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Dolphin Therapy and Autism Ranking: Mildly Hazardous Insufficient/Mixed evidence

Dolphin, photo by Charlie Phillips Dolphin therapy is any kind of intervention (treatment or service) which involves dolphins. 

There are many different kinds of dolphin therapy. The simplest involve the child swimming with, touching or 'looking after' dolphins.

The more complex therapies, such as Dolphin-Assisted Therapy (DAT), are based on structured programmes which are designed to meet the needs of the individual child.

In DAT the child is encouraged to complete one or more pre-determined tasks, such as placing a ring on a peg or saying a word. If the child completes the task to a satisfactory standard, they are rewarded by being allowed to interact with a dolphin.

This interaction may include touching or kissing the dolphin, or getting into the water and taking a ride holding onto the dolphin's dorsal fin.

Our Opinion

There is a very small amount of low quality research (two group studies and seven single case design studies with 3 or more participants) into the use of dolphin therapy as an intervention for people on the autism spectrum.

Because the quality of that research is so poor we cannot determine whether dolphin therapy is likely to provide any benefits to anyone on the autism spectrum. We must wait for further research of sufficiently high quality to be completed.

Dolphin therapy presents a number of ethical issues, and some physical threats, to both people and dolphins, which may be difficult to overcome. Of particular concern are the potential for aggressive behaviour by dolphins towards swimmers and the potential for disease transmission between humans and dolphins.

Alternatives to dolphin therapy are available, at a much lower financial cost and without the potential harm to the people and the dolphins involved. Because of this we cannot recommend the use of dolphin therapy as an intervention for people on the autism spectrum.

If more research into dolphin therapy is carried out, it should use scientifically robust, experimental methodologies.  However, given the high costs of the therapy, alongside the potential hazards to humans and dolphins, this intervention should not be considered as a priority for future research.

Disclaimer

Please read our Disclaimer on Autism Interventions


Audience

Dolphin therapy is used with a wide range of people with varying conditions, including people on the autism spectrum. For example:

  • According to Fiksdal et al (2012), “Supporters and therapists of DAT claim it is effective in treating people with clinical disorders as well as conditions including autism, epilepsy, Angelman syndrome, Down’s syndrome, dyslexia, Rett syndrome, Tay-Sachs disease, Tourette syndrome, William syndrome, cancer, and AIDS”. 
  • According to Kohn and Oerter (2013), dolphin therapy has been used with children and adults ranging in age from two to 30 years old and with a range of conditions including cerebral palsy, Down’s syndrome, epilepsy, ADHD and autism.

 

Aims and Claims

Aims

Different practitioners have different aims for their particular kind of dolphin therapy. For example:

  • Breitenbach et al (2009) stated that dolphin therapy has a number of aims including to increase communicative and social-emotional behaviour and to improve mother–child interactions.
  • Nathanson et al (1998) stated that the general purpose of their programme is to encourage children to engage in desired responses in accordance with the child’s individualised therapy program. The dolphin-assisted therapy sessions are designed to “jump start” the child and to complement or reinforce other, more traditional, therapeutic procedures.
  • Servais et al (1999) stated that the purpose of their programme was to “foster learning in autistic children, by increasing their attention faculty and their motivation.”

According to Fiksdal et al (2012), there are several different theories as to why dolphin therapy might help, some more credible than others. These theories include:

  • The effect of ultrasound on human tissue and cell-structure.
  • The fact that dolphins are attracted to people with disabilities and seek to help them.
  • The feelings of reconnection and happiness that dolphins bring to disabled people. 
  • The fact that children with disabilities increase their attention to relevant stimuli in the environment as a result of their desire to interact with dolphins.

Claims 

There have been various claims made for dolphin assisted therapy. For example:

  • Bin MdYusof and Chia (2012) claimed that dolphin therapy resulted in a significant reduction in stereotyped behaviors and a significant improvement in communication and social interaction in children diagnosed with autistic disorder.
  • Servais (1999) claimed that dolphin therapy can effectively improve language, behavior, cognitive processing, attention and motivation to learn in people with certain medical conditions including autism.
  • Nathanson et al (1997) claimed that dolphin therapy can significantly increase motivation, attention, gross and fine motor skills, speech and language in children with range of conditions including autism. In addition, they suggest that two weeks of dolphin therapy can achieve the same – or better – results as six months of conventional physical or speech therapy

Key Features

Dolphin therapy is any kind of intervention (treatment or service) which involves dolphins. 

