by Jacob Hiller & Amy Gifford

Introduction

Milo Vaccaro is an 11-year old boy with autism who frequently had severe outbursts in public and often tried to run away from his parents. It was only a matter of time before his family realized that they could not deal with his disability on their own. A few weeks later Chad, an autism service dog, walked through the door. The relationship between Milo and Chad developed rapidly, and soon Milo’s mother noticed significant positive changes in her son’s ability to communicate and be comfortable in social or public situations. Milo has progressed so well that the Vaccaros are thinking about lowering his medication (Baranauckas, 2009). This is just one of many recent examples demonstrating the mental and physical benefits of animal-assisted therapy in treating children with diseases and disabilities.

Pets are so often integrated into the American lifestyle that we tend to overlook the benefits that our interactions with them may have on our emotional well being. However, when suddenly deprived of our pets, for instance when taking a vacation, going to college, or staying in a hospital, we notice their absence considerably. In the latter situation, mental health can drastically decrease due to stress, fear, pain, and loneliness, which in turn can directly affect physical health. Interactions with animals can benefit a patient’s mental state by alleviating some of the emotional strain that comes from being sick.

Animal-assisted therapy (AAT) is now used throughout the country in nursing homes for elders with dementia or in pediatric hospitals for children with acute illnesses. It is used in physical rehabilitation facilities where patients with physical debilitations interact with animals on an active level such as riding a horse and in community centers where teenagers with learning and behavioral disabilities learn to care for animals. Some of the most positive results have come from animal therapy with children.

History

In their article “Pet Therapy Research,” therapy nurses Hooker, Freeman, and Stewart (2002) state that the first known account of animal assisted therapy was in England in 1792, where the belief promoted by an asylum-like facility, the York retreat, was that the use of birds and rabbits in the treatment of mentally ill patients was better than then-current treatment techniques, which according to Wikipedia were painful blistering, whipping, and long-term restraint (Hooker et al., 2002). Hooker et al. (2002) state that the systematic study of animal assisted therapy, with recorded observations, did not begin until the 1960s. Dr. Boris Levinson, a child psychologist, concluded that, “the use of a dog in psychiatric care was determined to be a positive focus in beginning communication, allowing defenses to soften, building a rapport, and initiating therapy” (p. 18). An explosion in animal assisted therapy research followed Dr. Levinson’s findings.

Current Examples

Many studies have been done looking at the effects of AAT on children with diagnosed mental disorders, hypothesizing that the animal interactions would improve social and behavioral functioning. In their article, “Animal-assisted Therapy for Children with Pervasive Developmental Disorders” Martin and Farnum (2002) conducted an experiment involving AAT with children diagnosed with “pervasive developmental disorder (PPD), disorders characterized by a severe impairment of social functioning and interactions…” (p. 657). This included children with diagnoses of autism and Asperger’s. Children with PPD are often unable to form relationships because they are socially withdrawn and disconnected. This study was conducted in the belief that animals can provide a stepping stone of sorts for children with social disabilities, allowing the children to form relationships with the animals first and then be able to expand their boundaries and form relationships with other humans (Martin & Farnum, 2002).

The experiment consisted of therapeutic sessions with a ball, a stuffed dog, and a live dog. The children with PPD were evaluated based on seven guidelines designed by Martin and Farnum (2002) “including imitation, perception, fine motor control, gross motor control, eye-hand coordination, cognitive performance, and cognitive verbal performance” (pp. 661). Their results provided insight that the AAT had beneficial effects on the children with PPD by overall increasing the children’s energy. This was expressed through play with the animal. The children also exhibited focused attention on the animal and were less easily distracted, something that is difficult for children with PPD. The most important evidence that AAT could help children with these diagnoses was that the children were subsequently able to stay on topic with the therapist as opposed to talking about unrelated subjects in response to questions due to an inability to communicate and interact. This result showed a direct improvement of the children’s social disorders. When the children were placed with the ball and stuffed dog the opposite result occurred. In therapy sessions the children were unfocused, unresponsive, and off-topic.

