Animal Therapies As a Treatment for Autism

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Animal Therapies As a Treatment for Autism

• Caldwell College
• Assessing Effective Treatment for Children With
  Autism
• Nicola Schneider Karen Martin
• October 30, 2007

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Dolphin Assisted Therapy (DAT)
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BackgroundJohn C. Lilly

• 1921-2001
• Led Study of Communication with Dolphins
• Trained in medicine, psychoanalysis biophysics
• A neuroscientist writer
• Explored human consciousness, dolphin
  communication the borders of reality
• Career shifted between research published in
  scientific journals speculation and
  self-experimentation

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John C. Lilly

• Pioneered work probing electrical activity in the
  brain the behavior of dolphins
• Experimented with hallucinogenic drugs
• Promoted recreational use of the isolation tank
• His work inspired movies Day of the Dolphins
  (1973) Altered States (1980)

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Background

• Lilly suggested dolphins could help humans learn
  to communicate better with one another
• 1960s first formulated idea that human
  interaction with dolphins may be beneficial
• DAT began in the 1970s

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Background

• Lillys ideas were extended in the 1970s
• Researchers examined effects that interacting
  with dolphins appeared to have on children with
  neurological impairments
• Procedure developed by David Nathanson

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David Nathanson

• Clinical psychologist
• Founder president of Dolphin Human Therapy
  (DHT)
• Founded this private company in 1989
• Dolphin Human Therapy located in Miami, Florida

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David Nathanson

• DHT commonly used with children diagnosed with
  non-specific brain damage, cerebral palsy, Down
  Syndrome autism Rett Syndrome
• Over 2,300 clients from 39 states 54 countries
• Over 30,000 individualized dolphin assisted
  therapy sessions conducted
• By 1998, the waiting list was 7 years long

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David Nathanson

• Cost of Dolphin Human Therapy as of February 2007
  reported to be
• 7,500 for two weeks of therapy (5 days per
  week, 40 minutes per day)
• 11,250 for three weeks (5 days per week, 40
  minutes per day)

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Costs of Other DAT Programs

• 2600 for five 40 minute sessions
  http//skepdic.com/dat.html (typical program)
• 500 for each individual therapy session
• www.livingfromtheheart.org/therapy.html
  (Mexico)

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Costs of Other DAT Programs

• 1000 for five private sessions over 1 or 2 days
  including a testimonial DVD
• www.vallarta-adventures.com/dolphins/dolphin-a
  ssisted.html (Mexico)
• 1000 consisting of 8 seances during 2
  weekswww.dolphintherapy.ru/en/pricez.shtml
  (Turkey)

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Claims

• As popularity of DAT has grown, claims as to its
  therapeutic benefits have also grown
• Facilities in U.S., Mexico, Israel, Russia,
  Japan, China, and the Bahamas
• Popular choice for illness, disability, and
  psychopathology in children adults

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Claims

• DAT can effectively improve
• - language
• - behavior
• - cognitive processing
• - attention
• - motivation to learn
• - certain medical conditions
• (Lukina, 1999 Servais, 1999)

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Claims

• Effective in treating the following
• - Autism (Hank Truby, Betsy Smith, Robert
  Nathanson)
• - Joint problems (various reports)
• - Downs syndrome (Nathanson)
• - Depression (Horace Dobbs, Operation
  Sunflower)
• - Cerebral Palsy (Nathanson, Dolphin Research
  Center)

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Claims

• - Improved learning Children can learn 2-10
  times faster around dolphins (Nathanson)
• - Angina (Roxanne Kremer)
• - Acoustic zap of a tumor
• - Microcephaly
• - Dreamer dolphin fixes a neck
• - Restoration of partial vision loss

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Testimonials

• Video http//www.pbs.org/wnet/nature/wisdom/dolp
  hin.html
• Dreamer Dolphin Pod Relieve Angina
• Improvement of Mental Age in Cerebral Palsy

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DAT Theories

• Sonar ability identifies neurological disorders
  in individuals then helps them relax and open
  up to learning and healing (Dolphin Therapy
  Recreation or Medicine?)

