a control

group, and the observations were videotaped for coding purposes. The results were inconclusive.

While one group of children displayed some benefits of working with the dolphins, it is highly

possible that they had a better relationship with the human therapist than they did with the actual

animal. Any positive changes were only seen when the child and the therapist had bonded.

Servais suggested that more research be done, and that it is more carefully organized.

Standardized experimental designs should be utilized and the scientific method should be strictly

adhered to (Servais, 1999).


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One issue with dolphin-assisted therapy is that dolphins have been found to prefer the

company of children to that of adults. They keep more distance between themselves and the

adult subjects (Brensing and Linke, 2003). A similar study was conducted in 2005, and it was

found that limited space affected the dolphins attraction to the swimmers and thus the quality of

therapy they were able to provide. The need for large, open spaces and greater distance between

the animal and the participant could negatively affect the outcome of dolphin-assisted therapy

and make it less effective or even ineffective (Brensing, Linke, Busch, Matthes, and Eke van der

Woude, 2005). This is particularly difficult because the therapy will be ineffective if too little

space is provided as well. The perfect amount of space must be determined and provided in order

to make DAT effective, and this is a unique difficulty not encountered in therapy with other

animals.

Potential Concerns of Animal-Assisted Therapy

A common concern to therapy animals in hospitals, schools, and other settings is that of

sanitation. An animal could be a carrier of diseases and infections transmitted from animals to

humans. This is of particular concern in hospital settings. Research has concluded that, while this

risk is certainly present, it can be completely avoided if responsible safety measures are taken

(Brodie, Biley & Shewring, 2002). These safety measures include having everyone involved

wash their hands before and after each visit, providing one-time use barriers such as pads for

the animals to sit on, and adhering to strict grooming and health care measures for every animal.

Therapy animals are also trained not to lick or scratch participants as this is a major way of

spreading infection. They have regular veterinary checkups and are kept in good health. While

trained not to, dogs can occasionally urinate or defecate in the hospital or school environment.

The responsibility of properly cleaning this up lies with their handlers, and they are trained to do


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so thoroughly and quickly. Allergic reactions to the animals are also a possibility. To minimize

the potential for allergic reactions, therapy animals are bathed and groomed immediately before

visiting with participants, and staff is requested to report specific allergies of the participants so

that proper accommodations can be made. This can include holding sessions in large, airy spaces

or outdoors, or simply reducing amount of time the participant is in contact with the animal. The

health and well-being of the animal is also a concern, and every effort should be made to ensure

that the animal is kept relatively stress-free. This includes having multiple therapy animals on

hand for different participants and a decent amount of time between sessions for the animal to

take a break and relax for a period of time.

General safety is another major concern, and this is addressed in therapy animal training

programs. Every animal must graduate from basic obedience classes as well as more specialized

training courses. They are tested for aggression towards humans or other animals and are trained

to stay calm and collected. Therapy animals are trained to the point that they are capable of

coping with situations that would irritate a typical animal or family pet. In some cultures

however, some animals, particularly dogs, are seen as unclean or uncivilized. It is up to the

professionals to determine whether or not the presence of a therapy animal is acceptable to all

participants. It is important that these matters are discussed in a way that is culturally receptive

and respectful. It has been found that, although not all cultures consider dogs to be acceptable

companions, a childs response to them can still be positive and helpful. It is important that

everyone involved keep an open mind. A related concern is that some participants or staff

members might have a fear of dogs or other animals involved in therapy. It is recommended that

professionals refrain from forcing the issue. If necessary, frightened children can stay a good

distance away from the animal and observe its interaction with others. This will allow the child


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to realize that animals are capable of being gentle and loving, and can help reframe their fears

into more positive mindsets.

With the growing recognition of animal-assisted therapy as a legitimate means of helping

people, it is important that professionals and participants alike educate and prepare themselves.

Handlers should ensure that their animals are properly trained and certified, as well as in good

health with up-to-date vaccines and tests. Handlers themselves should also be trained and

certified, and must pass a background test, a TB test, and several other clearances. Risk and

liability concerns should be minimized. Children and other participants should be properly

prepared for their visit with a therapy animal. They should be instructed on how to treat and

handle an animal, and taught to keep the animals safety and well-being in mind. Handlers

should be alert and keep their eyes open for any threatening or unsafe situations that could arise

during the therapy session. Everyone involved should stay calm and be responsible. In todays

society, it is also likely that handlers will have to sign into the building they are visiting and

possibly be screened.

A final concern of note is the cost of animal-assisted therapy. Hiring and training

handlers and animals is a lengthy process, and caring for the animals properly while at the same

time ensuring the handler is compensated can be difficult. Many families have already depleted

their resources on other therapies and treatments, and AAT may not be seen as an option to

them. It is important that every effort be made to help and accommodate families in need,

especially if AAT will be a beneficial and worthwhile part of their childs treatment.

Discussion

It is clear that there is a significant amount of evidence in favor of animal-assisted

therapy, particularly with children on the autism spectrum. However, AAT is a relatively new


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phenomenon that may or may not be right for all children. It is imperative that more research be

done on AAT. A majority of the studies discussed in this review lack scientific control, and

much of the information gleaned has been anecdotal or qualitative rather than quantitative. It is

important that the scientific method is adhered to as more investigating is done on AAT.

There were some significant limitations to the studies discussed. Besides the fact that

there is simply not enough research, many of the studies discussed are not empirical or unbiased.

There are a significant amount of discrepancies among the studies. For example, Anderson,

Reid, and Jennings (1992) had very different results than those found by Headey (1999). This is

due mostly to the different methodologies used by the researchers. The research is inconsistent.

Many of the studies had a very small number of participants, and the sample size was often not a

good representation of the population. This leads to a lack in generalizability. A number of

studies were affected by the natural maturation of the participants, and thus the data is

inconclusive. Overall, the research has been sloppy must consistently adhere to the scientific

method in the future in order to receive higher quality data.

In addition, there is the question of whether or not the benefits found in the studies are

exclusive to animal-assisted therapy. The same benefits could be taken from a variety of other

therapies, but since a majority of the studies discussed failed to appropriately compare and

contrast AAT to other types of therapies, it is unclear. What is also unclear is why AAT seems to

work. Researchers have questioned whether it is simply because of exposure to the animal, or if

a specific bonding process takes place. The full experience of AAT must also be taken into

consideration. The participants may bond with the human therapist over the animal therapist, and

it may be the sensory experience that elicits a change in behavior.


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Katcher (2000) notes that it is unknown whether or not responses to the animal are being

conditioned by the behavior of the owner or therapist, which could be a major flaw in the

therapy. Another issue is the possibility that simply owning a companion animal is as beneficial

to health and well-being as actively participating in animal-assisted therapy. A study done in

South Africa analyzed participants blood before and after interaction with both a pet dog and an

unfamiliar dog. The researchers came to the conclusion that there was a positive impact under

both conditions (Odendaal, 2001), and thus the need for human therapists may not be as great as

believed.

There is a definite need for more and better research in the area of animal-assisted

therapy. A set of standards must be consistently adhered to, and the scientific method should be

followed. Researchers should be unbiased and assistants should be properly trained. More effort

and time should be put into studies, as well as more thought and consideration as to possible

confounding factors and issues that may arise. The research discussed could use a great deal of

fine-tuning, and it should be used as an example of how to improve research on AAT in the

future.

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Honors Undergrad Thesis