Purewal et al. BMC Pediatrics(2024) 24:578
https://doi.org/10.1186/s12887-024-05049-7

BMC Pediatrics

RESEARCH

Open AccessCompanion animals and child development
outcomes: longitudinal and cross-sectional
analysis of a UK birth cohort study
Rebecca Purewal1, Robert Christley1, Katarzyna Kordas2, Carol Joinson3, Kerstin Meints4, Nancy Gee5 andCarri Westgarth1*
Abstract
Background Research into the impact of social relationships on childhood and adolescent health and wellbeing
has been largely limited to children’s relationships with other humans, while studies into the impact of pet ownershipare sparse and have generally not adjusted for potential confounders. This study aimed to investigate the association
between pet ownership and a range of developmental outcomes in childhood and adolescence.
Methods Data were self-reports and direct assessments of approx. 14,000 children from the Avon Longitudinal
Study of Parents and Children (ALSPAC). Multivariable regression models adjusting for confounding factors examinedassociations between developmental outcome measures (emotional health, behavioural development, cognitive
development, language development, educational attainment) and concurrent pet ownership, including species, andalso longitudinal pet ownership history and pet-interaction where possible. Analyses model numbers using multiple
imputation varied from n = 393–8963.
Results In cross-sectional analyses, owning a dog (b = 0.24, [0.06–0.41], p = .004) and owning other/miscellaneouspets (b = 0.18, [0.03–0.33], p = .021) at age 3 were associated with higher prosocial behaviour score. Owning a pet was
associated with a higher non-verbal communication score at age 2 (cross-sectional, b = 0.18, [0.04–0.32], p = .014),
and a higher language development score at age 5 (cross-sectional, b = 1.01, [0.18–1.83], p = .017). However, petownership was associated with lower educational attainment across a number of academic subjects and timepoints,
in both cross-sectional and longitudinal analyses. It was also cross-sectionally linked to hyperactivity at age 3 andconduct problems at age 3 and 11. Furthermore, at age 8, cross-sectional analysis showed that children who owned
any pets (OR [95% CI]: 0.85 [0.73–0.98], p= ·026) or cats (0.83, [0.73–0.95], p= ·006) had lower odds of high self-esteem(scholastic competence).
Conclusions Using a large, well-designed longitudinal study and adjusting for key confounders, we found little
evidence of cross-sectional or longitudinal associations between pet ownership and emotional health or cognitive
outcomes in children. There may, however, be some cross-sectional and longitudinal association with poorer
educational attainment and a positive impact on social interactions as seen through associations with enhanced*Correspondence:
Carri Westgarth
carri.westgarth@liverpool.ac.uk
Full list of author information is available at the end of the article© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) andthe source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in thisarticle are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not includedin the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you willneed to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Purewal et al. BMC Pediatrics(2024) 24:578

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language development and prosocial behaviour. This study demonstrates the importance of adjustment for
confounding variables and suggests that, contrary to popular belief, positive impacts of pet ownership on childhood
development may be mainly limited to social behaviour and language development.
Keywords ALSPAC, Animals, Child development, Dogs, Longitudinal studies, Ownership

BackgroundChildhood and adolescence are crucial life phases forcontribution to the quality of health, emotional wellbeing, learning and behaviour across the life span.
According to relationship psychology, social interaction
theories [1, 2] and attachment theory [3–5], social relationships contribute fundamentally to child and adolescent development, yet studies have been largely limited
to children’s relationships with other humans. In westerncultures, pet ownership is common; 70% of U.S. households [6] and 59% of British households [7] include atleast one companion animal. There is increasing researchinterest in the potential benefits of companion animals
on human health [8–10], but the relationship between
childhood animals and developmental outcomes is
unclear [11].
Emotional and behavioural development

Emotional and mental health difficulties, such as depression, separation and social anxiety disorder, are relatively
common in Children and Young People and increasing.
In 2017 the estimated prevalence in 5-19-year-olds in the
UK was 8.1% [12], but a follow-up in 2022 suggests that
18% of 7–16 year olds had a ‘probable’ and 11% a ‘possible’ mental disorder [13]. The percentage of behavioural disorders (e.g., hyperactivity, conduct disorders) isslightly lower, for example in 2017 it was reported among
5% of UK 5–19 year olds [12]. Emotional difficulties thatarise in childhood can persist into young adulthood [14,15]. Due to increasing pressures on mental and behavioural health spending, and the difficulty in accessing
specialist interventions, prevention and early intervention may be more cost-effective [16].
Interaction with animals can mediate human physiological responses to stressors and anxiety, and may
improve mental, social, and physical health [17–19].
Interaction with animals can also affect the endocrine
system. Oxytocin levels have been found to increase in
the presence of a pet [19] and in turn can stimulate social
interaction, increase social skills, increase positive selfperception, and decrease depressive symptoms [20, 21].
Oxytocin also has an anxiolytic effect for social anxiety[22] and social fear [23]. Interacting with dogs and catshas also been shown to lower the stress hormone, cortisol [17, 24].
Companion animals can act as social facilitators forinterpersonal human social interactions (social-catalyst effect) which in turn may reduce loneliness, social

anxiety and depression, and increase self-esteem [25].
Pets are also perceived to provide unconditional positive
regard, approval, and acceptance without judgement, forexample when these feelings or affirmations are lacking
from caregivers or peers [26, 27]. Gaining this type ofemotional support is essential for the healthy psychological development in childhood and adolescence, especiallyduring periods of growth, developmental changes, andchallenging social situations.
Animals have been involved with children in psychotherapy [28] and animal-assisted therapy [29], includingin the classroom [30], with some evidence of positive
outcomes. For example, significant effects on loweringof cortisol after 4 weeks of dog-assisted interventionsin school children with and without special educational
needs have been found [17]. However, involving animals
in ‘therapy’ in settings such as schools is not completely
free of criticism for example for welfare reasons [31], andthe extent to which these findings might apply insteadto the presence of companion animals in the home isunclear. It is also unknown which species/types may
be most beneficial for certain age groups, and whether
effects vary by developmental outcome. One recent study
found that dog-owning adolescents showed significantly
less psychological symptoms (sadness, depression, fear,
and nervousness) than adolescents who reported having
a cat, a dog and a cat, or having other pets [32].
Cognitive and language development and educational
attainment

Early enhancement of cognitive ability (executive function, general intelligence, and language) sets a child on a
trajectory for success in later life. For example, executivefunctions (e.g., working memory, inhibitory control, cognitive flexibility, planning, reasoning, problem-solving)are predictive of achievement throughout life, often moreso than IQ or socio-economic status [33]. Evidence suggests that early honing of executive functionss can reduce
later incidence of school failure, aggression, and antisocial behaviour [34].
It is noteworthy that executive function and emotion regulation are interlinked and influence each otherwith inhibitory control and self-regulation overlapping
to some extent [35]. Self-regulation may also impact
key social and emotional skills that affect school readiness and later school success [36]. Various studies havedemonstrated the positive effects of animal presence on
the enhancement of memory and attention [37, 38] andPurewal et al. BMC Pediatrics(2024) 24:578

improvements in children’s spatial abilities after dog andrelaxation interventions have also been seen [39].
Companion animals may indirectly improve emotional
regulation and cognition through improving executivefunction [34]. Maturational changes in executive function
develop over the first two decades of life, meaning that
infancy and childhood may be the optimal time for living with animals. Animals may also influence the development of self-regulation through stress regulation. As
executive functions are negatively impacted by chronic
stress but improved by social support [35], interaction
with companion animals may also indirectly improvechildren’s ability to self-regulate and could contributeto the prevention of public health issues resulting from
Early Adverse Childhood Experiences, however research
has not supported this hypothesis so far [40].
Animal-owing infants and children may also benefit
from a more linguistically stimulating environment, especially given that humans talk to pets in similar language
used for small children (“motherese”) [41], potentiallyleading to enhanced or earlier development of speech.
Interaction with animals during this developmental
stage, and watching others interact with the animal,
could also be hypothesized to enhance perspective-taking and prosocial behaviour [11]. Prosocial behaviour
refers to actions intended to benefit others [42]. Attention to social cues like eye gaze direction has been shown
to predict language outcome [43, 44]. During interaction
with animals, where the reliance of verbal commands
alone is rarely sufficient, social cues may be particularly
important.
Limited evidence for effects of pet ownership on childhood
development

The findings of current research into the effects of companion animals are often difficult to interpret due tosmall samples, cross-sectional designs, lack of adjustment
for known confounding factors such as socioeconomic
variables, and often reducing complex and variable interactions with multiple species to simple animal presence/
absence [9]. A previous systematic review [11] foundthat companion animal ownership and the significanceof children’s bonds with them have been underexploredwithin the field of child development, particularly forthe outcomes of cognitive and language development,
and educational attainment. Further, there is a shortageof high quality and longitudinal studies that sufficiently
controlled for confounding, which often attenuates positive effects of companion animals on child developmental
outcomes [45, 46]. New well-designed research is neededusing large, prospective datasets that examine the influence of different species which may be expected to beinteracted with in different ways and intensities, whilst
controlling for important confounding variables.

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This study aims to address this research gap using alarge dataset from the Avon Longitudinal Study of Parents and Children (ALSPAC) [47]. We investigated theassociations between ‘pet ownership’ measured approximately every 18 months during childhood and adolescence, and a range of child developmental outcomes
including anxiety, depression, self-esteem, behaviouraldifficulties, executive function, language development
and educational attainment. Not only does this research
make a novel contribution to the literature but the findings reported here can serve as a resource to parents asthey make decisions about whether to introduce a newcompanion animal to the family.
Using examination of data from a longitudinal birthcohort, we hypothesised that companion animal ownership, in particular dog and cat ownership, would be:• 	 Positively associated with self-esteem, cognitive
ability, language development and educational
attainment.
• 	 Negatively associated with anxiety, depression, andbehavioural difficulties.