Type of dolphin therapy

There are many different kinds of dolphin therapy. The simplest involve the child swimming with, touching or 'looking after' dolphins.

The more complex therapies, such as Dolphin-Assisted Therapy (DAT), are based on structured programmes which are designed to meet the needs of the individual child.

According to Humphries (2003), “DAT consists of defining a treatment goal for the individual child, such as completing a gross or fine motor task (e.g. placing a ring on a peg) or producing a language behavior (e.g. independently saying a word). Materials used as adjuncts to therapy are typically present during a DAT session, including rubber balls or rings for eliciting motor responses, or flash cards depicting objects for language responses.

“Children receive on-dock orientation to the dolphins, with the child and the child’s therapist typically sitting at the edge of a padded floating dock about 2-3 inches above the water, while a dolphin trainer controls the movements of a dolphin in the water. During orientation, children are able to touch or play with the dolphin from the dock or to give hand signals to the dolphin to elicit specific dolphin behaviors.

“Following the orientation period, children engage in a series of therapeutic sessions during which they may interact with the dolphin from the dock or in the water after giving a correct motor, cognitive, or language response. Interactions with the dolphins may include touching, kissing, taking a short ride holding onto the dolphin’s dorsal fin, or dancing in a circular motion with the dolphin.

“Following each episode of reinforcement, the child and therapist return to the therapeutic task, often with an increasing frequency and complexity of correct responses required for the child to interact with the dolphin.” 

Type of dolphin

Most dolphin therapy programmes use dolphins which are native to the country in which the therapy is taking place. So, for example, bottlenose dolphins may be used in the USA while indo-pacific humpback dolphins may be used in Singapore. 

There are even some dolphin therapy programmes which use animatronic or digital versions of dolphins but we have not included these in our evaluation.

Cost and Time

Cost

According to Brakes and Williamson (2007), 

“The cost for two weeks of DAT varies a great deal and a variety of packages are available. Figures given by Humphries (2003) quote a typical price of around $2,600 (approximately £1,370) for five 40 minute sessions (Humphries 2003), but it can cost a participant and one parent more than £3,300 for two weeks, including flights and accommodation . At the more expensive end of the market is 'Dolphin Human Therapy', which, during 2006, cost US$7,850 for two weeks, or US$ 11,800 for three weeks. These quoted prices are for the therapy only (five sessions per week) and do not include flights and accommodation.”

“There are other hidden costs such as surcharges for health care, which should be taken into consideration. Families are generally encouraged to bring children for a minimum of two weeks of DAT. When flights, accommodation and loss of earnings are taken into account, such excursions can cost up to ₤10,000.”

Time

The length and frequency of dolphin therapy varies enormously from one organisation to another. Some providers of dolphin therapy run week or month-long programmes. Others provide single sessions that last a couple of hours.  You may also need to allow for travel time which may be considerable if you are travelling to and staying overseas.

Risks and Safety

Hazards

According to Marino and Lilienfeld (2007), dolphin therapy poses many potential hazards to the human participants including:

  • Aggressive behaviour by dolphins, which can lead to injury
  • Transmission of diseases from dolphins.

If the therapy takes place in the open sea there may be additional hazards including adverse sea conditions, boat traffic and harmful sea creatures.

Dolphin therapy also poses many potential hazards to the dolphins including:

  • Stress in captive dolphins
  • Transmission of diseases from humans
  • Pressure on wild dolphin populations.

“There is abundant evidence for injuries sustained by participants in DAT programs. Moreover, interactions between dolphins and humans carry a significant risk of infections and parasitism for both humans and dolphins.” 

Contraindications

There are no known contraindications (something which makes a particular treatment or procedure potentially inadvisable) for dolphin therapy other than the hazards listed above.

