background the field Interdisciplinary n PT, OT, SLP , psychology, - - PDF document

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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

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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

• rganizations

People with disabilities Service dogs Helper monkeys Guide horses

animal-assisted interventions (AAI)

10/25/15 ¡ 2 ¡ 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

10/25/15 ¡ 3 ¡ 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

• f 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)

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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.

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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

10/25/15 ¡ 5 ¡

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.

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thank you! questions

today or in the future: Jennie Feinstein <jdfeinstein@gmail.com>