A mixed methods systematic review of assistance dogs for people with autism

Objectives: To critically examine and synthesise the available evidence regarding the impact of assistance dogs on individuals with autism. Study design: Mixed methods systematic review with meta-analysis of quantitative data and meta-aggregation of qualitative data. Studies were eligible for inclusion if they included participants with autism and data describing the impact, effectiveness, or participant experience with an assistance dog or a companion dog. Data sources: CENTRAL, Embase, MEDLINE, and PsycINFO. Data synthesis: Fourteen studies (one randomised controlled trial, three cohort, seven cross-sectional, and three single-arm studies) were included in the meta-analysis and 13 studies (eight cross-sectional, three longitudinal, and two case studies) were included in the meta-aggregation. There was some quantitative evidence that assistance dogs may be associated with benefit, but the pooled effect sizes are similar to those associated with companion dogs. The qualitative data suggested that parents perceived a broad range of benefits of assistance dogs but may be unprepared for the challenges associated with owning an assistance dog. Conclusion: There is a lack of compelling evidence to suggest that assistance dogs confer unique benefits for individuals with autism. The evidence base is limited and of poor quality thus the potential benefits identified need to be interpreted with caution. Interpreting the quantitative and qualitative studies together, the findings indicate many potential benefits of assistance dogs for people with autism could be achieved by a companion dog.