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DAT Theories

• Telepathic experiences with dolphins lead to
  telepathic connections with autistic children
  which help improve the childrens functioning
  communication. (Dolphins, Therapy Autism)

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DAT Theories

• Autistic people are systemizing dolphins
  show great empathy and care, expecially with
  children. (Dolphins, Therapy Autism)
• Strong empathetic dolphins help balance autistic
  patterns. (Dolphins, Therapy Autism)

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Description of DAT

• Practiced under the name of Dolphin Human Therapy
• Procedure developed by David Nathanson
• Based on Nathansons theory

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Nathansons Theory

• Children with disabilities will increase their
  attention to relevant stimuli in the environment
  as a result of their desire to interact with
  dolphins
• Interaction with dolphins is used as a reward or
  reinforcer for correct responses

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Nathansons Theory

• Key to learning increase sensory attention so
  that increased learning will occur
• General purpose of DHT - motivational

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Dolphin Human Therapy

• Purpose to encourage children to engage in
  desired responses in accordance with childs
  individualized therapy program
• (Nathanson, 1998 Nathanson, de Castro,
  Friend, McMahon, 1997 Nathanson de Faria,
  1993)
• Designed to jump start the child to
  complement or reinforce other more traditional,
  therapeutic procedures
• (Nathanson, 1998)

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Dolphin Mechanisms Capabilities

• Resonance frequency of dolphins sound causes
  water to vibrate ( become warm)
• Entrainment a synchronization of two or more
  rhythmic cycles
• - Our bodies tend to match frequency of signals
  (sound, light or electrical)
• - EEG of humans reduced in frequency
  increased in power after swimming with free
  dolphins

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Dolphin Mechanisms Capabilities

• High frequency sounds made by dolphins can cause
  same effects as a medical ultrasound
• Ultrasound causes improved healing of bone
  fractures and non-unions and improves healing of
  soft tissue injuries

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Procedure Materials

• DAT consists of
• - defining a treatment goal for the child
• - (e.g., completing a fine or gross motor task
  or producing a language behavior)
• Materials
• - objects used to elicit a response
• - (e.g., rubber balls or rings or flash cards)

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Procedures

• On-dock orientation consists of
• Child therapist sit on edge of floating dock
• Dolphin trainer controls movements of dolphins
• Children able to touch or give hand signals to
  dolphins to elicit responses

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Procedures

• Therapeutic sessions may include
• Child interacting with dolphin from dock or in
  the water after giving a correct response
• Interactions with dolphins may include touching,
  kissing, taking a short ride holding onto the
  dolphins dorsal fin, etc.
• The child therapist then return to therapeutic
  task

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A Week in the Life of DHT

• Monday Day 1
• -Focus is on orientation
• -Children become familiar with dolphins,
  therapists surroundings
• -20 min. session with therapist child on
  platform
• -Orientation meeting with parents about
  therapy sessions, expectations, insurance,
  restaurant locations additional DHT activities

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A Week in the Life of DHT

• Tuesday - Day 2
• -40 min. session
• -All work takes place on platform or in the
  water
• -Childs reward takes place in water with the
  dolphins

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A Week in the Life of DHT

• Wednesday Day 3
• -40 min. session and in-water with the
  dolphins
• -Dr. Nathanson meets with each family
  individually off site to discuss therapy,
  insurance, and their childs progress
• -Optional parent meeting held with all
  parents. Parent meeting allows parents to
  interact with each other

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A Week in the Life of DHT

• Thursday Day 4
• -40 min. sessions and in-water with the
  dolphins
• Friday Day 5
• -Last day of therapy for one week program
• -40 min. session and in water with the
  dolphins

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Intervention for Young Effectiveness of DAT as a
Behavioral Children with Disabilities