Methods
Participants

Pregnant women resident in Avon, UK with expected
dates of delivery 1st April 1991 to 31st December 1992
were invited to take part in the study (Boyd et al., 2013;
Fraser et al. 2013). The initial number of pregnancies
enrolled was 14,541 (for these at least one questionnaire
had been returned or a “Children in Focus” clinic had
been attended by 19/07/99). Of these initial pregnancies,
there was a total of 14,676 foetuses, resulting in 14,062
live births and 13,988 children who were alive at 1 yearof age.
When the oldest children were approximately 7 yearsof age, an attempt was made to bolster the initial sample
with eligible cases who had failed to join the study originally. As a result, when considering variables collectedfrom the age of 7 onwards (and potentially abstracted
from obstetric notes) there are data available for morethan the 14,541 pregnancies mentioned above. The number of new pregnancies not in the initial sample (known
as Phase I enrolment) that are additionally represented
on the built files and reflecting enrolment status at
the age of 24 is 913 (456, 262 and 195 recruited during
Phases II, III and IV respectively). The phases of enrolment are described in more detail in the cohort profile paper (Boyd et al., 2013). The total sample size foranalyses using any data collected after the age of sevenis therefore 15,447 pregnancies, resulting in 15,589 foetuses. Of these 14,901 were alive at 1 year of age. 14,203
unique mothers were initially enrolled in the study. As a

Purewal et al. BMC Pediatrics(2024) 24:578

result of the additional phases of recruitment, a total of
14,833 unique women (G0 mothers) enrolled in ALSPAC
as of September 2021. Further, 12,113 G0 partners havebeen in contact with the study by providing data and/or
formally enrolling when this started in 2010. 3,807 G0
partners are currently enrolled.
A 10% sample of the ALSPAC cohort, known as theChildren in Focus (CiF) group, attended clinics at the
University of Bristol at various time intervals between
4 and 61 months of age in order to perform in-person
measures for example practical assessments. The CiF
group were chosen at random from the last 6 monthsof ALSPAC births (1432 families attended at least one
clinic). Excluded were those mothers who had moved outof the area or were lost to follow-up, and those partaking
in another study of infant development in Avon.
Compared to mothers in Avon and the rest of GreatBritain, the ALSPAC cohort had a slight shortfall in theless affluent families (those living in rented accommodation, not having a car or being single or unmarried cohabiting), as well as a shortfall in ethnic minority mothers[48]. Children also had higher educational attainment at
16 years than the national sample and those lost to follow up had a lower educational attainment, plus children
enrolled were more likely to be white and less likely to beeligible for free school meals than a national sample [47].
Those for whom ‘pet’ ownership was reported for the
teenage years were more likely to be female with a higher
maternal education level than those for whom ‘pet’ ownership was not reported [49].
Measures
Pet measures

We will refer onwards to pet ownership rather than companion animals, as this is how the data were collected at
the time. Pet data were collected approximately every 18
months. The pet ownership data from gestation up to age
18 years has been previously described in detail, pleasesee [49, 50] for further information. In brief, pet ownership during gestation was available for 13,557 (96%) children as reported by caregivers, 7800 (97%) children at age
10 years, and retrospectively for 3098 (58%) adolescentsat age 18 years, covering the 11–18 years period. Data
included “do you have any pets?” and if so, how many
cats, dogs, rabbits, rodents (mice, hamster, gerbil, etc.),
birds (budgerigar, parrot, etc.), fish, tortoises/turtles, andafter age 10, also horses. Parents or caregivers completed
a postal questionnaire enquiring about the child’s activities when their child was typically (65%) aged 77 months(6 years) and reported if their child looked after a pet athome ‘Often’ (1342), ‘Occasionally’ (2946) or ‘Not at all’(4045), which became our Pet Interaction (PI) variable.
To investigate the longitudinal impact of pet ownershipduration, pet ownership history was constructed using

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two-step cluster analyses, an exploratory tool designed
to reveal natural groupings (or clusters) within a datasetthat would otherwise not be apparent. These typicallyencompassed ‘always, sometimes or never owned a pet’
up until that time point [49], which could then be used as
an explanatory variable in its own right.
Outcome measures

The developmental outcome variables were derived
from a variety of questionnaires completed by mothers/caregivers, or by children themselves, collected bypost between age 2 and 15 years at specific time points,
or from questionnaires or tasks conducted in Children
in Focus (CiF) research clinics at specific ages (Table 1).
They consisted of five broad areas of psychosocial development: (i) emotional health, (ii) behaviour, (iii) cognition, (iv) educational and (v) language development.
Each area consisted of multiple endpoints (Table 1); moredetails about how specific measures were collected andanalysed, including sample sizes for each outcome andcorresponding pet ownership variable, are given in the
Additional data file including Supplementary Figs. 1–11).
Established cut-offs were used as described in the instrument validation where possible. Where no clinical cut-off
score exists (such as for the RRS), cut-offs were calculated using standardized z scores, taking the highest (orlowest) tertile.
Please note that the study website contains details of all
the data that is available through a fully searchable data
dictionary and variable search tool at http://www.bristol.
ac.uk/alspac/researchers/our-data/.
Confounding variables

Considering that the apparent associations between key
variables of interest and the effects of owning pets may
be influenced by numerous confounding factors, a large
range of variables were included within the project dataset. Final confounders in each model were chosen on thebasis of previous analyses that have found factors associated with PO in this cohort [49, 50], theoretical plausibility and based on what we know are associated withthe predictor and outcome variables from prior research.
Potential confounding measures adjusted for (see Additional File) included sex, ethnicity, maternal mental
health, socioeconomic status, family factors (older children living with the child, whether the child has a twin,child attended day care, and parental marital status),
and child factors (developmental delay (Denver development scale [51]), child temperament (Toddler Temperament Scale [52]), and stressful life events (maternal
questionnaire [53]). DAGitty software was used to build
causal models for each developmental outcome based on
the concept of directed acyclic graphs (see Supplementary Figs. 12–14) and by selecting confounders based onPurewal et al. BMC Pediatrics(2024) 24:578

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Table 1 ALSPAC outcomes and measures selected for the study (for how variables were analysed/coded see additional data file)
OutcomeAge(years)Emotional
HealthSelf-esteem (scholastic 8
competence)
Self-esteem (global self 8
worth)
Separation anxiety
7, 10
and 13Harter Self-Perception Profile (HSPP) (CiF clinic)

Cross-sectional analyses(Pet ownership = Has any
pet, has dog, has cat, hasother pet)
Pet ownership age 8Harter Self-Perception Profile (HSPP) (CiF clinic)

Pet ownership age 8

Development And Wellbeing Assessment(DAWBA) (child-based questionnaire (parent
reported))

Pet ownership age 7
Pet ownership age 10
Pet ownership age 13
Pet interaction age 6

Social anxiety

7, 10
and 13Development And Wellbeing Assessment(DAWBA) (child-based questionnaire (parent
reported))

Generalised anxiety

7, 10
and 13Development And Wellbeing Assessment(DAWBA) (child-based questionnaire (parent
reported))

Pet ownership age 7
Pet ownership age 10
Pet ownership age 13
Pet interaction age 6
Pet ownership age 7
Pet ownership age 10
Pet ownership age 13
Pet interaction age 6

Depression

7

DAWBA (child-based questionnaire (parent
reported))
Mood and Feelings Questionnaire (MFQ) (CiF
clinic)Revised Rutter Scale (RRS) (parent reported)
Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Revised Rutter Scale (RRS) (parent reported)
Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Revised Rutter Scale (RRS)
Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Revised Rutter Scale (RRS) (parent reported)
Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Revised Rutter Scale (RRS)

Pet ownership age 7
Pet interaction age 6
Pet ownership age 10
Pet ownership age13
Pet ownership age 3
Pet ownership age 11

Pet ownership age 11

Behaviour

Hyperactivity

Emotional symptoms

Conduct problems

10 and
13
3
11
3
11
3
11

Peer problems

11

Prosocial behaviour

3
11

Total behaviouraldifficulties

3
11

Cognition/
Executivefunction

MeasurePet ownership age 3
Pet ownership age 11
Pet ownership age 3
Pet ownership age 11
Pet ownership age 11
Pet ownership age 3
Pet ownership age 11

Selective attention

8 and
11

Attentional Switching

8 and
11

Tests of Everyday Attention for Children (TEACh)(CiF clinic) - Dual Task

Pet ownership age 8
Pet ownership age 11

Attentional control

8 and
11
8 and
11
10
10
8

Tests of Everyday Attention for Children (TEACh)(CiF clinic) - Same worlds
Tests of Everyday Attention for Children (TEACh)(CiF clinic) - Opposite worlds
Stop-signal task (CiF clinic) (150ms delay)
Stop-signal task (CiF clinic) (250ms delay)
Digit recall (CiF clinic)

Pet ownership age 8
Pet ownership age 11
Pet ownership age 8
Pet ownership age 11
Pet ownership age 10
Pet ownership age 10
Pet ownership age 8

Working memory

Pet ownership
repeated measures
all time points.
History of pet ownership by age 13
Repeated measures
all time points.
History of pet ownership by age 13
Pet ownership
repeated measures
all time points.
History of pet ownership by age 13

History of pet ownership by age 13
History of pet ownership by age 11
History of pet ownership by age 11
History of pet ownership by age 11
History of pet ownership by age 11
History of pet ownership by age 11

Pet ownership age 3

Strengths and Difficulties Questionnaire (SDQ)(parent reported)
Tests of Everyday Attention for Children (TEACh)(CiF clinic) - Sky Search

Inhibition/impulsivity

Longitudinal
analyses

Pet ownership age 8,
Pet ownership age 11

History of pet ownership by age 11
History of pet ownership by age 11
Pet ownership
repeated measures
all time points.
History of pet ownership by age 11.
History of pet ownership by age 11.
History of pet ownership by age 11

Purewal et al. BMC Pediatrics(2024) 24:578

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Table 1 (continued)
Outcome

EducationAge(years)Reading
Writing
Maths
Summary score
EnglishMaths
Science
Summary score
EnglishMaths
Biological Sciences
Chemistry
Physics
Achieved 5 A*-C

Language

Language development score
Total Communication
Score
Vocabulary score
Non-verbal communication scoreSocial development
score

