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HUMAN-ANIMAL INTERACTION FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES

October 22, 2015

Animal Matters Lecture

Jennie Dapice Feinstein PhD, OTR/L

Occupational Therapist, Perkins School for the Blind

background

¨  the field ¤  Interdisciplinary

n PT, OT, SLP, psychology, n education, social work, n nursing, medicine n veterinary medicine, neurology n  child development

¤ Nebulous, Growing ¤ Terminology is complex

n Pet therapy, hippotherapy, anthrozoology, etc.

foundation

¨  developmental disabilities (DD)

¨  human-animal interaction (HAI)

¨  occupational therapy (OT)

¨  animal health

animal health

¨  animal health takes precedence over client needs ¨  animal should be

¤ healthy, so as to reduce the bi-directional risk of transmission of zoonoses

¤ behaviorally appropriate for the program ¤ protected from being harmed by participation in the

program.

(from AVMA Wellness Guidelines)

HAI terminology

¨  Animal-Assisted Interventions (AAI) ¤ Animal-Assisted Therapy (AAT)

n Hippotherapy (HPOT)

¤ Animal-Assisted Activities (AAA) n Therapeutic Riding n Animal-Assisted Education (AAE)

¨  Facility animals ¨  Companion animals ¨  Service animals

   Intervention Legal

access Administered by

Population served

examples

Animal-Assisted Therapy

No Licensed Therapist within scope of practice

People with disabilities

Hippotherapy Equine Facilitated Psychotherapy

Animal-Assisted Activities

No Anyone (should receive training)

Anyone Visiting animal programs Therapeutic riding

Assistance Animals Yes Provided by training organizations

People with disabilities

Service dogs Helper monkeys Guide horses

animal-assisted interventions (AAI)

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animal-assisted therapy (AAT) (definition from PetPartners and IAHAIO)

¨  goal-oriented intervention, planned, structured, measured and documented

¨  animal (that meets specific criteria) is intentionally included as part of the treatment process

¨  designed to promote therapeutic gains in human physical, social, emotional, and/or cognitive functioning

¨  directed by a formally trained health/human service professional within the scope of their profession who knows both animal and human involved

¨  examples

hippotherapy (HPOT)

¨  Is a type of AAT ¨  administered by an occupational, physical, or speech

therapist ¤  specially trained to utilize the movement of the horse to facilitate

improvements in their clients/patients ¤  use traditional therapy techniques and incorporate the movement of the

horse as part of their treatment strategy ¤  Evaluate individual needs, address individual goals, document progress

animal-assisted activities (AAA) (definition from Pet Partners and IAHAIO)

¨  planned and goal oriented informal interaction or visitation

¨  provides opportunities for motivational, educational, recreational, and/or therapeutic benefits

¨  designed to enhance quality of life ¨  delivered in a variety of environments by specially

trained professionals, paraprofessionals, and/or volunteers

¨  human-animal team should have some training and screening

¨  examples

therapeutic riding

�  teaching individuals with disabilities to ride horses �  as with other recreational activities (swimming, martial

arts), can provide: ¡  sensory input ¡  opportunities for interaction with peers ¡  community participation (special olympics) ¡  opportunity to learn/master a skill

AAA in a recreational setting

¨  fairly loose in requirements: ¤  Suitable animal --Enough personnel

¨  can be a casual interaction or an organized group. Examples: ¤  Weekly social group with a group facilitator, volunteer handler, and

multiple children, similar to 4-H or scouts ¤  Visiting animal programs: a visiting animal and its handler visit a local

school for children.

¨  Not direct therapy, but therapists can recommend to families

facility animal

-lives with a facilitator who is responsible for care -lives in a facility

-variety of species

¨  depending on the setting, population, and human service professional working with the animal, facility animals can provide AAT or AAA.

¨  example

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children with developmental disabilities

¨  often have ¤  sensory differences (as described in Grandin, 2011) ¤ motor control problems

n  fine motor (difficulty using hands as needed) n gross motor (limited mobility or use of arms or legs)

¤ combination cause difficulties with daily living skills

presentation/what AAT looks like

¨  settings: ¤ home, school, clinic, farm

¨  providers: ¤ private therapist, school district therapist

¨  intervention: ¤ group or individual

¨  animal: ¤ horse, dog, cat, guinea pig, bird

AAT in a home, school or clinic setting

¨ as AAT definition: ¤ goal directed, documented ¤ Administered by an OT who is registered

and licensed to practice within the scope of their profession

¨ personnel issues ¨ animal is a partner in treatment process

Activity ideas to address specific treatment areas

¤  sensory processing, registration and modulation n animal can lay next to or on child’s lap, providing deep

pressure. n animal provides multiple textures to expose child to slowly (fur, tongue, paws)

¤ promote independence with functional self-help skills

demo with Norm

¨  therapeutic activities: directed activities to achieve therapy goals ¤ deep pressure activities ¤  interactive activities to support social goals ¤ activities to improve Range of Motion ¤ activities to improve fine motor skills ¤ activities to improve gross motor skills

activity ideas to address specific treatment areas ¨  motor function

¤  play touch the tail, ear, foot, etc. to challenge/facilitate stretching, balance