Animal-assisted therapy has also had other positive outcomes among children with behavioral conditions stemming not from a disorder but from abuse and/or neglect. In her article “Animal-assisted Therapy with Children Suffering from Insecure Attachment Due to Abuse and Neglect…” Parish-Plass (2008) discusses her experimental results implementing AAT with children removed from severely abusive and neglectful homes. Parish-Plass (2008) dictates that children who come from these types of home-lives have distrustful behaviors, especially around adults, and, as a result, are particularly hard to connect with in therapeutic sessions. Abused and neglected children also have a hard time behaving as normal children in the sense of playing pretend or using imagination, which is a tactic used by many therapists, as Parish-Plass (2008) explains, to “reach the inner world of the child” (pp. 8). In her experiment Parish-Plass (2008) used AAT with multiple children and carefully observed their resulting behaviors and the overall effects of this specific therapy. Parish-Plass (2008) concluded that AAT was effective with “children suffering from insecure attachment and the affects of trauma [from abuse and neglect]” (p. 27) because it could blend the line “between reality and play…. [and t]he child may take advantage of either play or reality, or combine the two” (p. 27). She also made several determinations as to why AAT was so effective among children from abusive backgrounds. Animal-assisted therapy requires children to form an immediate emotional connection with the animal, which in turn drives them to develop a relationship with the therapist who already has a relationship with the animal. This relationship also helps to raise the child’s self esteem and their feelings of competence and comfort because the animal has accepted them. On a more physical level, previous studies have proved that interactions with animals can reduce blood pressure and heart rate, which decreases stress and anxiety and leads to a feeling of ease. Among children who have spent their lives building defenses when in uncomfortable settings, their comfort is key to their emotional health and AAT provides a setting were this can occur. All in all, Parish-Plass made conclusion that the use of AAT with children from abusive and neglectful homes can be beneficial, which is extremely important since numerous studies have shown that abused children later become abusive parents. Animal-assisted therapy may be able help stop this pattern of violence.

Another important usage of animal-assisted therapy is for the management of pain in pediatric care settings. In the article “Animal-assisted Therapy As a Pain Relief Intervention for Children,” Braun, Stangler, Narveson, and Pettingell (2009) argue that their experiment proves that AAT can have notable effects alleviating pain in children with acute diseases. Their experiment was based off measured “pain scores” that were calculated from vital signs taken before and after children received animal therapy. These “pain scores” were then compared to scores taken from children who received no therapy. The results from Braun et al. (2009) showed that while certain vital signs seemed not to vary between the two groups there was a significant decrease in overall “pain scores” for the experimental group. This means the children receiving AAT had a significantly larger decrease in pain than the children who received no AAT. Braun et al. (2009) discussed the current reasoning behind the positive effects of animal-assisted therapy and pain level. A child interacting with an animal undergoes an emotional response which, as Braun et al. (2009) point out, in turn stimulates “the release of endorphins, which induce a feeling of well-being, and lymphocytes, which increase the immune response” (p. 107). These chemical releases in the body are directly connected to physical responses such as beneficial changes in heart rate, blood pressure, respiration rates, and temperature. These current beliefs are supported through the experiments done by Braun et al. (2009). They are important potential future uses of animal-assisted therapy with children diagnosed with both acute and chronic diseases that involve high levels of pain and stress.

Awareness of Anxiety and Training Solutions

All of these experiments have shown that AAT has beneficial physiological effects on children because their mental and emotional states improve through interactions with animals. However, there is also a possibility that AAT could sometimes have a negative emotional effect on the children the therapists are trying to help. For example, if a dog were to enter a hospital there would presumably be many children thrilled to see and to lay a hand on the dog. On the contrary, there may be children who are scared of dogs. This may be due to traumatic experiences with dogs, such as getting bitten, or because of never having been around an animal before. This may cause children to become nervous, causing an increased heart rate and blood pressure, and in turn having negative consequences such as anxiety. But, with the proper training, therapists can minimize this problem.