Measure10
7Counting span task (CiF clinic)
Standard Assessment Test (SATs) Key Stage 1(KS1)
7Standard Assessment Test (SATs) Key Stage 1(KS1)
7Standard Assessment Test (SATs) Key Stage 1(KS1)
7Standard Assessment Test (SATs) Key Stage 1(KS1)
11Standard Assessment Test (SATs) Key Stage 2 (KS)Standard Assessment Test (SATs) Key Stage 2 (KS)Standard Assessment Test (SATs) Key Stage 2 (KS)Standard Assessment Test (SATs) Key Stage 2 (KS)15
General Certificate of Secondary Education(GCSE) attainment grades
15
General Certificate of Secondary Education(GCSE) attainment grades
15
General Certificate of Secondary Education(GCSE) attainment grades
15
General Certificate of Secondary Education(GCSE) attainment grades
15
General Certificate of Secondary Education(GCSE) attainment grades
15
General Certificate of Secondary Education(GCSE) attainment grades
2 and 5 Reynell Development Language Scale (RDLS) (CiF
clinic)2
MacArthur Communicative Development Inventories (MCDI) (parent reported)
2
MacArthur Communicative Development Inventories (MCDI) (parent reported)
2
MacArthur Communicative Development Inventories (MCDI) (parent reported)
2
MacArthur Communicative Development Inventories (MCDI) (parent reported)

empirical evidence from previous studies. The primarytheoretical considerations when considering confounderselection are described below.
Detecting gender differences in pet ownership is difficult to do using only family pet ownership data, as manyfamilies have both male and female children [54]. Nonetheless, sex of the study child was controlled for within
all analyses as there are likely to be differences according
to developmental outcome. Girls have indicated higher
rates of ownership of pets in datasets including ALSPAC[50, 55].
As ALSPAC is not very ethnically diverse, ethnicity is
not usually used as a confounder. It was however, controlled for in the language analyses. Previous research has
found that compared with non-owners, dog and/or cat

Cross-sectional analyses(Pet ownership = Has any
pet, has dog, has cat, hasother pet)
Pet ownership age 10
Pet ownership age 7

Longitudinal
analyses

Pet ownership age 7
Pet ownership age 7
Pet ownership age 7
Pet ownership age 11
Pet ownership age 11
Pet ownership age 11
Pet ownership age 11
Pet ownership age 15
Pet ownership age 15
Pet ownership age 15
Pet ownership age 15
Pet ownership age 15
Pet ownership age 15

History of pet ownership by age 15
History of pet ownership by age 15
History of pet ownership by age 15
History of pet ownership by age 15
History of pet ownership by age 15
History of pet ownership by age 15

Pet ownership age 2
Pet ownership age 5
Pet ownership age 2
Pet ownership age 2
Pet ownership age 2
Pet ownership age 2

owners were more likely to be of Caucasian ethnicity andhave better English language skills [46].
Maternal mental health is frequently used as a confounding factor in many ASLPAC developmental studies [56, 57]. It can be hypothesised that experiencing
poor mental health may impact decisions to own pets,
especially in childhood as the parent is the one making
the pet-owning decisions. All models were adjusted formaternal depression (Edinburgh Postnatal Depression
Scale EPDS [58] dichotomized at a cut-off of 13), andmaternal anxiety (Crown-Crisp Experiential Index CCI[59] dichotomized at a cut-off of 9).
Again, it is to be expected that family demographic
factors such as socio-economic status exert some influence on the likelihood of acquisition of pets, as theyaffect the parent who makes the pet-owning decisions.

Purewal et al. BMC Pediatrics(2024) 24:578

Socioeconomic status is an important consideration
when looking at the pet effect on child development.
Previous research has found that compared with nonowners, dog and/or cat owners were significantly lesslikely to have a child who received free or reduced lunchat school, have higher monthly housing costs, worked
more hours per week, and more likely to live in a house[46]. Other research has found that dog ownership in thegeneral population decreases as years of education or
family affluence level increases [60–62]. Supporting this,another study found dog ownership in children was associated with higher levels of deprivation [63]. In ALSPAC,
throughout childhood and adolescence, professional
occupations were least likely to own pets [49, 50].
Confounding measures of socioeconomic status
included highest parental social class (occupational social
class 1991 British Office of Population and Census Statistics [64] classification), maternal education (coded ona five-level scale, with the lowest score indicating lowest
educational attainment Certificate of Secondary Education (CSE) or vocational qualification and the highest
level indicating university degree), grouped maternal age
at delivery (< 21, 21–30, > 30), overcrowding (> 5 people),house type (detached, semi-detached, end-terrace, terraced, flat/room in someone else’s house/other), financial
difficulties (occurrence of major financial problems sincepregnancy versus none), ownership of home (owned
accommodation; privately rented; subsidized housing), and housing defects, family income and car access(these variables were mainly derived from questionnaires
administered during the antenatal period).
Families who choose to own companion animals may
be different to families without companion animals interms of the ‘social climate’. Parenting practices andparental bonding effects on the development of children
are difficult to detangle from the contribution made bycompanion animals [65]. Research has found that not
only are families with children more likely to have pets
[66], but that pet ownership reaches a peak in families
with children at middle childhood, between 8 and 12
years [49, 54]. The absence of any or younger siblings canalso influence attachment to the pet [55]. Where appropriate, models were adjusted for older children livingwith the child, whether the child has a twin, if the childattends day care, and parental marital status (ALSPAC
maternally reported questionnaires [53]).
Lastly, there are child factors that are important toadjust for when exploring associations between PO
and developmental outcomes. These factors are rarely
accounted for in previous studies looking at the impactof pets on human development. It is plausible to suggestthat children with developmental or temperamental difficulties, and those who have been through stressful live
events, may be more likely to own pets, as parents often

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obtain pets in attempt to relieve their child’s difficulties
or to hone their social and emotional development [67].
Where appropriate, models have been adjusted for developmental delay (Denver development scale [51]), childtemperament (Toddler Temperament Scale [52]), andstressful life events (ALSPAC maternally reported questionnaires [53]).
Analysis

Univariable and multivariable linear or logistic regression
analyses examined associations between ownership ofany pets, dog, cat and other/miscellaneous pets, (or history of pet/dog ownership), and developmental outcomesfor each age at which the outcome was measured (SeeTable 1).
Cross-sectional and longitudinal analyses were conducted, depending on the availability of longitudinalmeasures. As outlined in Table 1, due to cohort design
and assessment schedules in ALSPAC, longitudinal data
is not available for all measures, while testing intervals
for exposure and outcome were not always identical.
Where repeated measures were available, associations
were assessed using random effect hierarchical regression
models in MLwiN version 3.02, to account for clusteringof data within individuals across all time points available.
The majority of analyses were based on contemporaneous associations of variables, as the data did not allow
for lag analyses due to different outcome measures being
used at different time points. However, the longer-term
longitudinal impact of pet ownership duration on development was also examined using the pet ownership history variables (excluding language development at youngages).
Final covariate selection for the adjustment in multivariable modelling was also based on statistical considerations as well as the causal models previously described.
Variables remained in the model if there was considerable wider evidence to support their inclusion for adjustment, e.g., factors associated with pet ownership [49, 50],
good evidence for an association (P < .05) in this model,
or if their removal (by backwards stepwise) resulted in
substantial change to the effect of other variables (10% or
greater). This method resulted in most confounding variables being included in each model; variables which were
and were not included are described in the legend to eachtable.
To address biases from attrition, missing data for all
confounders in the models were imputed using multiple imputation by chained equations (MICE) [68] in
SPSS Version 24 using an MCMC (Markov chain Monte
Carlo) algorithm known as fully conditional specificationor chained equations imputation (see Additional File formore information). Exposure and outcome variables were
not imputed. A more detailed description of missing dataPurewal et al. BMC Pediatrics(2024) 24:578

for each confounder at each time point can be found in
Additional File Supplementary Table 1.
Considering the number of multiple comparisons madewithin the study, reducing the P value criterion (Bonferroni correction) was considered in order to reduce thechance of Type 1 error. However, the Bonferroni correction addresses the Type 1 error problem at the expenseof Type 2 error, thus severely reducing power to detect
an important effect [69]. To remain cautious, we present patterns of results, and ‘weak’ or ‘strong’ evidence ofan association instead of stating statistical significanceor relying on the magnitude of P values [70], in line withALSPAC Committee recommendations. In addition, as
advised by other scholars [71] P values are presented but
not in isolation and effect estimates are also provided.
As the pet interaction variable was collected only once
(age 6 years), the developmental outcomes that could be
explored for association were: anxiety and depression atage 7 years.

Results
Pet ownership increased from 58% during gestation to
74% at 10 years and 72% by age 18 [49]. At age 10 years,
cat ownership was 31% and dog ownership was 26%.
Similarly, the frequency of owning fish, rodents and rabbits increased until age 11 years, but then declined. Cats
were the most commonly reported pet up to age 15 years;
dogs were the most common pet type among older adolescents, rising to 37% by 18 years. Findings from complete case analyses were very similar to the imputed
missing data analyses thus only the latter are presented.
Analyses model numbers using multiple imputation varied from n = 393–8963 (see Additional File Supplementary Figs. 1–11).
Emotional healthPrevalence of child emotional health outcomes ranged
from 4% (separation anxiety aged 13) to 23.9% (low scholastic competence aged 8) (for more details see Additional File Supplementary Tables 2–3). At age 8, children
who owned any pets (OR = 0.85, 95%ci-0.73–0.98, p=·026) or cats (OR = 0.83, 95%CI = 0.73–0.95, p= ·006)
had lower odds of concurrent high self-esteem (scholastic competence). In contrast, there was no evidence ofan association between pet ownership and self-esteem(global self-worth) at age 8 (Table 2). At age 7, there was
weak evidence of an association between owning any
pets (OR = 1.31, 95%CI = 1.03–1.67, p= ·027) or owning‘other/miscellaneous’ pets (OR = 1.28, 95%CI = 1.04–1.57,
p= ·021) and higher odds of social anxiety measured concurrently (Table 2). However, the association with owning any pets did not remain during longitudinal analyses
after accounting for scores at all three time points (7,10, 13) within a repeated measures model (b = 0.09,

Page 8 of 21

95%CI=-0.29-0.49, p = .621) (Additional file Supplementary Table 4). There was no evidence of an association
between pet ownership and separation anxiety, depression, anxious and depressive symptoms, or emotional
health difficulties at either age 7, 10 or 13 (Table 2; Additional file Supplementary Table 5) nor if considering longitudinal analysis using pet ownership history at 13 years(Additional file Supplementary Table 6) or pet interaction
at age 6 (Additional file Supplementary Table 7).
Behavioural development