• Tracy L. Humphries Ph.D.
• Research synthesis focusing on effectiveness of
  DAT for improving cognitive, physical, or
  social-emotional behaviors of young children with
  disabilities

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Humphries Research Synthesis

• Interactions with dolphins as reinforcement for
  childrens correct responses to different
  therapeutic tasks
• Selection criteria
• - Studies included children with
  disabilities under the age of six
• - Practice characteristics included
• - Outcomes of the practice had to be
  described

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Studies Reviewed

• Six studies met the selection criteria
• Lukina, 1999
• Nathanson, 1989
• Nathanson, 1998
• Nathanson et al., 1997
• Nathanson de Faria, 1993
• Servais, 1999

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Participants Major Findings

• Table 1Selected Characteristics of the Study
  Participants
• Table 2Major Findings and Outcomes Reported by
  Investigators
• Table 3Major Study Findings and Threats to
  Validity
• http//www.altonweb.com/cs/downsyndrome/index.htm?
  pagehumphries.html

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Rival Explanations

• Limited data
• - 3 studies by Nathanson presented only
  limited pretest/posttest results
• - 4 investigators claimed DAT maintained
  childrens attention in 3 of these studies by
  Nathanson no data was provided or collected

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Rival Explanations

• Limited data reported
• - No studies provided data on generalization
  of effects of DAT over time or settings
• - Lukina reported many outcomes collected
  data but data collection procedures were not
  described or presented in a useful way

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Rival Explanations

• Threats to research designs
• - no measures used to assess outcomes were
  standardized
• - Servais (1999), who used a control group,
  stated that procedures used were not
  well-controlled and validity was compromised

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Rival Explanations

• Threats to research designs
• - 4 studies used a one-group pretest/posttest
  design
• - one study used a one-group posttest only
  design
• - several of the studies took place over
  several months

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Rival Explanations

• Other possible threats
• - Investigator bias
• - Respondent bias
• - Novelty excitement of encountering
  dolphins
• - Children receiving other therapies
• - Water immersion

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Conclusion

• No scientific studies of animal therapy for
  individuals with autistic spectrum disorder
  (Association for Science in Autism Treatment)
• No credible scientific evidence for the
  effectiveness of DAT (Humphries)
• Studies reviewed are flawed plagued by threats
  to validity or alternative explanations (Marino
  Lilienfeld)

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Implications

• Further research needed
• Research design using appropriate sample size
  that compares DAT to alternative interventions
  that are just as novel and interesting to
  children
• Research needs to be better controlled for
  confounds

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Questions Comments
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References

• Animal Therapy. Retrieved on 10/25/07, from
  http//www.asatonline.org/resources/treatments/ani
  mal.htm
• Dolphin Human Therapy. Retrieved on 10/24/07,
  from http//www.dolphinscove.com/dolphin-human-the
  rapy.htm
• Dolphin Human Therapy A Professional Association
  Dedicated to Helping Disabled Children. Retrieved
  on 10/24/07, from http//www.aquathought.com/idatr
  a/symposium/95/nathason.html
• Dolphin Human Therapy and Down Syndrome
  Abstracts. Retrieved on 10/22/07, from
  http//altonweb.com/cs/downsyndrome/dolphinab.html
  
• Dolphin Human Therapy Research. Retrieved on
  10/24/07, from http//www.aquathought.com/idatra/s
  ymposium/96/nathan.html

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References

• Dolphins, Therapy Autism. Retrieved on 9/19/07,
  from http//planetpuna.com/dolphin-paper/Dolphin-P
  aper.html
• Dolphin Therapy Recreation or Medicine (1998).
  Retrieved on 10/24/07, from http//www.cnn.com/HEA
  LTH/9803/28/dolphin.therapy/index.html
• Effectiveness of Dolphin-Assisted Therapy as a
  Behavioral Intervention for Young Children with
  Disabilities (2003). Retrieved on 10/22/07, from
  http//www.altonweb.com/cs/downsyndrome/humphries.
  html
• Interview with John Lilly. Retrieved on 10/22/07,
  from http//levity.com/mavericks/lilly2.htm

