“There is no cure,” devastating words for any parent. Now add “it’s your fault” and any parent would be shocked, hurt and even desperate. For many parents, especially mothers, that was the message for more than 30 years (Bettelheim PAGE #). Told they were cold and had failed to bond with their children, many mothers had nowhere to turn. In the early days of autism there were few treatments available and only the inkling of understanding. How helpless it must have all felt.
It was during the 1960’s that our modern understanding of autism began to take shape, and the controversy over treatments and the causes of autism took off. By the 1970’s the origins of autism were beginning to become clear; the role of genetics helped to relieve some of the stigma that had surrounded a diagnosis of autism. As more and more children are diagnosed, boys far more than girls, the need for answers and effective treatments only becomes more urgent. There are a variety of treatments out there today touted as cures and overnight successes, none of which are backed by scientific proof, but there is growing research that animals can play a key part in managing the symptoms. Despite the fact that there is no cure for autism; animal therapy is an effective treatment for children with autism.
The discovery of autism has it roots in the study schizophrenia. In 1911, Eugene Bleuler who came up with the term schizophrenia noticed a segment of that population which was obviously different, and began to take note. Bleuler focused on a common symptom in this group, a disconnect with the outside world, and used the Greek word “autos” meaning “self” to coin the term “autism” (“autism”). Often considered retarded and psychologically flawed the outlook for these patients was grim. In the late 1930’s, Hans Asperger was doing his own research in Vienna which was instrumental in defining this disorder. Eventually, around 1980, his research was used to determine a distinct diagnosis within the autism spectrum, what we now call Asperger’s Syndrome (Lyons and Fitzgerald 2022). In 1943 Leo Kanner, another psychologist, was studying children here in the United States and changed things.
Kanner is considered a pioneer in the study of autism in children, and made great strides in diagnosis and treatment. The behaviors which set this group apart from all others, the severe delay or lack of verbal language, repetitive movements, an aversion to physical touch, and an obsessive restricted focus, all of which appear before age 3, became instrumental in diagnosing patients. During this time the common misconception that a failure to bond by mothers was the cause of these symptoms continued, it was also still often classified as a schizophrenic disorder (Rapin 302). Despite some major misconceptions about the origins of autism, there were great advances, one being that autism did not mean retardation, and as the study of autism continued, and so too the treatments.
In the early days treatments of autism was a grim prospect. Initially treated as a psychological disorder the treatments mirrored those for people labeled insane. Shock therapy was not uncommon, and is still used today, nor was isolation. It was a common practice to institutionalize children that were diagnosed. There they were often given drugs to subdue them, and “treat” their disorders. The most chronically used drugs, or first generation drugs, Thorazine and Haldol, were often used in conjunction with shock therapy from the 1950’s until the 1970’s (Watchel, Hermida and Dhossche). All of these treatments we now know to have side effects. The mild ones are hallucinations, prolonged contraction of muscles and medication induced Parkinsonism. If those are not enough to cope with, the severe ones like brain damage and involuntary muscle control can be permanent. These are the type of treatments that are responsible for the images of “zombie” patients wandering the halls of mental institutions. For parents coping with autism, these options weren’t easy choices.
A few were able to overcome the current ideology, and try things that weren’t common at the time. Temple Grandin, diagnosed in 1950, was a child that had one such parent. Her mother, Eustacia Cutler, went against all medical advice and treated her daughter with what at the time were unconventional and unproven methods (Cutler). Intense work on speech, social skills, public education (despite being labeled), and finally a college professor that recognized her abilities aside from her limitations has led her to be a well respected Professor of Animal Science at Colorado State University. Grandin, in her book Emergence: Labeled Autisic, says “I have read enough to know that there are still many parents, and yes, professionals too, who believe that ‘once autistic, always autistic.’ This dictum has meant sad and sorry lives for many children diagnosed, as I was in early life, as autistic. To these people, it is incomprehensible that the characteristics of autism can be modified and controlled. However, I feel strongly that I am living proof that they can” (16). Since that time, and indeed with her help, we have come a long way how we view and treat autism.
The treatments and diagnosis of autism have changed throughout the years just as much as the understanding of it has. “Autism is a developmental disorder, a defect in the systems which process incoming sensory information causes the child to over-react to some stimuli and under-react to others” (Grandin and Scariano). In simple terms this sensory issue is what causes the behaviors that have become the hallmark of autism. It is still difficult to measure the capabilities of a child with severely impaired communication skills, a lack of social awareness, and an inability to connect with the outside world. Some of the most successful treatments are physical therapy, occupational therapy, speech and language therapy, sensory integration therapy, and social skills therapy.
Many people are familiar with Physical Therapy (PT), which addresses things such as range of motion, balance, strength and dexterity. There are physical aspects of autism such as low muscle tone, toe walking and difficulty with coordination which can be addressed in PT. Treatment of these can also have other benefits as well. Things like attention, focus, and eye contact often improve during treatment (Spokes). It also has sets the stage for progressing into self care and self sufficient behaviors.