Prevalence of child behavioural difficulties by our cut
off method (note this is not a clinical diagnosis) ranged
from 7% (prosocial difficulties aged 11) to 57% (conduct
difficulties aged 3) (Additional file Supplementary Table
8). There was no evidence of an association between
pet ownership at ages 3 or 11 and concurrently measured emotional health difficulties (Table 3). At age 3,
there was weak evidence of an association between owning cats and higher odds of hyperactivity (OR = 1.12,
95%CI = 1.01–1.24, p = .037). Owning pets (OR = 1.14,
95%CI = 1.05–1.25; p = .003) and cats (OR = 1.17,
95%CI = 1.06–1.29, p = .001) at age 3, and dogs at ages 3(OR = 1.19, 95%CI = 1.07–1.33, p = .002) and 11 (OR = 1.44,
95%CI = 1.11–1.86, p = .006) were more strongly associated with a higher likelihood of conduct problems atthese ages. Owning ‘other/miscellaneous’ pets at age 3
was associated with lower likelihood of experiencing
prosocial difficulties at that age (OR = 0.88, 95%CI = 0.79–
0.97, p = .012). When prosocial behaviour analyses wererepeated using linear regression, we found that owning a dog at age 3 was associated with a higher concurrent prosocial behaviour score (b = 0.24, 95%=0.06–0.41,
p = .004), as was owning other/miscellaneous pets(b = 0.18, 95%CI = 0.03–0.33, p = .021). At age 11, owning‘other/miscellaneous’ pets wesre associated with a lower
likelihood of peer problems (b = 0.72, 95%CI-0.57–0.89,
p = .004) and weakly a lower likelihood of total behavioural difficulties (b = 0.73, 95%CI-0.53–0.99, p = .044) atthat age. There was no evidence of an association duringlongitudinal analyses of pet ownership history (sometimes or always owned pets up to 11 years) and behavioural difficulties symptoms at 11 years (Additional file
Supplementary data Table 9).
Cognitive development

At ages 8 and 11 there was no strong cross-sectional
evidence of an association between pet ownership andmeasures of selective attention, attentional control(Table 4), impulsivity or working memory (Additional file
Supplementary Table 10). However, owning a dog was
associated with scoring 0.42 points (95%CI = 0.12–0.17,
p = .005) higher (indicating poorer ability) in attentionalswitching only at age 11. This association remainedPurewal et al. BMC Pediatrics(2024) 24:578

Page 9 of 21

Table 2 Emotional health results showing: Univariable and multivariable associations between pet ownership at age 8 and thelikelihood of low self-esteem, as measured with the Harter self-perception profile subscales (scholastic competence and global selfworth) at age 8; Univariable and multivariable associations between pet ownership at ages 7, 10 and 13 and DAWBA (Development
and Wellbeing Assessment) separation anxiety, social anxiety, and generalized anxiety disorder symptoms at ages 7, 10 and 13 years.
For depression findings please see additional file supplementary table 5
Emotional health outcome
Age
8

8

Self esteem - Scholastic Competence (low score ≤ 14)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Self esteem - Global self-worth (low score ≤ 16)
Has any Pet
Has Dog
Has Cat
Has other /miscellaneous pets
Separation Anxiety (any separation anxiety symptom(s) “a lot more than others”)
Has any Pet

7
10
13

UnivariableN

OR (95% CI)

pMultivariable(adjusted)
OR (95% CI)

3951
3952
3952
3952

0.81 (0.71, 0.92)
0.79 (0.68, 0.92)
0.80 (0.71, 0.92)
0.92 (0.81, 1.04)

0.006*
0.002*
0.001*
0.197

0.85 (0.73, 0.98)
0.86 (0.74, 1.00)
0.83 (0.73, 0.95)
0.94 (0.83, 1.07)

0.026*
0.054
0.006*
0.323

3938
3939
3939
3939

0.91 (0.78, 1.05)
0.97 (0.83, 1.14)
0.92 (0.80, 1.06)
0.94 (0.82, 1.07)

0.199
0.747
0.244
0.338

0.93 (0.79, 1.09)
1.05 (0.89, 1.24)
0.94 (0.81, 1.08)
0.95 (0.83, 1.09)

0.368
0.544
0.374
0.451

6638
6375
2387

1.01 (0.82, 1.24)
1.15 (0.91, 1.46)
1.24 (0.69, 2.20)

0.945
0.230
0.465

0.99 (0.79, 1.22) 0.895
1.16 (0.91, 1.48) 0.220
1.15 (0.64, 2.07) 0.639

6635
6374
2390

0.96 (0.76, 1.22)
1.11 (0.88, 1.39)
1.30 (0.80, 2.11)

0.778
0.376
0.289

0.95 (0.75, 1.21) 0.692
1.12 (0.88, 1.41) 0.365
1.18 (0.71, 1.94) 0.525

6634
6374
2391

1.27 (0.95, 1.43)
1.22 (0.98, 1.50)
1.57 (0.98, 2.50)

0.132
0.069
0.059

1.11 (0.91, 1.36) 0.312
1.18 (0.95, 1.46) 0.138
1.49 (0.93, 2.40) 0.101

6635
6374
2389

1.04 (0.86, 1.26)
1.02 (0.83, 1.24)
0.86 (0.54, 1.38)

0.688
0.886
0.545

1.04 (0.85, 1.26) 0.714
1.03 (0.84, 1.27) 0.776
0.83 (0.52, 1.34) 0.450

7208
6714
2604

1.28 (1.01, 1.62)
1.23 (0.97, 1.55)
1.44 (0.99, 2.09)

0.040*
0.092
0.056

1.31 (1.03, 1.67) 0.027*
1.25 (0.98, 1.59) 0.068
1.30 (0.89, 1.90) 0.178

7204
6713
2608

0.91 (0.70, 1.17)
1.04 (0.83, 1.30)
1.10 (0.80, 1.51)

0.467
0.724
0.533

0.92 (0.71, 1.19) 0.529
1.05 (0.83, 1.33) 0.679
0.97 (0.70, 1.34) 0.847

7203
6713
2609

1.18 (0.95, 1.46)
1.13 (0.91, 1.39)
1.08 (0.79, 1.47)

0.131
0.257
0.627

1.15 (0.92, 1.42) 0.221
1.10 (0.89, 1.36) 0.382
1.05 (0.77, 1.44) 0.771

7204
6713
2607

1.24 (1.01, 1.52)
1.10 (0.90, 1.35)
1.06 (0.79, 1.41)

0.035*
0.326
0.713

1.28 (1.04, 1.57) 0.021*
1.14 (0.93, 1.39) 0.197
0.99 (0.73, 1.33) 0.920

7244
2890

1.05 (0.87, 1.27)
1.03 (0.83, 1.27)

0.568
0.820

1.06 (0.88, 1.28) 0.544
1.01 (0.81, 1.26) 0.933

p

Has Dog
7
10
13
Has Cat7
10
13
Has other/miscellaneous pets
7
10
13
Social Anxiety (any social fears “a lot”)
Has any Pet
710
13
Has Dog
7
10
13
Has Cat7
10
13
Has other/miscellaneous pets
7
10
13
Generalized Anxiety (any of the worries “often”)
Has any Pet
710

Purewal et al. BMC Pediatrics(2024) 24:578

Page 10 of 21

Table 2 (continued)
Emotional health outcome
Age
13

UnivariableN1126

OR (95% CI)
1.22 (0.84, 1.76)

p
0.294

Multivariable(adjusted)
OR (95% CI)
p1.13 (0.77, 1.66) 0.524

7240
2889
1129

0.98 (0.80, 1.20)
1.19 (0.97, 1.47)
1.10 (0.79, 1.53)

0.872
0.089
0.547

0.98 (0.79, 1.20) 0.828
1.17 (0.95, 1.46) 0.145
0.98 (0.69, 1.38) 0.891

7239
2889
1130

1.19 ( 0.99, 1.41)
1.25 (1.03, 1.51)
1.14 (0.83, 1.55)

0.055
0.022*
0.419

1.12 (0.94, 1.34) 0.205
1.19 (0.99, 1.46) 0.068
1.08 (0.78, 1.50) 0.647

7240
2889
1128

1.07 (0.91, 1.27)
1.05 (0.87, 1.26)
1.05 (0.78, 1.42)

0.379
0.632
0.735

1.11 (0.94, 1.32) 0.215
1.02 (0.85, 1.24) 0.803
1.02 (0.75, 1.40) 0.890

Has Dog
7
10
13
Has Cat7
10
13
Has other/miscellaneous pets
7
10
13
*P < .05
Analyses of self-esteem measures adjusted for: sex, maternal depression measured at child age 8, maternal anxiety measured at child age 6, overcrowding (childage 8), house type (child age 7), highest parental social class (antenatal period), maternal education (antenatal period), maternal age at delivery (antenatal period),financial difficulties (antenatal period), home ownership status (antenatal period), car ownership (antenatal period), older children living with child (antenatal
period), developmental delay measured at child age 30 months old, IQ measured at child age 8 years (accounted for in scholastic competence only), stressful life
events measured at child age 4 years and maternal bonding measured at child age 3
Analyses of anxiety measures adjusted for: sex, maternal depression measured at child age 8 and 11 years, maternal anxiety measured at child age 6 and 11 years,
overcrowding (child age 7, 8 and 10 years), house type (child age 7 and 10 years), highest parental social class (antenatal period), maternal education (antenatal
period), maternal age at delivery (antenatal period), financial difficulties (antenatal period), home ownership status (antenatal period), and car ownership (antenatal
period), developmental delay measured at child age 30 months, older children living with child, stressful life events at child age 3, 9 and 11 years and maternalbonding measured at child age 3 years
Results did not differ when accounting for parental marital status, child temperament and dog walking (Number of times in typical week respondent walked orjogged with household dog(s)), therefore these variables were discarded from the final models

during longitudinal analyses accounting for scores at bothtime points within a repeated measures model (b = 0.67,
95%CI = 0.25–1.08, p = .001). There was no evidence of alongitudinal association between pet ownership history
and cognitive performance at 11 years (Additional file
Supplementary Table 11).
Educational development

Key Stage 1 (KS1) and Key Stage 2 (KS2) level attainment
within ALSPAC were equivalent to national averages,
however, children in ALSPAC had a higher GCSE attainment at the age of 16 years in comparison to the National
Pupil Database (NPD) ‘Key Stage 4’ (KS4) national sample dataset records (Boyd et al., 2013).
Children who owned pets, dogs and other pets atage 6–7 years (KS1) scored 0.09, (95% CI-0.17- -0.02),
p = .012), 0.17, (95% CI=-0.25- -0.08), p < .001) and 0.12,(95% CI=-0.l9- -0.06, p < .001) points respectively lower
in reading scores at this stage (Table 5). Similarly, theyscored lower in writing (pets b=-0.13, 95% CI= -0.19-0.06, p = .001; dogs b=-0.15, 95% CI=-0.22- -0.08, p < .001;
other pets b=-0.12, 95% CI=-0.17- -0.06, p < .001), maths(pets b= -0.07, 95% CI=-0.14- -0.00, p = .041; dogs b=-0.09, 95% CI=-0.17- -0.02, p = .015; other pets b=-0.08,
95% CI=-0.14- -0.02, p = .013) and total Standard Assessment Tests (SAT) summary scores (pets b=-0.29, 95%

