[State of knowledge: effects of assistance dogs and companion animals on persons with autism spectrum disorder or post-traumatic stress disorder]

I. Linteau, M. H. Raymond, C. Gaumont
Record ID 32018000867
Original Title: État des connaissances: effets des chiens d'assistance et des animaux de compagnie chez les personnes présentant un trouble du spectre de l'autisme ou un trouble de stress post-traumatique
Authors' objectives: Assistance dogs are dogs that have been specially trained to carry out various tasks intended to mitigate the effects of a disability or disorder [ADI, 2019a]. Traditionally used to compensate for a physical disability, these dogs represent a relatively recent avenue of intervention for youths with autism spectrum disorder (ASD) and persons with post-traumatic stress disorder (PTSD). Currently, Quebec offers the Mobility Assistance Dog Reimbursement Program and the Visual Aids Program, which are covered by the Régie de l’assurance maladie du Québec (RAMQ). These programs pay a portion of the annual maintenance expenses incurred by people using mobility assistance dogs and guide dogs (e.g., food, grooming, veterinary care, etc.). The relevance of such a program for persons with ASD or PTSD still needs to be clarified. To help gain insight on this issue, the Ministère de la Santé et des Services sociaux (MSSS) sought the support of the Institut national d’excellence en santé et en services sociaux (INESSS) in documenting the effects of using assistance dogs on persons with ASD or PTSD. As part of this mandate, the MSSS also wanted to know the effects of companion animals on these two populations in order to assess the added value offered by assistance dogs.
Authors' results and conclusions: RESULTS: The analysis of the scientific publications showed that the use of assistance dogs and the presence of companion animals can have various types of effects on persons with ASD or PTSD and on their families. Such effects may be positive or negative and, for some of them, the level of evidence was higher than for others. Some challenges and concerns regarding the integration of assistance dogs or companion animals were also identified. Other issues related to the acceptability and applicability of using assistance dogs were raised by the members of INESSS’ Clinical Excellence Committees on Social Services and are presented in the section entitled “Regulatory, Ethical and Clinical Implications.” CONCLUSION: The review of the scientific publications showed that the use of assistance dogs has positive effects on youths with ASD and on their families, as well as on military members or veterans with PTSD. In keeping with the definition of an assistance dog [ADI, 2019a], these animals can be considered as a way to mitigate the disabilities associated with ASD and PTSD. However, some questions remain unanswered, particularly concerning the profile of those users most likely to benefit from such an intervention (e.g., their age, severity of their disorder, etc.). To a lesser extent, it can be concluded from the analysis of the scientific publications on companion animals that they, too, provide certain beneficial effects, especially on youths with ASD and on their families. This type of intervention for persons with PTSD is very poorly documented. However, assistance dogs, when compared with companion animals, are not very accessible because it is expensive to acquire them and they are available in limited numbers. In addition, users of assistance dogs regularly run up against the public’s lack of knowledge or scepticism regarding the relevance of using these animals and the issue of access rights in public places for persons with ASD or PTSD. Other studies and consultations with various stakeholders would help to stimulate a reflection on the applicability of this type of intervention and on the acceptability of assistance dogs for users and their families, for clinical practice environments and for society in general.
Authors' methods: A systematic review of the scientific literature published between January 2008 and January 2019 was carried out. Two evaluators independently selected the studies. A total of 38 publications were chosen for review, of which 21 focused on ASD and 17 on PTSD. All of the ASD-related studies were conducted with youths and parents, while the PTSD-related studies were carried out with military members or veterans. The efficacy results for assistance dogs and companion animals are presented in the form of a narrative review. A statement of scientific evidence is provided for each outcome of interest, and a level of evidence (high, moderate, low or insufficient) was assigned on the basis of the following four criteria: the methodological properties of the studies involved; the consistency of the results; the clinical impact of these results; and the possibility of generalizing the results to the population and context that were targeted.
Project Status: Completed
Year Published: 2019
English language abstract: An English language summary is available
Publication Type: Other
Country: Canada
Province: Quebec
MeSH Terms
  • Autism Spectrum Disorder
  • Stress Disorders, Post-Traumatic
  • Animal Assisted Therapy
  • Pets
  • Autism
  • post-traumatic stress disorder
  • Assistance dogs
  • Companion animals
Organisation Name: Institut national d'excellence en sante et en services sociaux
Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name: demande@inesss.qc.ca
Contact Email: demande@inesss.qc.ca
Copyright: Gouvernement du Québec
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.