Occupational Therapy (OT) is less well known than PT, but is often more appropriate for autism patients. Unlike PT which focuses only on the mechanics of the body, OT takes it a step further and addresses daily tasks relevant to the patient. In a child that might include dressing, grooming, eating, and standing in line at school. All of which can be upsetting and even painful for an autistic child. It is also difficult for parents who are trying to go about daily life with an autistic child. Just getting bathed and dressed in the morning can turn into hour’s long tests of patience and will, all before you even step out the door. OT is a great way to get individualized treatment for the varied issues autism can have. Some kids are just fine with tight socks and jeans, others will roll on the floor screaming in agony; knowing what can trigger the floor rolling and screaming, be it socks or sweatpants can be the difference between being homebound, and making it to the car in the morning. Quite often parents deal with these “meltdowns” which are a result of overstimulation. Just as in PT, OT also has other benefits such as structured time and repetitive activities, both shown to help alleviate some of the anxiety that autistic children suffer from (Spokes). It can also begin to address some of the sensory discomfort associated with autism, known as Sensory Integration Disorder.
Sensory Integration Therapy, or SIT, is a therapy more specific to autism. It is actually a combination of therapies used to address the sensory aspects of autism, like touch, smell, sound and taste, as well as the social ramifications. The major issue in autism is an imbalance in sensory reception (Bender). What may feel soft and comforting to us, can feel like needles to an autistic child. A routine trip to the grocery store can be simply awful for a child that can hear the piercing sound of the fluorescent lights. On top of that, imagine something as simple as your socks feeling like they are stabbing your ankles. These are the types of things the parent of an autistic child has to deal with on a daily basis, even a minute by minute basis. SIT is critical to functioning in our everyday world. Since autism is characterized by an inward focus, and disconnect from the outside world, it can be a challenge to coax such a child into interacting, even with the help of all of these therapies. This is when something almost magical, yet scientifically sound, can bridge that gap between a child stuck inside their own mind and the living world around them, the answer is animals.
There are several key factors that make animals a perfect fit for treatment of autistic children, our genetic predisposition toward animals domestic and otherwise (biophilia), the biological health benefits, and the practical benefits of a service animal; it is also the connection between animals and humans and the feedback loop that benefits us both (Tobin, et. al). There are many possible reasons for the effects of animals on autism, none of which have been proven in long term scientific studies. However, like the early days of treatments such as occupational therapy or sensory integration therapy that does not mean it doesn’t work. As you will see there is scientific evidence of the positive effects of animals involved in the treatment and assessment of autism.
The first challenge in treating a disorder like autism is evaluating the severity. You need to know where the starting point is, and if you can’t get a child to even look at a test what do you do? You use animals. It may seem trivial, but remember that autistic children find it extremely difficult, if not impossible, to make eye contact. It has been proven that typical testing, which often uses cards depicting human facial expressions, do not get a response from autistic children. This affects not only their ability to notice the surrounding environment, but also to read the faces of those around them, causing significant social dysfunction.
Just as with treatments, animals can play a pivotal role in evaluation and in measuring the progress of an autistic child. One of our first connections with animals was by observation in the time of the caveman this disposition towards animals is beneficial today as well. Simply replacing those faces with animal ones, there is a marked response (Hu). This is where biophilia and autism have common ground, the predisposition towards the natural world is not hampered by autism, it is not a social construct, it simply is. As simple as this may sound the use of animal representations in testing is still not widely accepted, utilized or understood. It is an emerging topic of study (New). If pictures of animals elicit a response, what kind of reaction do living ones have?
The most widely acknowledge aspect of autism is the lack of verbal communication, which causes severe social deficits. Here is where animals, especially domesticated, appear almost magical. Unlike people who have a myriad of potential responses, both physical and verbal, animal communication is more predictable. A set pattern of behavior and response allows autistic children communicate without the clutter human interaction can cause, thus avoiding overstimulation. There is some research which uses robots to mimic this set behavior and response pattern in conjunction with autism treatments, but it lacks the feedback that animals provide (Jannot). Animals being largely nonverbal creatures; can read our intentions in the subtle shift of our bodies, the look in our eyes, and the smell of our skin (McCullough). The pressure to communicate, which can be overwhelming in autism, is moot. This nonverbal communication makes animals a perfect choice for autism treatment. This does not mean that therapy is not needed, in fact it is the opposite; animals and therapy go hand in hand.
The therapies commonly used today to treat the symptoms of autism can be difficult at best. It is a deliberate exposure to the very things that can irritate an autistic child; however the addition of an animal in therapy sessions has been shown to improve social interactions and language, the top two issues those with autism face. Using animals for treatment in this manner is called a biocentric approach because it goes hand in hand with the theory of biophilia.
Therapy can present a challenge for an autistic child; verbal directions, physical contact, and the sheer overwhelming aspect of the environment can make it nearly impossible to function. A study titled “Occupational Therapy Incorporating Animals” profiled the use of animals during therapy sessions and “found that children with autism demonstrated fewer stereotyped behaviors such as hand-posturing and humming, and increased socially appropriate behavior such as joining the therapist in simple games, when a friendly therapy dog was introduced into the sessions” (pg. 270). We may not know exactly why this works, but we do know that “incorporating animals in the occupational therapy session was unique in that it allowed the children to learn to interpret and respond to the less complex social and behavioral cues of animals, which may provide a bridge to learning to interpret the more subtle behavior of human beings” (Sams). Animals of all kinds are not only beneficial in conjunction with therapy, but as a therapy themselves.