CI=-0.47- -0.11, p = .002; dogs b=-0.41, 95% CI=-0.61-0.21, p < .001; other pets b=-0.32, 95% CI=-0.48- -0.15,
p < .001) (Table 5). Although the evidence for these associations appears strong (P < .001) it is worth noting, however, that effect sizes were very small (range. 0.07–0.41
point decrease in score for owning the type of pet) andmay not be clinically significant. There was consistently
no evidence that ownership of a cat at this stage wasassociated with KS1 SAT attainment (Table 5).
At KS2 (Age 7–11), effect sizes were slightly larger(range 1.04–2.27 points lower score). Cross-sectionalmodels demonstrated that owning a dog at this stage wasassociated with a lower score in English (b=-1.75, 95%
CI=-3.03- -0.47, p = .007), as well as lower in Maths (b=2.27, 95%CI=-3.95- -0.58, p = .009) and Science (b=-1.04,
95% CI=-1.96- − 0.011, p = .028) (Table 5). Owning cats
was also associated with a poorer attainment in Maths(b=-1.91, 95% CI=-3.44- -0.37, p = .015) and Science (b=1.20, 95% CI=-2.04- -0.37), p = .005) (Table 5).
At General Certificate of Secondary Education (GCSE– age 15–16), all pet types were associated in cross-sectional models with poorer attainment of an A/A* compared to B or lower, in a variety of subjects (Table 5).
Specifically, owning any pet was associated with a lower
likelihood of achieving top grades in Biological sciences(OR = 0.63, 95% CI = 0.39–0.99, p = .048), and Chemistry

Purewal et al. BMC Pediatrics(2024) 24:578

Page 11 of 21

Table 3 Univariable and multivariable associations between pet ownership at ages 3 and 11 years and behavioural difficulties andages 3 and 11 years. Two different measures, using the same subscales, but different scoring methods, were used at age 3 (revised
Rutter score) and at age 11 (strengths and difficulties Questionnaire)
Age

N

Univariable
OR (95% CI)

pMultivariable (adjusted)
OR (95% CI)
p

8980
2642

0.94 (0.86, 1.02)
1.17 (0.86, 1.58)

0.127
0.307

0.95 (0.87, 1.04)
0.98 (0.71, 1.34)

0.265
0.886

8973
2645

0.97 (0.88, 1.08)
1.16 (0.89, 1.51)

0.627
0.258

0.97 (0.87, 1.08)
1.08 (0.82, 1.42)

0.545
0.586

8973
2646

0.95 (0.87, 1.05)
1.09 (0.86, 1.41)

0.326
0.459

0.96 (0.87, 1.05)
0.99 (0.76, 1.28)

0.359
0.925

8973
2645

0.89 (0.82, 0.98)
1.03 (0.81, 1.31)

0.017*
0.799

0.92 (0.84, 1.02)
0.91 (0.71, 1.17)

0.097
0.479

7789
2640

1.05 (0.96, 1.15)
1.12 (0.78, 1.60)

0.278
0.535

1.09 (0.99, 1.21)
1.28 (0.87, 1.86)

0.057
0.207

7783
2643

1.03 (0.92, 1.15)
1.18 (0.86, 1.60)

0.670
0.309

1.05 (0.92, 1.17)
1.22 (0.88, 1.69)

0.464
0.231

7783
2644

1.09 (0.98, 1.20)
1.19 (0.88, 1.60)

0.095
0.243

1.12 (1.01, 1.24)
1.21 (0.89, 1.65)

0.037*
0.221

7783
2643

0.96 (0.87, 1.06)
0.73 (0.55, 0.97)

0.396
0.029*

1.00 (0.91, 1.11)
0.78 (0.58, 1.05)

0.954
0.103

8980
2643

1.14 (1.05, 1.24)
1.38 (1.02, 1.86)

0.002*
0.040*

1.14 (1.05, 1.25)
1.29 (0.94, 1.78)

0.003*
0.111

8973
2646

1.18 (1.06, 1.31)
1.47 (1.15, 1.88)

0.002*
0.002*

1.19 (1.07, 1.33)
1.44 (1.11, 1.86)

0.002*
0.006*

8973
2647

1.16 (1.06, 1.27)
1.17 (0.93, 1.49)

0.002*
0.188

1.17 (1.06, 1.29)
1.09 (0.85, 1.39)

0.001*
0.509

8973
2646

1.04 (0.95, 1.14)
0.90 (0.72, 1.14)

0.365
0.381

1.01 (0.92, 1.11)
0.85 (0.66, 1.08)

0.851
0.173

2644
2647
2648
2647

0.93 (0.72, 1.20)
1.15 (0.91, 1.45)
1.19 (0.96, 1.49)
0.73 (0.59, 0.91)

0.574
0.233
0.113
0.004*

0.93 (0.71, 1.22)
1.16 (0.91, 1.49)
1.17 (0.93, 1.47)
0.72 (0.57, 0.89)

0.593
0.234
0.192
0.004*

7944
2645

0.93 (0.85, 1.01)
0.84 (0.57, 1.23)

0.098
0.371

0.95 (0.86, 1.04)
0.91 (0.61, 1.37)

0.261
0.656

7937

0.89 (0.79, 0.99)

0.033*

0.89 (0.79, 1.01)

0.068

Emotional difficulties
Has any Pet
311
Has Dog3
11
Has Cat3
11
Has other/miscellaneous pets3
11
Hyperactivity
Has any Pet
311
Has Dog3
11
Has Cat3
11
Has other/miscellaneous pets3
11
Conduct Difficulties
Has any Pet
311
Has Dog3
11
Has Cat3
11
Has other/miscellaneous pets
3
11
11

Peer Problems
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Prosocial
Has any Pet

311
Has Dog3

Purewal et al. BMC Pediatrics(2024) 24:578

Page 12 of 21

Table 3 (continued)
Age
11

N
2648

Univariable
OR (95% CI)
1.20 (0.84, 1.72)

p
0.309

Multivariable (adjusted)
OR (95% CI)
p1.37 (0.94, 1.99)
0.103

7937
2649

1.01 (0.91, 1.11)
0.96 (0.67, 1.36)

0.885
0.803

1.02 (0.92, 1.13)
0.95 (0.66, 1.37)

0.737
0.795

7937
2648

0.87 (0.79, 0.96)
0.76 (0.55, 1.06)

0.004*
0.109

0.88 (0.79, 0.97)
0.79 (0.57, 1.13)

0.012*
0.202

8963
2643

1.04 (0.95, 1.13)
1.23 (0.84, 1.79)

0.435
0.282

1.07 (0.97, 1.17)
1.15 (0.77, 1.72)

0.167
0.506

8956
2646

1.04 (0.94, 1.16)
1.33 (0.97, 1.82)

0.465
0.079

1.05 (0.93, 1.17)
1.29 (0.92, 1.80)

0.450
0.141

8956
2647

1.06 (0.96, 1.16)
1.29 (0.96, 1.75)

0.251
0.090

1.07 (0.97, 1.19)
1.21 (0.88, 1.66)

0.181
0.242

8956
2646

0.95 (0.87, 1.04)
0.79 (0.59, 1.06)

0.294
0.116

0.98 (0.88, 1.08)
0.73 (0.53, 0.99)

0.615
0.044*

Has Cat3
11
Has other/miscellaneous pets
3
11
Total Behavioural Difficulties
Has any Pet
311
Has Dog3
11
Has Cat3
11
Has other/miscellaneous pets3
11
*P < .05
Analyses adjusted for: sex, birthweight, maternal depression measured at child age 2 and 11 years, maternal anxiety measured at child age 2 and 11 years,
overcrowding (child age 2 and 10 years), highest parental social class (antenatal period), maternal education (antenatal period), maternal age at delivery (antenatal
period), family income (antenatal period), housing defects (antenatal period), financial difficulties (antenatal period), home ownership status (antenatal period),
car ownership (antenatal period), developmental delay measured at child age 30 months, child temperament at 2 years, older children living with child (antenatal
period), stressful life events at child age 2 and 11 years and maternal bonding measured at child age 3 years
Results did not differ when accounting for house type or dog walking (Number of times in typical week respondent walked or jogged with household dog(s)),
therefore these variables were discarded from the final model(OR = 0.46, 95% CI = 0.29–0.73, p = .001). Owning a
dog was associated with a lower likelihood of achieving top grades in English (OR = 0.75, 95% CI = 0.59–0.94,
p = .014), Maths (OR = 0.67, 95% CI = 0.54–0.85, p= ·001),
Chemistry (OR = 0.63, 95% CI = 0.40–0.99, p = .049)
and a lower likelihood of achieving five GCSEs A*-C
(OR = 0.76, 95% CI = 0.60–0.96, p = .023). Owning a cat
was associated with a lower likelihood of achieving top
grades in Maths (OR = 0.79, 95% CI = 0.63–0.98, p = .035).
Owning other pets was associated with a lower likelihoodof achieving top grades in Biological Science (OR = 0.61,
95% CI = 0.40–0.92, p = .019), and Chemistry (OR = 0.56,
95% CI = 0.37–0.84, p= ·0.005).
When longitudinally exploring pet ownership history
in relation to GCSE attainment, there was some evidenceof an association (Additional file Supplementary Table
12). Specifically, there was weak evidence of an association between always owning pets up to 15 years anda lower likelihood of attainment of top grades in English (OR = 0.79, 95% CI = 0.63–0.99, p = .037), and strong
evidence of an association with Maths OR = 0.67, 95%
CI = 0.53–0.85, p = .001) compared to sometimes owningpets.

Language Development

Owning a pet at age 5 was associated with a 1.01 (95%CI = 0.18–1.83, p = .017) higher Reynell Developmental
Language Scale score at that age (Table 6). However, thisassociation did not remain in a linear regression repeatedmeasures design accounting for scores at both 2 and 5
years of age (b = 0.41, 95% CI=-2.04 -2.86, p = .743). Owning a pet at age 2 was associated with 0.18 points (95%CI = 0.04–0.3, p = .014) higher non-verbal communication
score at that age (Table 6).