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References

• John C. Lilly Dies at 86 Led Study of
  Communication with Dolphins. (10/7/01) Retrieved
  on 10/22/07, from http//query.nytimes.com/gst/ful
  lpage.html?res9503EEDC123CF934A35753C1
• Marino, L. and Lilienfeld, Scott O. 2007. Dolphin
  assisted therapy more flawed data and more
  flawed conclusions. Anthrozoos 20 239-240.
• The Healing of Gentle Giants. Retrieved on
  10/24/07, from http//www.manyhands.com/articles/s
  tory.cfm?id_no22700102006

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Hippotherapy
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What is Hippotherapy?

• treatment with the help of the horse

Greek Root Hippo-/Hipp- horse
? ? G ? ? ? ? T ? ? ? ? ? ? ? ? ? S ? ? F ? ? O
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History of Hippotherapy

• Before 1900 460-377 B.C. - Hippocrates
• 1569 - Merkurialis of Italy
• 1780 - Tissot of France in his book 'Medical and
  Surgical Gymnastics'
• Since 1900
• 1952 at the Helsinki Olympics
• 1960's therapeutic riding centers
• 1960's the horse views
• 1969 North American Riding for the Handicapped
  Association (NARHA)
• 1970's physical therapists
• 1987 a group of 18 American and Canadian
  therapists went to Germany to study hippotherapy
• 1988-1992 National hippotherapy curriculum
  Development Committee.
• 1992 American Hippotherapy Association.
• 1993 The American Hippotherapy Association
• 1994 AHA Inc.
• 1999 American Hippotherapy Certification Board
• 1999 first Hippotherapy Clinical Specialists
  (HPCS) examination

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Who does it help?

• People suffering from
• Cerebral Palsy
• Multiple Sclerosis
• Developmental delays
• Traumatic brain injuries
• Strokes
• Autism
• Learning or language disabilities

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What is hippotherapy?

• Integrated intervention program paired with
• P.T.
• O.T.
• S.L.P.

• Using the movement of the horse to
• assist in motor planning
• increase sensory input
• help in posture control

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The Therapists Role

• Physical Therapists
• Integrate multiple motor tasks in conjunction
  with the horse's movement to
• address motor needs of each patient
• promote functional outcomes in gross motor
  ability such as sitting, standing, and walking.
• Occupational Therapists
• Combine equine movement with other standard
  intervention strategies for
• fine motor control
• sensory integration
• feeding skills
• attentional skills
• activities of daily living
• Speech-Language Pathologists
• Use equine movement to facilitate the physiologic
  systems that support speech and language.
• combined with standard speech-language
  intervention strategies
• speech-language pathologist can form strategies
  foe communication disorders and enhance
  functional communication

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The Horses Movement

• Motor planning
• Adjust body position to horses gait
• Gait of horse similar to human
• Sensory Input
• Vestibular
• Proprioceptive
• Tactile
• Visual channels.
• Posture Control
• Trunk strength and control
• Balance
• Endurance
• Weight bearing

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What does Motor Planning, Sensory Input, and
Posture Control help to do?

• Coordination
• Timing
• Grading of responses
• Respiratory control
• Sensory integration skills
• Attentional skills
• Support activities of daily living

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Who implements hippotherapy?