 

Suppliers and Availability

Suppliers 

Dolphin therapies are available in many different locations around the world including Europe, the Middle East, Asia, the USA, the Caribbean and South America.

Credentials

Dolphin therapy is a wholly unaccredited and unregulated industry. According to Brake and Williamson (2007), 

“[The Whale and Dolphin Conservation Society] is not aware of any regulations governing DAT or swim-with-the-dolphins programmes in the countries where DAT is conducted. Swim-with regulations alone are also scarce, although the current marine mammal regulations in the Bahamas include specific requirements for interactive programmes and the Italian regulations on the maintenance of dolphins in captivity prohibit dolphins coming into physical contact with members of the public. Since the suspension of regulations governing dolphin interactive programmes in April 1999, there have been no specific operational requirements for swim-with-the-dolphins programmes in the United States, where some DAT facilities are located. Without such regulations, it is not possible for the authorities to enforce any operational standards on national swim-with and DAT facilities.”

History

In the 1960s Dr. John Lilly, a physician and psychoanalyst, studied dolphin-human communication. He was one of the first people to suggest that dolphins could help humans learn to communicate better with one another.

In the 1970s Dr. Betsy Smith, an educational anthropologist noticed the therapeutic effects of dolphins on her disabled brother. She and other researchers began to study the effects that interacting with dolphins appeared to have on children with neurological impairments.

In the 1980s Dr. David Nathanson of the Dolphin Human Therapy centre in Florida developed dolphin human therapy, a form of dolphin-assisted therapy.

Various dolphin therapy programmes have since been established in other countries in Europe, the Middle East, Asia, the Caribbean and South America.

 

Current Research

We have identified nine* studies of dolphin therapy as an intervention for people on the autism spectrum published in English-language, peer-reviewed journals.

We have been unable to identify exactly how many participants on the autism spectrum were included in these studies because some of them included a wide range of participants but did not state how many of those participants were on the autism spectrum. 

Different studies looked at different programmes in different countries.  For example, the study by Chia et al (2009) looked at the use of indo-pacific humpback dolphins in the Dolphin Encounter for Special Children programme in Singapore while the study by Nathanson et al (1997) looked at the use of bottlenose dolphins in the Dolphin Human Therapy programme in Florida. The length of treatment in the studies varied from two weeks to more than a year, although only one study (Servais, 1999) lasted longer than a year. 

There were a number of studies which compared dolphin therapy with other interventions. For example, the study by Breitenbach et al, 2009 compared two versions of dolphin therapy with two other treatments (including parent counselling and interaction with farm animals). The study by Servais, 1999 compared dolphin therapy with control groups which received classroom or computer instruction. 

The majority of the studies reported a number of benefits to the participants. For example:

  • Some of the studies (such as Breitenbach et al (2009) reported increases in social and communication skills, along with increases in self-confidence.
  • Some of the studies (such as Chia et al, 2009) reported reductions in repetitive and restricted behaviours.
  • Some of the studies (such as Nathanson, 1998) reported that the benefits were long lasting (over six months to a year after intervention).
  • One study (Salgueiro et al, 2012) reported no significant effects and one study (Chia et al, 2009) reported a decrease in social and communication skills.

*Please note: We have not included studies where artificial dolphins (animatronic or digital) were used.

Status Research

There have been a number of literature reviews published in peer review journals on the subject of dolphin therapy, each of which identified significant flaws in the existing research studies.

-    Humphries (2003)

Humphries reviewed a number of studies which purported to have found positive benefits to people from DAT and found that all the research examined "failed to adequately control for a number of possible threats to validity or alternative explanations".

She notes: "The studies included in this synthesis are so plagued with methodological flaws that claims that the reported outcomes are due to dolphin assisted therapy may be erroneous" and that "the results of the synthesis do not support the notion that using interactions with dolphins is any more effective than other reinforcers for improving child-learning or social-emotional development".

She also states: "Claims of the effectiveness of using dolphins as a procedure for improving the behaviours of young children with disabilities are therefore not supported by available research evidence".

-    Marino and Lilienfeld (2007)

Marino and Lilienfeld conducted a review of studies published between 1999 and 2005, and found that "all five studies were methodologically flawed and plagued by several threats to both internal and construct validity".

