Therapist’s Best Friend?
Monday January 18, 2010
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Resources
• Gee NR, Harris SL, Johnson KL. The role of therapy dogs in speed and accuracy to complete motor skills tasks for preschool children. Anthrozoos 2007; 20(4):375-386.
• Kaminski M, Pellino T, Wish J. Play and pets: the physical and emotional impact of child-life and pet therapy on hospitalized children. Chil Health 2002;31(4):329-330.
• Kidd A, Kidd R. Reactions of infants and toddlers to live and toy animals. Psych Reports 1987;61(2):455-464.
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“We have found that patients are more motivated in their therapy when an animal is involved,” says Claire Peel, PT, PhD, professor of physical therapy at the University of Alabama in Birmingham. “For many, it makes therapy more fun and is a good distraction from the task at hand.”
For the past three decades, AAT has been successfully used with children and adults for physical, occupational, and speech therapy. In PT-directed programs, AAT, also referred to as animal-assisted activities or pet-facilitated therapy, is most frequently designed to improve patients’ ambulatory skills.
Dogs are most commonly used by PTs, but therapists also work with cats, rabbits, and larger animals such as horses. There are numerous programs that train animals and their owners to visit patients in nursing homes, hospitals, and rehabilitation centers. The Delta Society is the leading international organization educating healthcare professionals about how to incorporate animals into treatment programs.
Before animals can participate in a therapy session, the animal and its owner must complete training, explained Sheree Chapman York, PT, MS, PCS, director of the PT/OT department at Children’s Hospital in Birmingham, and president of the American Physical Therapy Association’s section on pediatrics. “Since not all dogs have the right temperament to be in public, they must be adequately trained before being around people, particularly children.”
Pet Benefits
When Melissa Levato, PT, joined Centegra Health System in McHenry, Ill., she was excited to learn that they offered AAT. Although Centegra allows dogs only in the adult inpatient rehab unit, staffers successfully lobbied the Illinois Department of Public Health to allow animals on the acute care floors, where children are also seen. “Soon we will be able to provide animal-assisted therapy to a much broader group of patients at our center,” Levato says.
Levato works with a recreational therapist along with the dog’s owner, who is always with the animal. “The owners know their animal’s habits so well that it’s important to have them present during each session,” she says.
AAT is used with children with a wide range of conditions, including those who have undergone surgery, those with developmental delays, and others with disorders such as cerebral palsy, Down syndrome, or muscular dystrophy. How the animals are incorporated into therapy depends on the individual needs of the patient. Therapists often involve animals to assist children with walking, transfers, balancing, and cruising. This helps children increase their endurance, ambulation distance, motor-skill development, and independence while playing with the animal.
For example, a therapist may decide to incorporate a large dog into therapy to help a child learn how to master the skill of cruising. The dog can stand in place while the child cruises around the animal, making the activity both fun and rewarding.
Playful Activity
There are countless anecdotal stories about the benefits of AAT that range from reducing depression and anxiety to lowering blood pressure and triglycerides, but so far only a handful of small studies have evaluated this approach in the physical therapy setting.
In one controlled study of children who were hospitalized, the children who participated in AAT did not talk as much about being sick or wanting to go home as children in a control group. In another study, researchers evaluated the effects of therapy dogs on the speed and accuracy of performing 10 motor tasks in children between the ages of 4 and 6. The children were found to complete the tasks faster and more accurately when the dog was present.
More recently, Peel conducted a study in children with Down syndrome to determine the effectiveness of AAT in facilitating the performance of certain gross motor activities. The researchers identified three to five motor skills for each patient, and observed their performance during six sessions (three animal sessions and three control sessions) at the Bell Center for Early Intervention in Birmingham.
The results of Peel’s study were reported at the 2009 APTA national conference in Baltimore. They found that four of the children demonstrated higher frequency of goal achievement when an animal was present. However, the other four children showed similar performance during each type of session, and one showed better performance during a no animal session.
The results suggested AAT can have a positive effect in children with Down syndrome in attempting gross motor skills. “We have conducted another study in all children to determine which specific activities with animals make the biggest difference — and hope to present those results in the future,” Peel says.
Paul Wynn is a contributing writer for Today in PT.
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