Long-term sustainability of dog-assisted therapy in fetal alcohol spectrum disorder: 12-month follow-up of child and caregiver outcomes

Background

Fetal alcohol spectrum disorder (FASD) is a complex neurodevelopmental condition associated with persistent behavioral, emotional, cognitive, and social difficulties that often affect functioning across home, school, and peer environments. Children and adolescents with FASD frequently present with inattention, impulsivity, emotional dysregulation, and impaired social skills, all of which contribute to reduced quality of life and increased caregiving demands. These challenges also place a substantial psychological burden on caregivers, who often report elevated levels of stress, anxiety, and depressive symptoms. Dog-assisted therapy (DAT) has emerged as a promising complementary intervention for neurodevelopmental disorders because it may enhance motivation, emotional regulation, and social engagement within a structured therapeutic context. Although previous work has shown short-term benefits of DAT in children and adolescents with FASD, the durability of these effects over time, particularly for both patients and caregivers, remains unclear.

Objectives

To evaluate the long-term sustainability of clinical, functional, and family outcomes following a manualized DAT intervention in children and adolescents with FASD, with follow-up at 3, 6, and 12 months after treatment. A secondary objective is to examine whether caregiver depression and anxiety also show sustained improvement over time.

Methods: This longitudinal follow-up study will include participants from a prior randomized controlled trial comparing two formats of the same manualized DAT protocol: a short version consisting of 8 weekly sessions and a long version consisting of 16 sessions. In the original trial, 64 participants aged 6 -18 years with a confirmed FASD diagnosis were randomized to one of the two interventions, and 55 completed treatment. Both versions included individual and group sessions designed to target executive functioning, emotional regulation, impulsivity, problem-solving, communication, empathy, and social skills through structured interaction with certified therapy dogs. Assessments will be conducted at baseline, post-treatment, and at 3-, 6-, and 12-month follow-up. Outcomes will include behavioral symptoms, social skills, quality of life, global clinical severity, and caregiver emotional outcomes, including depression and anxiety.

Results

Findings from the original trial demonstrated significant improvements across both treatment groups in several clinically relevant domains, including externalizing symptoms, social skills, FASD severity, and overall quality of life. However, the long-version DAT format was associated with greater benefits in areas requiring sustained practice and consolidation, including inattention, problem behaviors, clinician- and parent-rated severity, and peer/social support. Caregiver outcomes also improved, with both groups showing reductions in anxiety, while the 16-session intervention showed greater improvement in caregiver depressive symptoms. The present follow-up study will determine whether these treatment-related gains are maintained over time and whether the longer intervention format is associated with more durable effects across child and caregiver outcomes.

Conclusions

This study will provide important evidence on the long-term durability of DAT effects in FASD and on the evolution of caregiver depression and anxiety following treatment. The findings may help clarify the treatment duration needed to achieve sustained benefit and may inform the development of more effective, scalable, and family-centered intervention strategies for children and adolescents with FASD and their caregivers

References

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