Hippotherapy, also known as equine therapy, is the use of the horses as treatment, and encompasses physical, occupational and speech therapy. Each person is assessed and a treatment plan is made, just as in occupational therapy individual needs are the focus, which is especially useful in autism since no two autistic children are alike. Horses have a similar pelvic movement as humans when walking; feeling this sensory input, which is steady and rhythmic, deals with the sensory input imbalance intrinsic to autism (Bender). It also encompasses multiple sensory areas like smell, vision, touch, movement, balance and sound. Learning to process this sensory input can lead to better functioning in environments where overstimulation is rife, and decrease the “meltdowns.” Aside from the physical benefits of horse therapy there are psychological ones as well. A recent study in the journal, Occupational Therapy in Mental Health, noted that “violition”, or motivation, is adversely affected by the impairments of autism. The study was able to show an increase in violition, or participation, and an increase in interest in new activities as a direct result of Hippotherapy (Taylor, et al.). The effects of animal therapy, although not always explained, are both obvious and often dramatic.
The benefits of animals involved in therapy are not limited to physical and occupational therapy. There are notable physical effects as well. Science has known oxytocin for some time, but its true functions are just beginning to be revealed. It is now known that increased levels will reduce high blood pressure, lower heart rate and decrease stress responses (Olmert). Where can we get this? Animals. The simple act of petting an animal creates a feedback loop in which oxytocin levels are increased in both the person and the animal. For a parent much of our time can be spent calming our autistic child, which is especially difficult after a “meltdown.” It can take hours for a child to return to a state calm enough to tolerate physical touch. A pet, cat or dog, can reduce the time it takes to recover from, and even sometimes avoid, these meltdowns.
Animals often have an instant impact on autistic children, and the benefits last long past the immediate. Even though no one single treatment works for all, it is most often that animals create that immediate positive response which can last long past the therapy session. Research “has indicated that the gains associated with the involvement of the animals were valuable and observable in the children’s daily lives” (Sams, Fortney, and Willenbring 273). The simple presence of an animal created immediate and lasting results, which then begs the question what would a trained animal do for autism? Service animals, although currently controversial, are another way animals can improve the daily life of someone with autism.
Service animals are a common treatment for disabled individuals. We are familiar with ones used to assist the physically handicapped. In recent years the use of service animals for children with autism have become a more recognized and accepted option. A service animal is an ideal choice for the physical aspects of a disability, but more now than ever we are seeing the positive effects on “invisible disabilities” such as autism (Skloot). Though we most often relate service animal with dogs, there are many types of animals which have been proven to benefit autistic children, even guinea pigs (KrA?kova, TalaroviA?ova and Olexova 143). An animal can be trained to do the more obvious tasks of alerting parents when an autistic child wanders away, to the less obvious ones of sensing increased agitation and responding.
Not only are there benefits that arise from the trained aspects of a service animal, there are coincidental benefits which can be an immense help in the area of social skills. A service animal can be a conversational cue for autistic children who have poor social and language skills. An animal trained to read hand signals can be used when a child lacks language, and the training of hand cues itself benefits the child by teaching the verbal counterparts. Also by removing the stress of verbal communication the service animal becomes an oasis, which can reduce meltdowns. There are many ways a service animal benefits an autistic child, but they are not appropriate for everyone. As with any treatment, not all autistic children respond the same. The severity of impairment and temperament also factor into whether a service animal is appropriate. Acceptance of service animals can also be an issue.
Service animals are under fire at all levels. Simple getting into everyday places like a grocery store, restaurant, bus or even the doctor can be a hassle. The laws regulating service animals are undergoing change right now, and legal cases are cropping up across the nation. In Oregon, an autistic boy has been denied his service dog while in school (Owen). Since trained service dogs for autism, especially in school, are still rare the outcome is not clear. Autism is getting more attention and more study is needed, but the need for effective treatments will remain as long as autism remains.
Although there is ongoing research and development in the area of animals and autism treatment, it is still considered a “new” field of study. Doubt among scientist remains to the origins of autism, and hence even more so over the treatments. Many people hesitate to ascribe to any specific therapy; however, as during the time of Temple Grandin when therapies which are common today were either not available or not recognized as treatment, that does not lessen their effectiveness. That did not deter her mother, and it should not deter us today. For Temple animals were not only a fascination, but a gateway for her to connect to the world around her, and in turn to the rest of us. We should not shun any treatment that shows not only promise, but results.
It is a fact, there is still no cure for autism, but there is hope, where none was before. As we understand the origins of this disorder, so too do we understand the treatments. It has been shown time and again our undeniable connection to animals. The title of Temple Grandin’s latest book is “Animals Make us Human,” and I think she may be right. Animals have a natural ability to calm and comfort us, and as the evidence can attest to heal us as well.