Effects of Therapy Dogs on Social Behavior in Group Social Skills Instruction With Children With Autism

Approximately 1 in 68 children are diagnosed with autism spectrum disorder (ASD). The most
detrimental hallmarks of autism are significant deficits in social and conversational skills,
resulting in difficulties forming and maintaining social relationships. Children who have few
friends are at a high risk for having depression, doing poorly in school, and not being
employed as adults. Animal-Assisted Interventions (AAI) have been shown to increase social
behavior in both children with ASD as well as in various human populations. Children with ASD
display more social behavior in a classroom setting when a therapy dog is present, but while
the effect dogs have on increasing social behavior has been well-established, the mechanism
by which this increase occurs remains elusive.

Our long-term goal is to identify causal mechanisms that may ameliorate the social behavior
deficit in autism. The specific goal of this research is to identify the mechanisms involved
in the social-enhancing effect of dogs on children with ASD. Our central hypothesis is that
therapy dogs have a specific and measurable effect on children's social behaviors.
Furthermore, by directly testing a number of significant confounds frequently found in AAI
research (novelty effects and the effects of the dog on the therapist), the investigators
will rule out alternative hypotheses. It has been suggested that the effects of AAI are
partly caused by the novelty of having an animal in a location where animals are not
typically seen (such as a classroom) rather than caused by an underlying feature specific to
the animal. Additionally, the therapist's potentially altered quality of instruction in
response to the presence of a dog in the room has not been previously explored.

The investigators will attain our goal by incorporating therapy dogs into an established
group social skills instruction program for children with ASD, using a quasi-experimental,
repeated-measures counter-balanced mixed design with physiological and behavioral outcome
measures. Furthermore, using a rigorous experimental single-subject design, the investigators
will assess the effect of the dogs on therapists. Group social skills instruction
interventions based on the principles of applied behavior analysis (ABA) and that target
conversational and communication skills have been shown as particularly successful at
improving social behavior in individuals with ASD. Despite the beneficial outcomes, any
educational interventions, especially those that require social interaction, can be a source
of stress for children with ASD, and stress can impact learning and memory. Creating an
educational setting that balances the levels of stress is beneficial. Dogs may have a
stress-ameliorating effect on the child, thereby allowing social behavior to emerge during
the instructional period and enhance the child's ability to learn social skills. Another
barrier to effective instruction may be that peer-to-peer contact is perceived as highly
aversive to children with ASD. Thus, by providing a non-judgmental therapy dog learning
partner, the children may first practice social skills in a safer environment, free from
negative feedback.

Aim 1: Identify the mechanism by which dogs increase group social behavior in children with
ASD.

The investigators will directly test two complementary hypotheses: (1) stress-ameliorating
effect of the dog on the child, and (2) the dog as a non-judgmental learning partner. The
investigators predict that the presence of the dog in group social skills instruction program
(n = 72 children, with 8 children per group) will not only improve the quantity and quality
of social behavior, but also reduce physiological (salivary cortisol, heart rate, and
electrodermal activity) and behavioral signs of stress compared to the absence of the dog.
The investigators further predict that during therapy sessions with dogs, most of the
children's social behavior will be directed towards the dog rather than peers.

Aim 2: Identify if and how repeated exposure to the dog influences social behavior of
children with ASD.

The investigators hypothesize that repeated exposure to the therapy dog across sessions will
alter 1) the preference to spend time with the dog, as measured by changes in time spent in
proximity, and 2) the social-enhancing effects of the dog.

Aim 3: Identify the effects of the dog on the therapist. The investigators hypothesize that
during repeated sessions with the dog, therapists (n = 6) will experience less stress (as
measured by salivary cortisol, heart rate, and electrodermal activity), engage in more social
and affiliative behavior towards the children, and deliver higher quality instruction.

The outcomes of this research will lead to significant enhancements in the current
understanding of the mechanism by which dogs increase social behavior in children with ASD.

The innovative combination of methodologies from animal science and ABA therapy is uniquely
suited for the determination of the mechanism of the social-enhancement effect of dogs. By
measuring both behavioral responses and physiological biomarkers of stress during the
intervention, the investigators will determine the mechanism through a rigorous and
all-inclusive approach. Furthermore, by directly assessing two key confounding variables, the
novelty effect and the effect of the dog on the therapist, the investigators will pave the
way for more rigorous research into AAI. Completion of this research will expand our
knowledge about the mechanism by which dogs may benefit children with ASD, introduce new
intervention methods to provide longer-term benefits for children, and provide a starting
point for research into new interdisciplinary technology using animals in ABA-based therapy.

Inclusion Criteria:

- Children 11-17 years of age

- Children with a diagnosis of autism spectrum disorder (ASD)

- Children with receptive and expressive language skills

Exclusion Criteria:

- Foster children

- Children with a phobia of dogs as reported by a parent or any behavioral signs during
the study (crying, withdrawing from dog, body shaking, verbal report, etc.)

- Children with a history of animal mistreatment, abuse, or aggressive behavior toward
animals as reported verbally by parents and/or through the screening questionnaire
(Children's Attitude and Behaviors towards Animals, CABTA), or any behavioral signs
(attempts to swat, hit, pinch, kick or pull the dog's hair) during the study

- Children who have a service animal as reported by the parent