• Occupational Therapists
• Physical Therapists
• Speech-Language Pathologists

• HPCS Hippotherapy Clinical Specialist
• AHCB Board Certification in Hippotherapy.
• Hippotherapy Clinical Specialists names are
  followed by 'HPCS'
• Level II Therapist - A therapist who has
• completed Level I and II AHA Approved Workshops
  who
• demonstrates clinical problem solving with
  respect to clinical reasoning from the
  Hippotherapy Conceptual Framework and application
  of the Disablement Model.
• Level I Therapist - A therapist who has
• completed the AHA Approved Level I Workshop who
  has gained the
• basic knowledge of the horse's movement and its
  application to patients with neuromuscular
  disorders
• knowledge of horse and patient selection,
  evaluation, treatment planning, and business
  aspects

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How does it work?
Horse manipulates the client
Therapist directs the horses movement
Client responds to horses movement
Therapist analyzes and adjusts treatment
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Claims

• Can improve
• muscle tone
• Balance
• posture
• coordination
• motivation
• motor development
• mobility
• emotional well-being

May affect psychological, cognitive, behavioral
and communication functions.
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Testimonials
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Olivia Whitefield, a speech language pathologist
at The Texas Tech Therapeutic Riding Center

• "That helps those patients who haven't walked
  before or, in the case of stroke victims, have
  forgotten how to walk," said "Sometimes we turn
  them backwards on the horse with their hands on
  the horse's rump," Whitefield said. "The movement
  of the horse's walk provides stimulation through
  the hands, arms and up into the face. It
  stimulates the oral and facial musculature."

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Estevan

• The world outside one's own home can be a cruel
  reminder that the disabled continue to have a
  hard time fitting in. Hippotherapy is more
  effective than traditional therapies because
  horses have a unique ability to motivate children
  to try new things. The therapy team is also
  instrumental in tailoring the program to meet a
  child's particular needs. Fear is a looming
  threat -- Fear of exclusion fear of
  disappointment, fear of failure fear of pain
  fear of risk taking and fear of the unknown.
  Hippotherapy provides a safe, supportive
  environment in which Estevan and us (his parents)
  can let go of some of our fears. Hippotherapy
  gives Estevan 'Joie de Vivre', Joy of living.
  Estevan is, in a word, Joyful.

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Victoria

• "Hippotherapy has improved Victoria's balance.
  After hippotherapy her muscles are more relaxed.
  The hippotherapy has given her much more
  confidence. Victoria was afraid of animals when
  she started and now loves horses as well as
  interacting with other animals. She enjoys the
  entire experience at NCEFT the riding, the other
  activities, caring for and brushing the horses,
  the stables, etcHippotherapy has also helped
  Victoria's concentration and attention. This
  means more confidence and joy. What is different
  and so impressive about hippotherapy is its
  uniqueness. Our daughter does not show pictures
  of her other therapies or laugh and talk about
  them. Hippotherapy gives our daughter a unique
  experience to be proud of. It is the most
  important and beneficial therapy of the week.
  Victoria cannot do what her peers can in almost
  any way. With hippotherapy now she can do
  something that none of her peers ever think about
  trying. It is something she can be very proud of
  and others marvel at. Right now, Victoria's
  proudest possession is the little trophy
  presented to her by NCEFT for a job well done!"

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Evidence

• There was no researched based evidence to support
  the claims made.

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References

• American Hippotherapy Association. Retrieved on
  10/14/07, from http//www.americanhippotherapyasso
  ciation.org/
• Ride On Therapeutic Horsemanship. Retrieved on
  10/20/07, from http//www.rideon.org/what_is_hippo
  therapy.htm
• Therapeutic Riding Program American Hippotherapy
  Association. Retrieved on 10/14/07, from
  http//www.americanequestrian.com/hippotherapy.htm
  
• The Daily Toreador Hippotherapy treatment
  assists with serious medical conditions.
  Retrieved on 10/21/07, from http//media.www.daily
  toreador.com/media/storage/paper870/news/2007/09/2
  0/News/Hippotherapy.Treatment.Assists.With.Serious
  .Medical.Conditions-2979450.shtml

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Questions?
Comments?
Concerns?
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How do you feel about Animal Therapy?

• Claims
• Historical Perspectives
• Evidence
• Testimonials