Animal-assisted Interventions for Individuals with Autism

Merope Pavlides

• Publisher: Jessica Kingsley Publishers
• Year: 2008
• Print ISBN: 9781849854665
• eBook ISBN: 9781846427954
• Topic: Psychology
• Subtopic: Inclusive Education
• Index: Psychology

This book looks at how therapies involving animals can be used to help individuals with autism to develop skills, including sensory and social skills, to manage challenging behaviors, and improve quality of life.

Whether participating in therapeutic horseback riding, utilizing a trained service dog, visiting a dolphin therapy center, or simply experiencing companion animal therapy, people with autism can reap a multitude of benefits from interaction with furry, feathered, and finned friends. Merope Pavlides relates the success stories of different animal-assisted interventions, as well as noting the challenges of working with particular animal species. She also emphasizes the importance of tailoring interventions to the specific needs of the individual and of monitoring progress.

With recommendations for resources and further reading, this book will be of great interest to people with autism, their parents, and the professionals who work with them.

CHAPTER ONE

Introduction

I remember clearly the moment I realized that my son, Kyle, had autism. I was in the basement, feeding our three dogs. We had yet to be given a formal diagnosis for Kyle and I had been reading and researching all manner of learning disabilities and childhood illnesses. Nothing seemed to fit the composite of developmental delays and challenging behaviors he was exhibiting. The description of autism didn’t match perfectly either—nothing I had read referred to it as a spectrum disorder, nor indicated how individualized symptoms could be. Yet little else made sense, and some of the descriptions of behaviors associated with autism were excruciatingly familiar. When the light bulb switched on, and I realized this was what we were facing, I sat down hard on the dog food bin. All three mixed breeds looked up at me with curiosity, munching kibble. In that instant, the life of my family changed forever, for better and for worse.

Kyle was diagnosed in the spring of 1995, just as he was turning four. A few years later our younger son, Jake, was also diagnosed with learning disabilities. The past twelve years have proven to be amazing in so many ways, not only for us personally, but also for the autism community. When we were searching for answers for Kyle, information on autism was difficult to locate. Now parents are overwhelmed with research, services, and advice. Until we began attending support groups, we knew no other parents who had children with autism. Now it seems as though everyone has a friend or family member touched by an ASD. Most importantly, when we were given Kyle’s diagnosis we were told that his future looked grim. I would like to think that no parent hears an autism diagnosis today without also being given a myriad of reasons for hope.

When Kyle was born, he came home to a multi-dog household. We joked that he, like Kipling’s Mowgli, would be raised by a pack of wild canines. He was intrigued with the dogs’ activities from the moment he could focus on them. Although he displayed little interest in other children, the antics of the canine pack never failed to elicit giggles. And whenever given the opportunity, he would snuggle up against our Sheltie mix, his little fingers buried in her silky fur.

When Kyle was diagnosed with autism, we searched for therapeutic options that made sense for his particular needs. Another parent mentioned the existence of a nearby therapeutic riding center. Knowing that Kyle’s love of animals was central to his personality, and being a rider myself, I quickly put him into the program. Watching my son and other children with autism on horseback convinced me that I should begin volunteering at the center. Soon I was teaching therapeutic riding to other children with autism, which I would do for two years. Thus my instinctual perception that interaction with animals was therapeutic for my son developed into a conviction that utilizing animals in teaching children with autism was a valuable and underused protocol.

Autism Spectrum Disorders

Autism is a complex disability with symptoms that differ from individual to individual. One child may lack expressive language and have violent tantrums. Another may have functional communication skills and yet withdraw deeply into himself whenever task demand is increased. A third may seem to desire interaction, and may possess solid language skills, but may seem unable to grasp the fundamentals of social reciprocity. Autism is a “spectrum disorder,” meaning that presentations range from individuals who are profoundly affected to those whose symptoms are mild. To complicate matters, individuals with autism often possess splinter skills—specific skill areas that are much more highly developed than others—and conditions such as mental retardation and epilepsy may be present as well. In this book, I use the term “autism” as synonymous with Autism Spectrum Disorders (ASDs), and consider it to include all variances along the spectrum, including Autistic Disorder, Asperger’s Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder, Rett Syndrome, and all “autistic-like” presentations. While this might not be entirely precise, I am less concerned here with specific diagnoses than I am with possible intervention techniques that may be useful for anyone possessing certain types of challenges.

The diagnosis of an Autism Spectrum Disorder is extremely painful for a family to receive. It is also a difficult diagnosis to deliver. My son was diagnosed with “autism” in 1995, shortly after his fourth birthday. However, there were many classic symptoms present well before that time. He had a vocabulary of nearly a dozen words at ten months of age, all of which he lost by his first birthday. Once he did start speaking again, the language consisted of simply repeating phrases he heard in videos (echolalia) rather than being functional. He walked on his toes and flapped his hands. He had little interest in people, but would sit for hours lining up toys and spinning them. He engaged in explosive tantrums that sometimes included biting himself or someone else. He had a series of ear infections and intestinal problems, and often had significant reactions to routine vaccinations.