Discussion
Pet ownership was positively associated with aspects ofsocial development including language development,
non-verbal communication and prosocial behaviour.
However, contrary to popular belief, pet ownership did
not appear to have any considerable beneficial association with emotional, cognitive or educational development of children. In fact, pet ownership was associatedwith lower educational attainment across a number ofassessments in Key stage 1 and 2 and a range of subjects
including Maths, English, and Sciences. Furthermore, atage 8, children who owned any pets had lower odds ofhigh self-esteem (scholastic competence). The presentPurewal et al. BMC Pediatrics(2024) 24:578

Page 13 of 21

Table 4 Univariable and multivariable associations between pet ownership at ages 8, 10 and 11, and attention. For impulsivity andworking memory please see additional file supplementary table 10
Age

N

Univariableb (95% CI)

pMultivariable (adjusted)b (95% CI)
p

5720
2522

-0.02 (-0.13, 0.09)-0.02 (-0.13, 0.08)

0.693
0.682

0.03 (-0.08, 0.14)
0.09 (-0.02, 0.19)

0.577
0.100

5721
2524

0.05 (-0.06, 0.168)
0.02 (-0.08, 0.12)

0.352
0.687

0.05 (-0.06, 0.16)
0.06 (-0.04, 0.16)

0.388
0.209

5721
2525

-0.03 (-0.13, 0.08)-0.08 (-0.16, 0.01)

0.606
0.094

-0.01 (-0.10, 0.09)-0.04 (-0.13, 0.05)

0.983
0.399

5721
2524

-0.07 (-0.17, 0.02)-0.09 (-0.17, 0.00)

0.132
0.051

-0.00 (-0.09, 0.08)-0.03 (-0.13, 0.06)

0.947
0.490

5228
2357

0.32 (-0.72, 1.35)
0.15 (-0.15, 0.46)

0.548
0.326

0.71 (-0.32, 1.75)
0.27 (-0.05, 0.59)

0.178
0.098

5228
2359

0.46 (-0.64, 1.55)
0.39 (0.10, 0.67)

0.414
0.007*

0.46 (-0.65, 1.56)
0.42 (0.12, 0.71)

0.417
0.005*

5228
2360

0.49 (-0.48, 1.47)
0.01 (-0.26, 0.27)

0.325
0.950

0.65 (-0.33, 1.62)
0.05 (-0.22, 0.32)

0.192
0.715

5228
2359

-0.35 (-1.25, 0.56)-0.08 (-0.33, 0.17)

0.459
0.559

-0.06 (-0.97, 0.85)-0.01 (-0.26, 0.25)

0.894
0.991

5745
2448

-0.06 (-0.25, 0.12)-0.03 (-0.20, 0.14)

0.477
0.715

-0.03 (-0.21, 0.16)
0.03 (-0.14, 0.20)

0.773
0.723

5746
2450

0.18 (-0.01, 0.38)
0.09 (-0.06, 0.25)

0.055
0.236

0.16 (-0.04, 0.35)
0.07 (-0.09, 0.23)

0.111
0.376

5746
2451

-0.02 (-0.19, 0.16)
0.01 (-0.14, 0.15)

0.867
0.910

-0.01 (-0.17, 0.17)
0.02 (-0.12, 0.17)

0.966
0.778

5746
2450

-0.13 (-0.28, 0.04)-0.13 (-0.26, 0.01)

0.126
0.071

-0.09 (-0.25, 0.07)-0.08 (-0.22, 0.06)

0.268
0.250

5739
2446

-0.33 (-0.67, 0.02)
0.01 (-0.22, 0.25)

0.068
0.911

-0.27 (-0.63, 0.08)
0.14 (-0.09, 0.38)

0.126
0.232

5740
2448

0.23 (-0.14, 0.59)
0.11 (-0.10, 0.32)

0.231
0.303

0.16 (-0.21, 0.53)
0.09 (-0.12, 0.31)

0.400
0.389

5740
2449

-0.07 (-0.40, 0.26)
0.06 (-0.14, 0.25)

0.686
0.580

-0.05 (-0.38, 0.28)
0.11 (-0.09, 0.30)

0.764
0.282

Selective Attention
Sky Search Task (score)
Has any Pet
811
Has Dog
811
Has Cat
8
11
Has other/miscellaneous pets
8
11
Attentional Switching (Dual Task) (score)
Has any Pet
811
Has Dog
811
Has Cat
8
11
Has other/miscellaneous pets
8
11
Attentional Control
Same worlds task (time seconds)
Has any Pet
811
Has Dog
811
Has Cat
8
11
Has other/miscellaneous pets
8
11
Opposite worlds task (time seconds)
Has any Pet
811
Has Dog
811
Has Cat8
11

Purewal et al. BMC Pediatrics(2024) 24:578

Page 14 of 21

Table 4 (continued)
AgeN

Univariableb (95% CI)

pMultivariable (adjusted)b (95% CI)
p

5740
2448

-0.31 (-0.62, -0.01)-0.19 (-0.37, 0.00)

0.047*
0.050*-0.26 (-0.56, 0.05)-0.11 (-0.29, 0.08)

Has other/miscellaneous pets
8
11

0.105
0.268

*P < .05
Analyses were adjusted for: sex, maternal depression at ages 8 and 11 years, maternal anxiety at ages 6 and 11 years, overcrowding at 8 and 10 years, house typeat ages 7 and 10 years, highest parental social class (antenatal period), maternal education (antenatal period), maternal age at delivery (antenatal period), homeownership status (antenatal period), family income (antenatal period) and car ownership (antenatal period), birthweight, developmental delay measured at childage 30 months, child temperament at 2 years, older children living in the house (antenatal period), stressful life events at almost 4 years, 9 and 11 years old, andmother-child bonding at child age 3 years
Results did not differ when accounting for parental marital status and financial difficulties therefore these variables were discarded from the final models

findings are largely inconsistent with our hypotheses andprevious research in the field - the majority being qualitative research- which tends to find positive effects of pets
on child development, particularly in emotional health[11].
Emotional health

Our findings are at odds with a common belief that companion animals benefit the emotional health of children
and young people, formulated on the basis of resultsfrom other cross-sectional and qualitative studies previously reviewed [11]. The potential association we foundbetween cat ownership and lower self-perceived scholastic competence was unexpected and could be due toresidual confounding. It is also unclear why ‘any’ and‘other’ pet ownership was associated with a higher odds
of social anxiety symptoms at age 7. A prospective studyof children aged 8–12 years [72] also found pet ownership to be partly detrimental to the level of children’ssocial interaction; attachment to pets at the 12 monthfollow-up was associated with both increases in theamount of time spent alone and decreases in children’stime spent with family and friends, which in turn may
influence social anxiety.
Our mostly null results regarding emotional healthsupport those of a recent study using a longitudinal
design [46]; this propensity-score-weighted populationbased study established that any benefits of owningcompanion animals on psychological health in children
and adolescents were largely explained by confounding
factors. Their results also suggested that factors such associo-economic status are more important predictors ofemotional health in children and young people than animals. The buffering hypothesis [73] may also help explain
our mostly null findings; social support and emotional
benefits of companion animals may only come into playfor individuals experiencing adverse or stressful events.
Population-based studies are not well suited to detectsuch effects [46]. Furthermore, it is important to recognize that, at least in some instances, animal caregiving
may elicit negative emotions related to pet care, health,and separations [27, 74] and strong attachment to animals has been associated with emotional distress anddepressive symptoms [27, 75].
Behavioural and cognitive development

Owning ‘other/miscellaneous’ pets at age 3 was associated with a lower likelihood of experiencing prosocial difficulties, and dog ownership at age 3 with increased score
for prosocial behaviours (kind to others and animals,considerate of other’s feelings, shares toys). Other studies
have found similar effects in similarly-aged children [76,77]. Therefore companion animals may be hypothesized
to indirectly increase young children’s prosocial behaviour through acting as a point of conversation between
adults, peers and children [77], or by adults teaching children how to correctly care for animals [78].
However, the ownership of cats at age 3 was associatedwith higher odds of hyperactivity but not at age 11, andpet/dog/cat ownership also showed some associations
with conduct problems at ages 3 and 11 years. Similarly,
in other research children owning pets have been foundto be more likely to have ADHD [46], hyperactivity/inattention and also conduct problems [79]. This finding has
been previously attributed to the exposure of increased
microbial contact such as mould and dampness caused
by indoor pets potentially affecting cognitive function,
however, we were able to control for housing defects
within ALSPAC and our associations did not attenuate so
this explanation seems unlikely. Addressing an identified
research gap on companion animals and cognitive development of children, including executive function [11],our study also found no evidence of positive associations
here, potentially supporting the behavioural findings.
Surprisingly, dog ownership was associated with a poorer
ability in attentional switching only at age 11. Attentionalswitching or ‘cognitive flexibility’ is arguably the mostcomplex executive function as it both requires and builds
on inhibition and working memory [80]. Studies on executive attention show a developmental transition fromperceptual to executive attention between the ages of 9
and 12 years [81], and the Dual Task used may not be thePurewal et al. BMC Pediatrics(2024) 24:578

Page 15 of 21

Table 5 Univariable and multivariable associations between pet ownership at ages 7, 11 and 15, and Key Stage 1 (KS1), Key Stage 2(KS2) and General Certificate of Secondary Education (GCSE) attainment
Univariable
KS1
Subject
Reading (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Writing (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Maths (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Total summary score
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
KS2
Subject
English (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Maths (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Science (score)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Total summary score
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
GCSE
Subject
English (A/A* versus B or lower)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Maths (A/A* versus B or lower)

Multivariable (adjusted)N

B (95% CI)p

B (95% CI)

p

5760
5755
5755
5755

-0.20 (-0.28, -0.11)-0.36 (-0.46, -0.27)-0.05 (-0.14, 0.03)-0.19 (-0.27, -0.12)< 0.001*< 0.001*
0.228< 0.001*-0.09 (-0.17, -0.02)-0.17 (-0.25, -0.08)-0.01 (-0.09, 0.06)-0.12 (-0.19, -0.06)

0.012*< 0.001*
0.726< 0.001*

5762
5757
5757
5757

-0.21 (-0.29, -0.14)-0.31 (-0.39, -0.23)-0.08 (-0.15, -0.01)-0.16 (-0.23, -0.09)< 0.001*< 0.001*
0.035*< 0.001*-0.13 (-0.19, -0.06)-0.15 (-0.22, -0.08)-0.04 (-0.10, 0.02)-0.12 (-0.17, -0.06)< 0.001*< 0.001*0.170< 0.001*

