Date Presented 04/05/19
Children can display maladaptive behaviors (MB) during OT sessions. MB hinder progress to goal attainment. Animal-assisted therapy (AAT) is a cost-effective method to mitigate MB. Children's behaviors during OT sessions with and without a therapy dog were compared using qualitative and quantitative measures. Children remained on-task longer during sessions with a dog than without a dog. Additionally, therapists described positive effects from AAT during OT sessions.
Primary Author and Speaker: Nicole Huang
Contributing Authors: Regina Abel, Lindsay Mouradian, Sonya Steckler
BACKGROUND: With increased identification of developmental disabilities (DD), demand for pediatric therapy services has increased. However, maladaptive behaviors (MB) often seen in children who have DD can distract from therapeutic tasks in occupational therapy (OT). Reducing MB can allow for more effective interventions to address the child’s needs. A cost-effective complementary therapy, such as animal assisted therapy (AAT), could increase the efficiency of treatment sessions without sacrificing quality of care. AAT improves physiological and psychological health. AAT has been shown to diminish MB by improving communication through increased social skills and behavioral regulation. Likewise, the presence of a therapy dog (TD) can reduce pain and stress by reducing blood pressure (BP) and cortisol. AAT can also increase motivation and participation, enabling children to sustain attention. Reduction of MB provides strong support for incorporating AAT to complement OT intervention. In this study, we analyze the effect of AAT on MB and goal attainment in pediatric OT.
OBJECTIVES: We sought to determine the effects of AAT on the child’s behavior during outpatient OT sessions by analyzing the behavior of the child, occupational therapist, TD, and TD handler.
METHODS: Children participated in a total of 10 occupational therapy sessions. Children were randomly assigned to session order. Each child had two sessions to assess the child’s baseline behavior. Children were then randomly assigned to four TD sessions followed by four non-TD sessions, or the reverse order. All sessions were video recorded and individual behaviors were operationally defined and quantified using Behavioral Observation Interactive Software (BORIS). BORIS was used to analyze behaviors of the child, therapist, TD, and TD handler. Multiple dogs were included in the study, with a single dog paired with each child when possible. The Behavior Rating Inventory of Executive Function (BRIEF), Measurement of Pet Intervention (MOPI) and the therapists’ notes were also used to determine the extent to which the dog affected the child’s behaviors. Therapists had discretion on how to utilize the dogs within the session. Study received IRB approval.
RESULTS: Children with various behavioral and physical diagnoses have participated in the study. The mean composite scores of all children on the BRIEF were in the clinically significant range for all domains. Preliminary results indicate that TD’s positively affect children’s behavior during OT sessions. We found increased time of on-task behavior during sessions with a dog compared to sessions without a dog. Therapists reported positive effects of AAT on MB and goal attainment. Therapists used the dogs both passively, by the dog’s presence alone, or actively, such as using the dog as a topic of conversation or as a tool for fine- or gross-motor activities. In addition to improved outcomes during sessions, parents have reported a carry-over effect to behavior at home and school. We have also found a wide variety of behavior patterns in the therapy dogs, with significant differences in the initiation of interaction by the dog, overall activity level, and stress behaviors. This study is currently on-going.
IMPLICATIONS: Our study serves as a pilot for determining the effects of AAT on pediatric OT. Our results suggest that TD’s can have a positive effect on OT sessions and goal attainment by increasing on-task behaviors and decreasing MB. Further, therapists can implement AAT in a variety of ways. An innovative element of this study is the on-going analysis of the behavior of the dog and the relation to outcome measures. Overall, AAT may prove to be a cost-effective complementary intervention to enhance traditional OT.
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