In hindsight, it is amazing that it took us so long to realize what these symptoms meant. However, no one else—including two pediatricians and a child psychologist—seemed to know either. Fortunately, thanks to parental advocacy and increased commitment in the medical and educational communities, ASDs are being diagnosed much earlier now. Early diagnosis and subsequent intervention have been recognized as fundamental for achievement of best possible outcome (Dawson and Osterling 1997; Guralnick 1991; Smith 1999).

There are a “triad” of symptoms present in ASDs: impairment in communication skills; impairment in social interactions; and presence of restrictive/repetitive behaviors (Frith 2003; Wing 2001). The severity of involvement with these symptoms varies along the autism spectrum, and within any one “category” such as Autistic Disorder or Asperger’s Syndrome, a multitude of possible presentations exists. In addition, the specific symptoms of any one individual may change over his lifespan, due to medical or educational interventions, neurological development or changes, or the presence of co-existing conditions such as epilepsy. My son was originally diagnosed with Autistic Disorder—autism presenting in a rather classical way. After years of intensive therapy, dietary intervention, and biological maturation, however, he was recently given an Asperger’s Syndrome designation. For anyone involved with individuals with autism, it is crucial to remember that although diagnostic labels can be extremely useful in accessing services, they are poor representations of abilities and challenges. Each person with an ASD has very specific needs, and those needs will undoubtedly change over time, and with different people and environments.

Understanding autism from an historical perspective is as challenging as pinning down symptomology. Scholars now see autistic symptoms in numerous historical figures (Fitzgerald 2005; James 2005; Ledgin and Grandin 2002), with the clearest case appearing to be that of Victor, the “wild boy” found in the woods of Aveyron, France at the end of the eighteenth century (Frith 2003). Description of the disorder and employment of the term “autism”—from the Greek word autos, meaning self—is usually linked to the writings of two men working independently in the 1940s: Leo Kanner and Hans Asperger (although the term was first coined by psychiatrist Eugen Bleuler in 1912). In 1943, Kanner published a seminal work on the subject, “Autistic Disturbances of Affective Contact” in the journal Nervous Child. Autism was then correlated with childhood schizophrenia, although Kanner suspected that such an assumption might be inaccurate. The cases Asperger described in his 1944 article, “Die Autistichen Psychopathen im Kindesalter” (“Autistic Psychopathy in Childhood”) were of children we might now refer to as “high-functioning”; thus the distinction that bears his name implies the presence of less profound symptoms (Wing 1981).

In attempting to ascertain the causes of autism, Kanner observed that the children he saw seemed to have parents who were intelligent, “obsessive,” and emotionally distant. On July 25, 1960, Time published an article entitled “The Child is Father,” in which Kanner is quoted as describing the parents of children with autism as “just happening to defrost enough to produce a child.” In The Empty Fortress (1967), psychoanalyst Bruno Bettelheim furthered this notion that autism was the result of ineffectual parenting and noted that children with autism were best served by removing them from their homes:

In those children destined to become autistic, their oversensitivity to the mother’s emotions may be such that they try, in defense, to blot out what is too destructive an experience for them. Little is known about the relation between the development of the child’s feelings and his cognition. But to blot out emotional experience probably impedes the development of cognition, and it may be that the two reinforce each other until autism results. (p.198)

A concentration camp survivor, Bettelheim noticed similarities in the behaviors of children with autism and victims of the camps, and erroneously deduced a correlation in etiology. Ironically, three years earlier, psychologist Bernard Rimland, himself the father of a son with autism, had published a biological study entitled, Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior (1964). Rimland’s argument that autism has physiological origins was sufficiently compelling for Kanner to agree to write the book’s preface. However, in spite of the work of Rimland and others, debunking psychoanalytic theory regarding autism would not come easily. The popular press latched onto Bettelheim’s hypothesis without accurate assessments of outcome data (Pollack 1997; Sutton 1996) perhaps at the expense of progress in autism research.

One of the researchers championed by Rimland was O. Ivar Lovaas, a psychology professor at UCLA who took a behavioral approach to teaching children with autism. Lovaas argued for extremely intensive early intervention, based on the principles of Applied Behavior Analysis. In this method, desired behaviors are broken into their smallest components and taught individually through drills (discrete trials). Correct responses are reinforced with something the child enjoys. In the early days of Lovaas’ work, he included punishment in his method as well. In 1987, Lovaas published “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children,” in the Journal of Consulting and Clinical Psychology, delineating his research in which 47 per cent of the children “achieved normal intellectual and educational functioning…” (p.8). Lovaas’ approach raised controversy, both in terms of method and accuracy of reported results. Yet Lovaas made a great contribution to the field by empowering parents (Mesibov, Adams and Klinger 1997). Because this protocol was so intensive and not readily available in clinical or education settings, many families chose to take on in-home versions, hiring UCLA trained consultants and cobbling together teams of therapists. Catherine Maurice’s 1993 account of successfully utilizing a “Lovaas Program” with her two children on the autism spectrum, Let Me Hear Your Voice, helped popularize this approach.