5754
5749
5749
5749

-0.16 (-0.24, -0.08)-0.25 (-0.34, -0.16)-0.11 (-0.18, -0.03)-0.12 (-0.19, -0.04)< 0.001*< 0.001*
0.007*
0.002*-0.07 (-0.14, -0.00)-0.09 (-0.17, -0.02)-0.07 (-0.13, 0.00)-0.08 (-0.14, -0.02)

0.041*
0.015*
0.054
0.013*

5756
5756
5756
5756

-0.58 (-0.79, -0.36)-0.93 (-1.16, -0.69)-0.24 (-0.45, -0.03)-0.49 (-0.68, -0.29)< 0.001*< 0.001*
0.026*< 0.001*-0.29 (-0.47, -0.11)-0.41 (-0.61, -0.21)-0.12 (-0.29, 0.05)-0.32 (-0.48, -0.15)

0.002*< 0.001*
0.174< 0.001*N

B (95% CI)p

B (95% CI)

p

2035
2037
2037
2037

-0.08 (-1.56, 1.40)-2.23 (-3.61, -0.86)-1.17 (-2.45, 0.11)
0.35 (-0.86, 1.56)

0.915
0.001*
0.072
0.565-0.20 (-1.56, 1.15)-1.75 (-3.03, -0.47)-1.02 (-2.18, 0.15)
0.67 (-0.44, 1.79)

0.770
0.007*
0.087
0.237

2028
2029
2029
2029

-2.48 (-4.41, -0.54)-2.95 (-4.75, -1.14)-2.39 (-4.07, -0.71)-0.38 (-1.98, 1.21)

0.012*
0.001*
0.005*
0.640-1.34 (-3.13, 0.45)-2.27 (-3.95, -0.58)-1.91 (-3.44, -0.37)-0.02 (-1.48, 1.47)

0.142
0.009*
0.015*
0.998

2032
2034
2034
2034

-0.95 –(2.00, 0.10)-1.55 (-2.54, -0.58)-1.48 (-2.39, -0.57)
0.08 (-0.78, 0.95)

0.077
0.002*
0.001*
0.850-0.36 (-1.34, 0.62)-1.04 (-1.96, -0.11)-1.20 (-2.04, -0.37)
0.36 (-0.45, 1.16)

0.467
0.028*
0.005*
0.387

407
407
407
407

0.47 (-2.37, 3.31)-2.36 (-5.05, 0.32)-1.54 (-4.08, 0.99)
1.98 (-0.38, 4.34)
OR (95% CI)

0.743
0.084
0.231
0.100

-0.40 (-3.06, 2.26)-1.63 (-4.19, 0.94)-0.46 (-2.76, 1.84)
0.61 (-1.59, 2.82)
OR (95% CI)

0.768
0.215
0.698
0.586

1990
1993
1993
1994

0.85 (0.71, 1.02)
0.63 (0.52, 0.75)
1.03 (0.87, 1.23)
0.78 (0.66, 0.93)

0.081< 0.001*
0.716
0.004*

0.84 (0.67, 1.05)
0.75 (0.59, 0.94)
0.88 (0.071, 1.09)
0.87 (0.71, 1.08)

0.131
0.014*
0.256
0.203

Purewal et al. BMC Pediatrics(2024) 24:578

Page 16 of 21

Table 5 (continued)
Univariable
KS1
Subject
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Biological Sciences (A/A* versus B or lower)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Chemistry (A/A* versus B or lower)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Physics (A/A* versus B or lower)
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Achieved 5 GCSEs A*-C
Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets

Multivariable (adjusted)

N
1919
1922
1922
1923

B (95% CI)
0.76 (0.63, 0.91)
0.57 (0.48, 0.69)
0.85 (0.72, 1.02)
0.92 (0.77, 1.08)p
0.003*< 0.001*
0.081
0.305

B (95% CI)
0.82 (0.66, 1.03)
0.67 (0.54, 0.85)
0.79 (0.63, 0.98)
1.03 (0.84, 1.27)p
0.089
0.001*
0.035*
0.770

490
490
490
490

0.65 (0.45, 0.95)
0.73 (0.52, 1.04)
0.88 (0.63, 1.25)
0.60 (0.43, 0.84)

0.024*
0.084
0.485
0.003*

0.63 (0.39, 0.99)
0.76 (0.48, 1.20)
0.93 (0.59, 1.45)
0.61 (0.40, 0.92)

0.048*
0.237
0.750
0.019*

478
478
478
478

0.56 (0.38, 0.82)
0.65 (0.45, 0.92)
0.83 (0.59, 1.17)
0.63 (0.45, 0.88)

0.003*
0.016*
0.287
0.007*

0.46 (0.29, 0.73)
0.63 (0.40, 0.99)
0.79 (0.52, 1.23)
0.56 (0.37, 0.84)

0.001*
0.049*
0.305
0.005*

475
476
476
476

0.76 (0.59, 0.97)
0.63 (0.49, 0.80)
0.82 (0.65, 1.05)
0.85 (0.68, 1.06)

0.027*< 0.001*
0.114
0.153

0.86 (0.64, 1.16)
0.83 (0.61, 1.12)
0.76 (0.57, 1.03)
1.01 (0.76, 1.34)

0.310
0.228
0.075
0.935

2010
2013
2013
2014

0.89 (0.72, 1.09)
0.65 (0.54, 0.79)
1.06 (0.88, 1.29)
0.89 (0.75, 1.07)

0.249< 0.001*
0.527
0.224

0.94 (0.73, 1.21)
0.76 (0.60, 0.96)
1.02 (0.80, 1.29)
0.97 (0.78, 1.22)

0.634
0.023*
0.873
0.818*P < .05
Analyses were adjusted for: sex, maternal depression at ages 6, 8 and 11 years, maternal anxiety at ages 6 and 11 years, overcrowding at 7 and 10 years, house
type at ages 7 and 10 years, highest parental social class (antenatal period), maternal education (antenatal period), maternal age at delivery (antenatal period),
home ownership status (antenatal period), family income (antenatal period) and car ownership (antenatal period), school identifier, school type, birthweight,
developmental delay measured at child age 30 months, child temperament at 2 years, older children living in the house (antenatal period), stressful life events at
almost 4 years, 9 and 11 years old, and mother-child bonding at age 3
Results did not differ when accounting for parental marital status, maternal smoking, financial difficulties, dog walking, and time spent watching TV, outdoors anddoing homework therefore these variables were discarded from the final models

most methodologically accurate way to capture the complexity of attentional switching in this age group [82].
An alternative explanation for our findings regarding behavioural difficulties and cognitive development
is reverse causation. There is evidence that families may
acquire dogs to support children with developmental
delays or disabilities (or at least, symptoms of poorer
performance or disability) [83]. Therefore one might
expect that higher incidence of behavioural difficulties,
or poorer performance in attentional switching as seen in
ADHD [84] and often Autism Spectrum Disorder (ASD)[85], would be found in animal owners.
Findings did not support previous research where animal presence during task completion has positive effects
on memory and attention [37, 38, 86]. This is likely due tothe closer proximity and direct involvement of the animalin these experimental tests, and potentially to these animals not being participants’ pets. The dopamine releasefrom an interaction with a dog [87], which is known toenhance concentration and attention [88], may be too
distal to ALSPAC children who completed the task in CiF
clinics whilst the pets were at home.
Educational development

This was the first known study to assess whether pet
ownership in childhood and adolescence is associatedwith educational attainment. Pet ownership was consistently associated with poorer educational attainment at
KS1, KS2 and GCSE in a variety of subjects, and findings were generally consistent across pet types, although
effect sizes detected were sometimes very small, ranging 0.07–2.27 points lower for SATs and 0.79 − 0.46
lower odds (equivalent to 1.3–2.4 times more likely) ofachieving high GCSE grades. No evidence was found in
ALSPAC supporting previous research that pet owners
may be better at biological subjects [89, 90].
It is possible that the association between pet ownership and poorer educational attainment is attributable toPurewal et al. BMC Pediatrics(2024) 24:578

Page 17 of 21

Table 6 Univariable and multivariable associations between pet ownership at ages 2 and 5, and language development scores
Age

N

Univariable
B (95% CI)

pMultivariable (adjusted)
B (95% CI)
p

713
393

-1.17 (-2.47, 0.13)
0.39 (-0.35, 1.13)

0.077
0.299

-0.04 (-1.13, 1.05)
1.01 (0.18, 1.83)

0.843
0.017*

712
393-1.89 (-3.71, -0.07)-0.24 (-1.25, 0.77)

0.041*
0.646-1.09 (-2.58, 0.39)
0.93 (-0.19, 2.04)

0.149
0.103

712
393

-0.78 (-2.15, 0.60)
0.27 (-0.53, 1.09)

0.270
0.502

-0.15 (-1.29, 0.99)-0.24 (-1.10, 0.63)

0.800
0.595

712
393

-2.23 (-6.05, 1.58)
0.65 (-1.33, 2.63)

0.251
0.520

-2.76 (-6.04, 0.52)
0.87 (-1.13, 2.88)

0.099
0.393

6112
6105
6107
6108

1.31 (-1.33, 3.95)-1.01 (-4.43, 2.42)-0.89 (-3.77, 2.00)-2.76 (-10.81, 5.29)

0.330
0.565
0.547
0.502

0.27 (-1.71, 2.25)-1.27 (-3.77, 1.24)-1.56 (-3.72, 0.59)
4.27 (-1.63, 10.18)

0.787
0.321
0.154
0.156

6176
6169
6171
6172

0.99 (-1.29, 3.28)-0.79 (-3.75, 2.17)-0.72 (-3.22, 1.78)-2.09 (-9.07, 4.88)

0.395
0.602
0.572
0.556

-0.02 (-1.80, 1.77)-1.13 (0.33, -3.39)-1.53 (-3.47, 0.42)
3.78 (-1.55, 9.13)

0.985
0.326
0.124
0.164

6150
6143
6145
6146

0.22 (0.05, 0.39)
0.08 (-0.14, 0.31)
0.02 (-0.17, 0.21)-0.09 (-0.62, 0.44)

0.014*
0.469
0.823
0.731

0.18 (0.04, 0.32)
0.06 (-0.12, 0.24)
0.05 (-0.10, 0.21)
0.18 (-0.25, 0.60)

0.014*
0.524
0.517
0.420

6158
6151
6153
6154

0.06 (-0.24, 0.36)-0.41 (-0.79, -0.03)-0.03 (-0.36, 0.29)
0.25 (-0.66, 1.16)

