The child-animal bond

Introduction 

Watching a child gently playing with a puppy, when the child is giggling and laughing and the puppy is frolicking, both delighting in the shared game they have created in that moment, is a fundamentally joyful and heartwarming experience (Figure 1). Onlookers tend to smile and take pleasure from observing this simple human-animal interaction (HAI) experience. Most humans intuitively enjoy watching or participating in such interactions, and many companion animals, particularly dogs and puppies, also appear to enjoy interacting with humans. The scientific study of HAI, known as anthrozoology, is now accumulating evidence which demonstrates the many ways in which interaction between humans and companion animals can be beneficial for both parties, with the vast majority of that evidence focusing on the human benefits. A large proportion of the high-quality research in this field (thanks to funding from the Waltham Petcare Science Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development) focuses specifically on children.

Companion animals play an important role in the lives of children

Around 60% of United States households include a pet and approximately 70% of pets live in homes with children 1. A sobering statistic indicates the importance of pets in the lives of children: children in the US are more likely to grow up with a pet in their home than a father 2. Research reveals the many ways in which pets impact the lives of children, starting at a very early age 1.

For example, some of the most frequently occurring words in the vocabularies of infants include “cat,” “dog,” and the name of the family pet. Infants also demonstrate a clear preference for animals through their tendency to respond to animate compared to inanimate stimuli, showing more visual attention and greater affective responsiveness. In one series of studies infants spent time looking at animals, smiling, laughing, waving, and in one instance blowing a kiss to the animate stimulus, while virtually never directing these kinds of affective behaviors towards inanimate stimuli 1.

By the time children reach preschool they can appropriately identify cats, dogs, kittens and puppies, and they know that adult animals take care of their young 3. Preschool and elementary school classrooms include images of animals virtually everywhere – in books, on the walls, on clothing, backpacks, school supplies, lesson plans and homework assignments, and even as classroom pets. Teachers have known for decades that children are innately drawn to animals and they capitalize on this information to deliver lessons in fun and interesting ways involving animals.

The pervasiveness of animals in the lives of children has prompted scholars to consider the ways animals may be impacting child development 4, including stress coping, emotional regulation, social support, physical activity, and providing an opportunity to practice and develop nurturance and empathy. The most frequent reasons parents give for the acquisition of a pet for their child include increasing responsibility, companionship, and enjoyment. Parents are acutely aware that their children find interacting with animals to be fun, in no small measure because their children are likely to point this out repeatedly.

The benefits of children interacting with animals 

There is mounting evidence, summarized below, that shows predominantly positive effects of pets in a few key categorical areas of study: physiological development, cognitive development, and socio-emotional development. These results notwithstanding, it is important to point out that some children may fear animals, become stressed by them, abuse or neglect them, or be injured via bites, scratches, or the transmission of zoonotic diseases 4.  4.Therefore, it is extremely important to provide clear instructions to parents, relatives and relatives on how to help children interact with pets safely (Figure 2).

Physiological development

Although most studies of human physiological responses to pets focus on the adult population (eg, reduced risk of cardiovascular disease), recent research seems to show a similar trend in children. For example, bonding with a pet has been associated with lower systolic blood pressure (BP), thinking about a pet has been associated with lower BP, and children have been observed to experience a decreased heart rate. heart rate after interacting with your feline pets 5.

While animal-assisted interactions have quickly become commonplace in the general hospital setting, this is particularly true in pediatric oncology and palliative care units 6,where parents, children and staff have indicated that these visits are perceived positively. Therapy dogs have been shown to decrease pain perception in some pediatric populations and may speed recovery from anesthesia after surgery 6, In addition, hospitalized children have reported feeling less stress, worry, tiredness, fear and sadness after visits from a therapy dog.

One well-established such program is the Virginia Commonwealth University (VCU) School of Medicine’s Dogs on Call (DoC) program ¹ 7 which currently includes 88 therapy dog teams that routinely visit nearly all parts of the VCU hospital system. The handler/dog teams are all registered with a therapy dog organization, either Pet Partners or Alliance of Therapy Dogs, and have undergone additional training and evaluation to qualify for the DoC program. All patients, family and staff may request a DoC visit anywhere in the hospital, except inside the operating or delivery rooms, dining areas, and isolation areas (Figure 3).