Maureen and Gary Ross established a company known as “Therapet” in an attempt to establish “standards of practice for use of specially trained animals in the healthcare setting” (Therapet 2009). The Therapet website (2009) suggests that any animal to be used in AAT should be a domesticated animal and should be able to complete a comprehensive certification program. The first step of their program is to go through a very intense obedience training. Therapet (2009) suggest that the owner and the animal “attend a beginner, intermediate and advanced level class before testing. Each of these levels are usually offered in 6-8 week sessions” (para. 3). In order for the animal to become “Therapet” certified, they must also pass a Canine Good Citizens Test, which Therapet (2009) explains, is a test that “evaluates the dog to see if they have basic obedience skills” (ll. 10-11). The second step of the intensive program is the skills class, a five-week long class in which, Therapet (2009) explains, the “[p]articipants learn all the special commands needed to work in a hospital environment and practice around all the equipment including hospital beds, walkers, crutches, canes and therapy tables” (para. 4). Before the final step can be completed the animals must be thoroughly examined by a veterinarian. Upon completion of the examination, the animal and owner may move on the final step, the Temperament Test. Therapet (2009) states that, “animals may only be tested twice…. [i]f the dog passes, then it is able to begin a probationary period volunteering with supervision” (para. 5). Through their training, the pets become much like nurses, caring and bringing a smile to each patient they come in contact with.

Conclusion

Animal-assisted therapy is currently integrated into numerous rehabilitation, therapeutic, and medical facilities for all types of patients, old and young, suffering from mentally and physically debilitating diseases. One particular area of AAT effectiveness is with children. Even though a great deal of research continues to be done on this type of therapy, the AAT programs throughout the country, such as the Canine for Kids program at the Schneider Children’s Hospital (Byalick, 1999) have realized that animals have a marked beneficial effect on children. In a hospital setting, children can easily become depressed or anxious especially if they don’t fully understand what is going on and often visitation from a pet is the only effective way to improve their mental state. In her New York Times article Byalick (1999) states that according to Dr. Bob Gluck, a man closely affiliated with Canines for Kids, “[t]hese dogs have a kind of primitive attraction for a lot of kids. Those who don’t respond to clowns and athletes light up when the dogs arrive” (Byalick, 1999). Children’s mental state is closely connected with their physical health and even if AAT can only provide simple companionship, it is often a significant improvement. Emily Grankowski, in charge of the pet therapy program at the Children’s Hospital of Orange County, is quoted in Baranaucka’s article, “Exploring the Health Benefits of Pets” (2009) on her personal experiences with sick children and animal-assisted therapy. She says that “some patients who have refused to speak will talk to the dogs and others who have refused to move often reach for the dogs so they can pet them” (p. 2). Children are extremely resilient both mentally and physically. However sometimes it takes that unexplainable bond between humans and animals to help them overcome their mental or physical pain.

References

Baranauckas, C. (2009, October 6). Exploring the health benefits of pets. The New York Times. Retrieved from nytimes.com

Braun, C., Stangler, T., Narveson, & J., Pettingell, S. (2009). Animal-assisted therapy as a pain relief intervention for children. Complementary Therapies in Clinical Practice, 15, 105-109. doi: 10.1016/j.ctcp.2009.02.0008

Byalick, M. (2009, April 18). When command is ‘heal,’ these dogs obey. The New York Times. Retrieved from nytimes.com

Heimlich, K. (Oct-Dec 2001). Animal-assisted therapy and the severely disabled child: a quantitative study. Journal of Rehabilitation, 67, 48-54. Retrieved from web.ebscohost.com

Hooker, S. Freeman, L. & Stewart, P. (2002). Pet therapy research: a historical review. Holistic Nursing Practice, 17, 17-23. Retrieved from ncbi.nlm.nih.gov, PMID: 12465214

Martin, F. & Farnum, J. (2002). Animal-assisted therapy for children with pervasive developmental disorders. Western Journal of Nursing Research, 24, 657-670. doi: 10.1177/019394502320555403

Parish-Plass, N. (2008). Animal-assisted therapy with children suffering from insecure attachment due to abuse and neglect: a method to lower the risk of intergenerational transmission of abuse? Clinical Child Psychology and Psychiatry, 13, 7-30. doi: 10.1177/1359194507086338.

Therapet Foundation (2009). Therapet Animal Assisted Therapy. [Ross, G. and Ross, M., co-founders] Retrieved from www.therapet.com