0.687
0.035*
0.852
0.587

0.13 (-0.09, 0.36)-0.21 (-0.49, 0.08)-0.03 (-0.27, 0.22)
0.67 (-0.01, 1.35)

0.270
0.159
0.829
0.053

Reynell Developmental Language Scale
Has any Pet
25
Has Dog2
5
Has Cat2
5
Has other/miscellaneous pets
2
5
2

2

2

2

Total Communication Score (MacArthur)Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Vocabulary Score (MacArthur)Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Non-Verbal Communication Score (MacArthur)Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets
Social Development Score (MacArthur)Has any Pet
Has Dog
Has Cat
Has other/miscellaneous pets

*P < .05
Analyses were adjusted for: sex, ethnicity, maternal depression at almost 2 and 4 years, maternal anxiety at ages almost 2 and 4 years, overcrowding at 2 years, house
type at ages 2 and 3 years, highest parental social class, maternal education, maternal age at delivery, home ownership status, family income and car ownership,birthweight, child has twin, child attended day care at 15 months, and 4 years, number of languages spoken in the home, developmental delay at 18 months, childtemperament, older children living in the house, stressful life events at almost 2 and 4 years old and mother-child bonding at age 3 years
Results did not differ when accounting for house type or dog walking (Number of times in typical week respondent walked or jogged with household dog(s)),
therefore these variables were discarded from the final model

unknown confounding factors. To explore this, we further adjusted using multivariable modelling for additional
hypothetical variables including parental marital status,
maternal smoking, financial difficulties, dog walking,time spent watching TV, time spent outdoors and timespent doing homework, with no change in effect. Again,
it may be hypothesized that parents may acquire dogs to
support children with poorer educational attainment.
Language development

This was also the first study to examine potential associations between pet ownership and language development

outcomes in childhood. Owning a pet was associatedwith a higher comprehension score at age 5 (RDLS) of
about 1 point on the scale. In contrast to 2-year-olds whoare still in the stages of word learning, 5-year-olds cancommunicate with their animals as social partners andcan talk to them more. Five-year-olds may also utilise
multiple cues pets may give better, and they may employ
social-pragmatic factors and global attentional mechanisms [91] to interpret pet behaviour and talk to theiranimals. This area requires further investigation.
Interestingly, owning a pet at age 2 was associatedwith slightly higher non-verbal communication scores.

Purewal et al. BMC Pediatrics(2024) 24:578

Non-verbal communication includes eye gaze, vocalizations, and prelinguistic gestures. It is possible that young
children whose families own animals are better practisedin such body language and communication, to enable
them to interact with the animal, or with parents/siblings
to communicate about the animal as an additional andhighly interesting object of interest. Interaction with animals may enhance social cues such as eye gaze, pointing,and speaker intention, needed for language development
through usage-based language acquisition theory [92].
Again, this will need further systematic investigation.
Our findings support previous suggestions that owning
animals may facilitate language acquisition, with the pet
acting as a recipient of conversation, an additional subject of conversation, to stimulate communication, andpotentially build vocabulary [77]. The presence of dogs
has also been shown to influence reading ability in school
age children [93]. Further research is needed in particular
to understand whether companion animals can enhanceother aspects of language e.g., semantics, pragmatics orsyntactic development.
Limitations

The ALSPAC dataset has many strengths as it is a large
community-based cohort with availability of data on awide range of developmental outcomes. It also has theability to adjust for confounding factors (which pertinently attenuated effects in some models). Consistentfindings to ours from one other well-designed longitudinal study [46] indicate that more research is needed,
including well designed longitudinal studies and randomised controlled trials.
However, some limitations should be considered wheninterpreting our findings. First, our mostly small effectsizes observed may not relate to clinically significant differences for individuals. We did examine numerous outcomes so some of our findings could be due to statisticalchance – for this reason and as recommended we havenot used statistical cut offs but presented the full P Valueand 95% confidence intervals so the reader can maketheir own interpretation [70]. We also emphasise patterns in our interpretation of findings rather than relying
on single associations. Further, ALSPAC did not measure
the child’s relationship with or ‘attachment’ to their companion animals directly, for example using a validated
measure, and it is precisely this relationship that may bemost salient in conferring psychological benefits, rather
than the presence of companion animals as such. However, analyses of the pet-interaction variable which may
have acted as a substitute for attachment presented noevidence of associations. We also explored history of pet
ownership, i.e., a longitudinal and cumulative perspective, which again presented us with no evidence of associations. In addition, as the emotional, behavioural andPage 18 of 21

cognitive development of young people is a dynamic process, variables are not always fully independent, but can
influence each other. There are complexities when examining such health outcomes and it is difficult to teaseapart associations, for example, poor self-esteem maylead to depression and vice versa. Likewise, reverse causality may be occurring; if families of children with mental, behavioural or cognitive health problems are more
likely to get a pet to alleviate symptoms and support parents and children, then at a cross-sectional examination
one could expect worse, not better, mental health, behaviour and cognition in children with companion animals– which fits our results to some extent. Future researchshould investigate causal pathways in more detail foreach type of outcome. We also did not examine interactions between variables and these should be consideredin future more detailed research into outcomes wheresuggested associations are present, for example whether
results differ by sex or socioeconomic status. Finally forconsideration, due to the nature of the cohort recruitment and attrition, the sample involves mainly white,
more affluent children in the UK, and findings may not
generalise outside these contexts.

Conclusions
In conclusion, the present study found evidence ofimproved language and prosocial development in children who owned companion animals. However, it also
found isolated and small associations between pet ownership and poorer self-esteem, higher social anxiety,more hyperactivity and conduct difficulties, and poorer
cognitive ability in dual attention. Further, consistently
poorer educational attainment was seen across many
types of pet ownership. Our data evidences that companion animals may have a sociability function in childrenthat may echo that seen in adults [25, 94].
Whilst our study provides novel evidence and demonstrates the importance of using large, well-designed longitudinal studies and controlling for key confounders, italso illustrates the complexity and importance of studying the impact of companion animal ownership on childhood development. Future cohort studies should collectdetailed information on children’s relationships with
their companion animals, including validated measuresof pet attachment and the nature of interactions with theanimal. Longitudinal investigation using repeated measures, and potentially randomised experimental conditions, if possible, are also required in order to determine
cause and effect, and to determine clinical significance ofany differences.
Abbreviations
ALSPAC	Avon Longitudinal Study of Parents and Children
CiF	Children in Focus Clinic
DAWBA	Development And Wellbeing Assessment

Purewal et al. BMC Pediatrics(2024) 24:578

GCSE	General Certificate Secondary Education
HSPP	Harter Self-Perception Profile
KS1	Key Stage 1
KS2	Key Stage 2
MCDI	MacArthur Communication Development Inventories
MFQ	Mood and Feelings Questionnaire
RDLA	Reynell Development Language Scale
RRS	Revised Rutter Scale
SAT	Standard Assessment Test
SDQ	Strengths and Difficulties Questionnaire
TEACh	Tests of Everyday Attention for Children

Supplementary Information

The online version contains supplementary material available at https://doi.
org/10.1186/s12887-024-05049-7.
Supplementary Material 1
Acknowledgements
We are extremely grateful to all the families who took part in this study, themidwives for their help in recruiting them, and the whole ALSPAC team, which
includes interviewers, computer and laboratory technicians, clerical workers,
research scientists, volunteers, managers, receptionists and nurses.
Author contributions
CW conceptualised the study, designed the analysis, interpreted the data,
and revised the manuscript. RP designed the analysis, performed the analysis,
interpreted the data and drafted the manuscript. CJ, KK, RC, KM and NG
contributed to study design, analysis, data interpretation and manuscript
revision. All authors approved the final manuscript.
Funding
This work was supported by the Waltham Petcare Science Institute which
funded the PhD studentship of RP, through a grant held by CW as Principal
Investigator. The funder had no role in the data collection but provided
guidance on data analysis and editorial assistance in the development of
the publication. The UK Medical Research Council and Wellcome (Grant ref:217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC.
A comprehensive list of grants funding is available on the ALSPAC website.
Data availability
Requests to access ALSPAC data can be made via https://www.bristol.ac.uk/
alspac/researchers/access/.

Declarations
Ethics approval and consent to participate
Ethical approvals for the study were obtained from the ALSPAC Law and Ethics
Committee and the Local Research Ethics Committees. Informed consent for
the use of data collected via questionnaires and clinics was obtained fromparticipants following the recommendations of the ALSPAC Ethics and Law
Committee at the time. At age 18, study children were sent ‘fair processing’materials describing ALSPAC’s intended use of their health and administrative
records and were given clear means to informed consent or object via awritten form. Data were not extracted for participants who objected, or who
were not sent fair processing materials. The data access and analysis for thispaper was approved by the ALSPAC Executive Committee.
Consent for publication
Not applicable.
Competing interests
The study was funded by Waltham Petcare Science Institute with a grant heldby Carri Westgarth and used to fund the studentship of Rebecca Purewal. Carri
Westgarth reports a relationship with Waltham Petcare Science Institute that
includes: consulting or advisory. Carri Westgarth reports a relationship with
Forthglade Dog Food that includes: consulting or advisory. Nancy Gee reportsthat she was employed by the Waltham Petcare Science Institute at the time
the study was selected for funding and conducted, is principal investigator

Page 19 of 21

on a separate study funded by Waltham, and has a consulting/advising
relationship with Waltham and Animal Assisted Interventions of Singapore.
Kerstin Meints reports grant funding from Waltham Petcare Science Institutefor a separate research project from 2015 to 2019. Robert Christley reports that
he currently works for Dogs Trust but did not at the time of this study.
Author details
1
Department of Livestock and One Health, School of Veterinary Science,
Institute of Infection, Veterinary and Ecological Sciences, Faculty of Healthand Life Sciences, University of Liverpool, Leahurst Campus,
Neston CH64 7TE, Cheshire, UK
2
Department of Epidemiology and Environmental Health, University at
Buffalo, 270 Farber Hall, Buffalo, NY 14214, USA
3
Population Health Sciences, Bristol Medical School, University of Bristol,
1-5 Whiteladies Road, Clifton BS8 1NU, Bristol, UK
4
School of Psychology, University of Lincoln, Brayford Wharf East,
Lincoln LN5 7AY, Lincolnshire, UK
5Center for Human-Animal Interaction, School of Medicine, Virginia
Commonwealth University, Richmond, VA 23298-0710, USA
Received: 31 October 2023 / Accepted: 3 September 2024

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