¹ https://chai.vcu.edu/programs--services/dogs-on-call/

Perhaps not surprisingly, there is an abundance of anecdotes supporting the scientific evidence mentioned above regarding the benefits of incorporating dogs in hospital settings. In one case, a non-verbal special needs child involved in a serious accident was taken to the emergency department, where he was combative and resistant to treatment. Upon learning that the child loved dogs, the staff called in a DoC team, and the child quickly calmed down when they arrived, focusing on the dog and accepting medical treatment. The child’s injuries required follow-up treatment, and DoC arranged to have the same handler/dog team meet the child at the entrance to the hospital to accompany and comfort the child throughout the necessary medical treatment.

Cognitive development

Recently there has been an increased attention on how companion animals may help students learn 8. In a randomized controlled trial, researchers found that interacting with a dog in a 4-week animal-assisted intervention program has beneficial effects on the executive functioning of college students, a cluster of cognitive processes well connected to educational success and life success 9. 

Reading to Dogs programs have become hugely popular around the world. The seminal program, Reading Education Assistance Dogs^® (R.E.A.D.^®) was begun by Intermountain Therapy Animals in 1999 and now supports affiliated programs in the US, Canada and Mexico, as well as 24 other countries ². Many other programs promote these interventions as well.

² www.therapyanimals.org

Although anecdotal reports by teachers, parents and dog handlers support the efficacy of these programs in improving reading skills, there is sparse empirical corroboration of such claims 10. The existing evidence indicates that Reading to Dogs programs may be particularly effective at improving reading for students with the most to gain, i.e., poor readers. Such programs have the potential to work because the dog may enhance positive attitudes and motivation in young readers; the presence of the dog may improve a child’s sense of confidence or moderate feelings of anxiety or stress, or the dog may provide a non-judgmental social support 8. Equally likely, having the dog as listener may cause the child to become more engaged with the act of reading; the presence of a dog has been found to have such an effect on preschoolers’ attention to tasks 8.

Another topic that has received widespread press coverage is the use of “autism dogs”. The intended function for these dogs is twofold: to protect children with autism spectrum disorder (ASD) from various forms of incidental self-harm, and to improve their social interactions. The dog may prevent the child from wandering off by being tethered together during the day, or by alerting the parents to a child leaving the bed (or even the house) at night 11. It has also been reported that having a pet dog improves family functioning and reduces anxiety in children with ASD 12. Overall results on the efficacy of autism dogs is mixed, and the role can be extremely challenging for the dog. Instead of bonding with one human, as is typically the case with a service dog, an autism dog must be responsive to one or more parents as well as the child – who is often non-responsive in return. Because children with ASD often have irregular sleep patterns, the dog may not get appropriate amounts of rest, and there may be significant obstacles to providing adequate time and supervision for outdoor exercise, eating, or drinking when the dog accompanies the child to school 11.

Another intellectual developmental disorder that seemingly responds to interventions involving dogs is attention deficit hyperactivity disorder (ADHD). One randomized control trial on this topic compared reductions in ADHD symptomatic behaviors between groups of children receiving traditional cognitive behavioral therapy with groups whose therapy also included interactions with dogs 13. The latter group showed significant improvements, suggesting that the effort of learning calm behaviors suitable to interacting with the dogs transferred to other parts of the children’s lives.

Socio-emotional development

Scientists have good reason to suspect that pet ownership or interaction may have a positive impact on socio-emotional development in children. For example, having a pet dog in the home is associated with reduce risk of childhood anxiety 14 and brief unstructured interactions with dogs boosts positive emotions and reduces anxiety in children 15. Similarly, hospitalized children show reduced anxiety following a pet therapy visit (Figure 4) 16 and children who were highly attached to their pets also scored higher on measures of empathy and prosocial orientation 17. 