¤  have a cape on the animal with fasteners and ask the child to complete them

¤  place small felt “fleas” on the animal and ask the child to pick them off

¨  Play and social skills

¤  video 1 Zachary ¤  video 2 Zachary 2

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the role of the therapy provider

similar to role when using other modalities: ¨  ensure you as a practitioner have proper training ¨  ensure clients’ safety and be aware of signs of

stress ¨  ensure animal’s suitability and safety and be aware

of signs of stress ¤  follow AVMA wellness guidelines

¨  educate clients and families on modality and requirements ¤ contraindications

effects of AAI on clients with autism

¨  provides significant sensory input: decreased sensory seeking or sensory aversive behaviors ¤  deep pressure and vestibular input ¤  tactile input (animal hair, saddle or pad, reins, brush) ¤  environment contains lots of auditory and visual information

¨  increased communication/verbalization ¨  improved cognitive skills via ability to follow multi

step directions ¨  improved balance and motor skills ¨  (my observations: not proven in the literature)  

look to the literature

¨  Grandin, T. (2011). People with autism often have ¤  difficulty w transitions(attention shifting), categorical, sensory

based thinking (as animals do), highly varied response to animals

¤  animals can provide companionship, motivation to participate in therapy, safety/stability

¨  Burrows et al. (2008) matched a “service” dog full time with a family with a child with autism (skilled companion assistance animal). ¤  Found that the animals: calmed the child, decreased tantrum

& bolting behavior  

literature (cont’d)

¨  Sams, M.J., Fortney, E.V., & Willenbring, S. (2006). Occupational therapy incorporating animals for children with autism: A pilot investigation.

¨  Incorporated animals into OT practice in an outpatient clinical setting, AAT treatment to traditional OT treatment.

¨  Found that children who received AAT demonstrated ¤  significantly more social interactions ¤  enhanced motivation ¤  greater treatment gains

¨  than children exposed to traditional therapy.  

literature (cont’d)

¨  Stoner, J. (2007). Efficacy of Hippotherapy as a Treatment Strategy for Children with Autism

¨  Children ages 4-10 with dx of PDD or autism

¨  Weekly parent/caretaker questionnaire

¨  Sensory Profile pretest /posttest

¨  Results: ¤  Improvements in multisensory and auditory processing, as well as

modulation of sensory input.

research related issues

¨  Wilson & Barker (2003) ¤ difficulty blinding ¤ presentation of HAI/AAT so different ¤ Presentation of AAT clients so varied ¤  long term outcomes difficult to measure/identify

causality ¤ No established outcome measures ¤ No established protocol

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recent literature reviews

¨  O’Haire, M. E. (2013). Animal-assisted intervention for autism spectrum disorder: A systematic literature review. ¤  14 articles ¤  presentation of AAI varied. ¤  dolphins, guinea pigs, ¤  found unanimously positive outcomes ¤  many methodological weaknesses ¤  preliminary “proof of concept”

¨  Berry et al. (2013) ¤  6 published studies, differing presentation ¤  llamas, dogs, rabbits ¤  animals

n  respond affectionately n  elicit prosocial behavior and positive feelings n  emotional bridge, social catalysts

promote verbal and nonverbal behaviors towards animals and people

my research

¨  single subject multiple baseline study with repetition ¤  10 subjects ages 6-13 with developmental disabilities ¤  6 girls, 4 boys ¤  students at Perkins (convenience sample)

¨  received OT ¤  using traditional techniques 1-2x/week for 3-5 weeks ¤  incorporating a trained therapy dog 1-2x/week for 3-5 weeks

¨  independent raters using established outcome measures to examine play/playfulness and participation

¨  mixed results, but generally positive: ¤  increased playfulness in OT-AAT sessions ¤  increased participation during OT-AAT sessions ¤  implementation schedule did not appear to change results

resources

¨  Pet Partners www.petpartners.org ¨  American Hippotherapy Asc. www.americanhippotherapyassociation.org ¨  North American Riding for the Handicapped Association

www.narha.org ¨  Intermountain Therapy Animals www.therapyanimals.org ¨  Assistance Dogs International www.assistancedogsinterntational.org ¨  American Veterinary Medical Association Wellness Guidelines for

AAT ¨  Fine, Aubrey H. (2010). Handbook on Animal-Assisted Therapy:

Theoretical Foundations and Guidelines for Practice, 3rd Ed. ¨  McCardle, P., McCune, S., Griffin, J. A., Esposito, L. & Freund, L.S. (2011).

Animals in our lives: Human-animal interaction in family, community & therapeutic settings. Baltimore, MD: Paul H. Brookes.

¨  Pavlides, M. (2008). Animal-assisted interventions for Individuals with autism.

 

thank you! questions today or in the future: Jennie Feinstein <jdfeinstein@gmail.com>