Effectiveness of animal-assisted activities and therapies for autism spectrum disorder: a systematic review and meta-analysis

Abstract

Background: Given the rising interest in complementary therapeutic strategies for autism spectrum disorder (ASD), this research aims to provide a comprehensive analysis of the impact of animal-assisted activities and therapies (AAAT) on various ASD symptoms.

Methods: A meticulous search of databases, including Scopus and PubMed, was conducted to gather relevant research on AAAT for ASD. This process led to the selection of 45 studies encompassing 1,212 participants. The chosen studies were then subjected to a meta-analysis to evaluate the efficacy of AAAT in alleviating core ASD symptoms.

Results: The meta-analysis revealed significant improvements in several core ASD symptoms due to AAAT. Notably, there were improvements in social communication (MD = -4.96, 95% CI [-7.49, -2.44]), irritability (MD = -2.38, 95% CI [-4.06, -0.71]), hyperactivity (MD = -4.03, 95% CI [-6.17, -1.89]), and different word usage skills (MD = 20.48, 95% CI [7.41, 33.55]). However, social awareness (MD = -1.63, 95% CI [-4.07, 0.81]), social cognition (MD = -3.60, 95% CI [-9.36, 2.17]), social mannerisms (MD = -0.73, 95% CI [-2.55, 1.09]), social motivation (MD = -1.21, 95% CI [-2.56, 0.13]), lethargy (MD = -1.12, 95% CI [-3.92, 1.68]), and stereotypical behaviors (MD = -0.23, 95% CI [-1.27, 0.80]) did not significantly improve.

Conclusion: The study demonstrates the potential of AAAT in improving certain core symptoms of ASD, such as social communication, irritability, hyperactivity, and word usage skills. However, the effectiveness of AAAT in other ASD symptom domains remains uncertain. The research is limited by the absence of long-term follow-up data and a high risk of bias in existing studies. Therefore, while the findings indicate the promise of AAAT in specific areas, caution is advised in generalizing its efficacy across all ASD symptoms.

Keywords: animal-assisted activities and therapies; animal-assisted interventions; animal-assisted therapy; autism spectrum disorder; autistic disorder; meta-analysis.

Figure 1

Flow diagram of systematic review and meta-analysis.

Figure 2

The number of publications and keywords citation bursts. AAI, Animal-assisted interventions; ASD, Autism spectrum disorder. Search terms in Web of Science (SCIE and SSCI): (1) TS = (“Animal Assisted Therapy”) OR TS = (“Animal Assisted Therap*”) OR TS = (“Therap*, Animal Assisted”) OR TS = (“Animal Facilitated Therap*”) OR TS = (“Animal Assisted Intervention*”) OR TS = (“Animal Assisted Activit*”) OR TS = (“Pet Therap*”) OR TS = (“Pet Assisted Therap*”) OR TS = (“Equine-Assisted Therapy”) OR TS = (“Equine Assisted Therap*”) OR TS = (“Equine Assisted Psychotherap*”) OR TS = (“Hippotherap*”) OR TS = (“Horseback Riding Therap*”) OR TS = (“Canine Assisted Therap*”) OR TS = (“Dog Assisted Therap*”) OR TS = (“Animal-Assisted Counseling”) OR TS = (“Animal-Assisted Education”) OR TS = (“Dolphin Assisted Therapy”) (2) TS = (“autism spectrum disorder”) OR TS = (“autistic spectrum disorder*”) OR TS = (“ASD”) OR TS = (“disorder, autistic spectrum”) OR TS = (“asperger syndrome”) OR TS = (“autis*”) OR TS = (“Pervasive Developmental Disorders”) OR TS = (“Rett syndrome”) OR TS = (“childhood disintegrative disorder”).

Figure 3

Quality assessment of included studies. This calculated by random-effects REML model; BA, barn activity; OT, occupational therapy.

Figure 4

(A) Forest plot of social function by SRS. (B) Forest plot of language ability by SALT.

Figure 5

(A) Forest plot of behavioral and physical function by ABC-C. (B) Forest plot of behavioral and physical function by VABS.