One study compared relationships of adolescents with their pets to those of their siblings 18. The fascinating results showed that the adolescents report greater satisfaction, and less conflict, in their relationships with their pets than with their own siblings. Attachment to pets may represent a stable relationship in a child’s life, with the pet providing a level of comfort, security and trust that may otherwise be missing 10. Additionally, the pet may provide older children with an opportunity to assume a caregiver role 10 and thus learn responsibility 19.

The downside of attachment, of course, is the potential need to assist a child in working through grief over the death of a pet. At least one study 20 presents a comprehensive analysis of this challenge, and suggests specific coping mechanisms.

Keeping children safe with animals

In 1998 a US study examining dog bite injuries treated in hospital emergency departments revealed a rate of 12.9 incidents per 10,000 people, resulting in approximately 914 new dog bite injuries requiring a visit to an emergency department per year 21. The median age of those bitten was 15 years, with children, especially boys aged 5-9 years, having the highest incident rate, and children were most likely to be bitten on the face, neck and head. A report in 2008 examined the incidence of dog bites in comparison to the previous study and found that, although the incidence of bites to children was lower, children were more likely to require medical treatment than adults 22, and the authors conclude that dog bites continue to represent a public health problem. 

Interestingly, a study that examined companion animal-related injuries from all emergency departments in the Netherlands for a one-year period (2015 April-2016 March) found that most injuries were to adult women and were most frequently caused by horses (although dogs and cats are more frequently kept as pets in the Netherlands) and most often resulted in fractures or contusions rather than wounds 23. It seems likely that this is related to the size of the animal, given that larger animals are more likely to cause a human injury than smaller animals, but the data does not indicate whether the injuries were incidental (e.g., a horse stepping on a human foot), or the result of animal stress or aggression. Determining the root causes of human injuries related to companion animals is complicated, since hospital reports seldom include detailed descriptions of antecedents to injuries, but also important for prevention. 

One program designed specifically to reduce the incidence of dog bites to children is The Blue Dog ³. Family dogs are the source of most bites, and the events result from interactions that humans perceive as benign. Parents of children who have been bitten by their own family dog often express surprise, indicating that it happened very quickly, and that the dog never previously showed any sign of aggression towards the child. Sadly, these statements frequently reflect a misunderstanding of dog behaviors that reflect increasing stress and discomfort with the situation. The Blue Dog program provides various educational resources, including a game that includes depictions of specific examples of child/dog interactions that are likely to lead to a potential bite risk situation (Figure 5).

³ www.thebluedog.org

The program was evaluated to determine the degree to which children could learn to make safe choices after receiving either verbal feedback or additional Blue Dog practice with their parents 24; the results showed significant increases in safe choices after each stage of training for all age groups tested (3 to 6 year old children), and the children retained their ability to make safe choices after two weeks. For children under the age of six, the best results were achieved when they practiced with their parents. A follow-up study 25 examined how children and parents interpret dogs’ body language. While adults make few mistakes in identifying angry dog faces, the researchers were disturbed to find that 4 to 6-year old children frequently make the mistake of confusing a dog baring its teeth and snarling with a smiling friendly dog.

Further, though children can learn dog stress signals, they need frequent reminders to continue to interpret the signals correctly and behave accordingly around dogs. There is no substitute for vigilant parental oversight when children are interacting with dogs; Table 1 lists online resources to help ensure the well-being of all.

Researchers studying children’s interactions with companion animals are finding that many benefits accrue from child-pet relationships. Evidence supports what many people believe to be intuitively obvious – that pets can facilitate physiological, cognitive and socio-emotional growth in children, along with bringing them happiness. However intriguing questions remain about the specific circumstances that will maximize the effectiveness of child-focused HAI while avoiding potential danger. Not every child will benefit from an animal interaction in the same way. A family pet can provide one kind of support, a weekly reading-focused session another, and a therapy dog visit yet another. How often, how long, what circumstances: these are all questions that still motivate researchers, and regardless of the environment in which the child-pet interaction occurs, safety, for both parties, must remain a priority.