Lovaas harnessed a power that had been coalescing for over two decades. Since the 1960s, the driving force behind much of the research on both the causes of autism and methods of intervention had been parents. Rimland founded two important organizations: the Autism Society of America (ASA) in 1965 and the Autism Research Institute (ARI) in 1967. ARI would go on in 1995 to spawn Defeat Autism Now! (DAN!), an organization dedicated to developing and disseminating biomedical protocols for the treatment of ASDs. In his 1994 essay, “The Modern History of Autism: A Personal Perspective,” Rimland wrote

When I first started my quest, autism was no less than an obsession. I quickly read everything I could find on the subject and hungered for more… This was war. I envisioned autism as a powerful monster that had seized my child. I could afford no errors. (p.2)

British psychiatrist Lorna Wing, also the parent of a child on the autism spectrum, has published numerous books and articles on ASDs and is credited with developing the Asperger’s Syndrome delineation (Wing 1981).

Advocacy has come not only from parents who happened to be medical or education professionals, but from grassroots movements as well. Living-room support groups all over the globe have turned into powerful voices for research, education, and inclusion in the community. Rather than relinquishing intervention plans to educators and doctors, families have gone head to head with school districts and legislators to provide better and earlier services. And as individuals with autism who had not been institutionalized reached adulthood, they began to publish accounts of their personal experiences, allowing more insight into what often seems an inaccessible world (Grandin and Scariano 1986; Shore 2001; Williams 1994). Where information for families was once scarce, it now abounds—both in print and online. Funding for research has increased, and in 2006, President George Bush signed the Combating Autism Act, which seeks to authorize increased funding for research and education.

While the growth of advocacy and burgeoning research in the last twenty years has been extremely good news, the bad news is that there also seems to be an increase in number of reported cases. When Kyle was diagnosed, we were told that autism occurred in a few births out of 10,000. In February 2007, the Department of Health and Human Services Centers for Disease Control and Prevention put the number at 1 in 150 (CDC 2007). Much debate has occurred regarding the meaning of such an important change in prevalence—certainly better and more complete diagnosis contributes to the statistics (Fombonne 2003; Frith 2003; Wing 2001). However, it is difficult to blame this shift entirely on the development of better diagnostic tools, or even on a broader definition of the disorder. Clearly something else is afoot.

It is beyond the scope of this book to discuss the state of autism research today; so much is being done on so many fronts. I am personally very interested in the studies being conducted on neuroinflammation (Pardo, Vargas and Zimmerman 2005; Vargas et al. 2005), as such etiology seems to make so much sense in light of our experience with dietary interventions and immunotherapy with Kyle. What many researchers are concluding, however, is that there is no one cause for autism (Rutter 2005). There may be a number of biological factors driving ASDs, as well as genetic predisposition. I am certain that I will not see a “cure” for autism in my lifetime; I suspect my son will not either. I am hopeful, however, that the next quarter century will move us in that direction, and will provide continued insight into how to more successfully manage the disorder.

What does “management” of an ASD mean? Certainly it may mean utilizing protocols that include medication, dietary intervention, vitamin therapy and a host of other biological treatments. But it also means educational, behavioral, and social interventions that enable individuals with autism to lead richer, more productive lives, in the community rather than in seclusion. Educational approaches proliferate, allowing families to choose those which best address specific learning needs and parenting styles. Although many educational strategies have proven very successful with skill acquisition, it seems that we are always struggling—as parents and educators—with engagement, generalization of behaviors, and social interaction. For this reason, many families search for therapeutic experiences that go beyond the classroom and the home. And for every child who has autism, it is necessary to create a truly individualized intervention plan. What often becomes obvious is that one “program” is not enough—parents and teachers must develop a therapeutic package that targets the specific needs of the child, choosing bits and pieces of protocols like delicacies at a smorgasbord. Because autism is not life threatening, individuals with ASDs require services and support throughout a typical lifespan. This means that as a society, we are compelled to discover and make available a variety of options that include not only early intervention and childhood education, but also job opportunities and support, appropriate living arrangements across the autism spectrum, and inclusive activities that provide an enriched quality of life—which brings us to animal-assisted interventions.

An overview of animal-assisted interventions

As parents of a child with autism, my husband and I have endeavored to help our son develop a skill set that will enable him to engage in meaningful work and leisure activities. We have, from the outset, prioritized his involvement in the life of our family. We would like to have a son who can support himself, who can survive well without us. That is our job as parents. But we would also like a son actively engaged in relationships, with us, with friends, with the community. Although Kyle will probably always struggle with social interactions to some degree, he seeks out interactions with the people around him, and makes a deliberate effort to ...

Table of contents

• Cover Page
• Of Related Interest
• Title Page
• Copyright
• Contents
• Dedication
• Foreword By Temple Grandin
• Acknowledgements
• 1. Introduction
• 2. Service Dogs
• 3. Animal-assisted Therapy and Activities
• 4. Companion Animals
• 5. Therapeutic Riding
• 6. Dolphin Therapy
• 7. Conclusion
• Appendix 1. Online Resources
• References
• Subject Index
• Author Index