They found that a consistent problem throughout the studies reviewed was a failure to control for other factors of the treatment which might influence results (for example: being in the water; swimming outdoors; interacting with therapists; experimental expectancy effects).

They concluded that: "the abundance of serious threats to validity in the five studies we examined renders each of their conclusions questionable at best, and entirely unwarranted at worst".

-    Fiksdal et al. (2012)

Fiksdal et al conducted a review of studies five years after Marino and Lilienfeld. They concluded

“The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodological concerns making it impossible to draw valid conclusions.”

- Individual studies

Please note: The research reviews listed above did not take account of some of the later studies and their conclusions should therefore be treated with some caution. However we believe that the overall thrust of their conclusions is still valid as the quality of most of the later studies is still quite poor. For example,

  • The studies by Bin MdYusof and Chia (2012), Chia et al (2009), Dilts et al (2011) and Kohn and Oerter (2013) used a simple pre-post-test design.  The study by Dilts et al had only nine participants, the study by Chia et al had only five participants.
  • The controlled study by Breitenbach et al (2009) compared four interventions (including a no treatment group) but the autistic participants were not split evenly between the groups and the study was not randomised and was not blinded. 
  • The studies by Breitenbach et al (2009) Kohn and Oerter (2013) did not use standardised outcome measures and did not provide separate outcome data for the autistic participants.
  • The study by Kohn and Oerter (2013) “… was funded by the University of Munich and by the organization ‘dolphin aid” which wanted to know whether its engagement in dolphin therapy is justified.” The researchers may therefore have been biased towards the intervention, however unconsciously.

For a comprehensive list of potential flaws in research studies, please see ‘Why some autism research studies are flawed’

Ongoing Research

We have been unable to identify any studies into dolphin therapy that are currently underway.  If you know of any other studies we should include please email info@researchautism.net with the details. 

Future Research

Summary of Existing Research

-    Individual studies

There is a very small amount of low quality research (two group studies and seven single case design studies with 3 or more participants) into the use of dolphin therapy as an intervention for people on the autism spectrum.

Because the quality of that research is so poor we cannot determine whether dolphin therapy is likely to provide any benefits to anyone on the autism spectrum. We must wait for further research of sufficiently high quality to be completed.

-    Research Reviews

There have been a number of research reviews into the use of dolphin therapy. All of the reviews we have identified have concluded that the quality of the existing research base is so poor that it is not possible to determine whether dolphin therapy is likely to provide any benefits to anyone on the autism spectrum.

Recommendations for Future Research

If more research into dolphin therapy is carried out, it should use scientifically robust, experimental methodologies.

However, given the high costs of the therapy, alongside the potential hazards to humans and dolphins, this intervention should not be considered as a priority for future research.

Studies and Trials

This section provides details of scientific studies into the effectiveness of this intervention for people with autism which have been published in English-language, peer-reviewed journals. If you know of any other studies we should include please email info@researchautism.net with the details.

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Other Reading

This section provides details of other publications on this topic. If you know of any other publications we should include please email info@researchautism.net with the details. 

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Personal Accounts

There are numerous personal accounts on the use of dolphin therapy for people on the autism spectrum which have been published on the websites of the organisations which provide that therapy.

Additional Information

According to Fiksdal et al (2012), 

“In 2003, Dr. Betsy Smith, one of the first researchers to investigate and propose the possibility of DAT having therapeutic value, denounced its use. Describing it as an ineffective and exploitative practice, Dr. Smith voiced two main concerns: (1) monetary gain was more involved with DAT’s practice than was empirical evidence supporting its use, and (2) it was undermined and detracted from valid therapy programs. Purveyors of DAT programs can expect to gain a substantial amount of money from every family and client who seeks their help. The potentially hazardous impact of time and money spent for DAT is compounded when the same resources could be spent on empirically supported treatments (e.g., discrete-trial teaching). Currently, there are no studies that show DAT to be consistently effective”.

Updated
18 Dec 2017
Last Review
01 Nov 2017
Next Review
01 Nov 2020