'More people talk to you when you have a dog' - dogs as catalysts for social inclusion of people with intellectual disabilities

What's Good About Inclusion? An Ethical Analysis of the Ideal of Social Inclusion for People with Profound Intellectual and Multiple Disabilities

'Social inclusion' is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. 'Social inclusion' can refer simply to full equal rights, but more often it is taken to mean something like 'community participation'. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise.

Therapy Dog Presence in an Undergraduate Nursing Program

ABSTRACT

Research supports the use of animal-assisted interactions and pet therapy in various settings. Undergraduate nursing students experience high levels of stress and anxiety which often continue as they become professional nurses. Entering the workforce equipped with positive coping strategies may help newly licensed nurses to combat stressors. This qualitative descriptive study examined the experiences of undergraduate nursing students with the presence of a therapy dog. Four major themes regarding the role of therapy dogs were identified: as a coping strategy, as a mood moderator, as a positive distraction, and for community building.

Pet ownership and maintenance of cognitive function in community-residing older adults: evidence from the Baltimore Longitudinal Study of Aging (BLSA)

Pet ownership has been associated with reduced deterioration in physical health as older adults age; little research focused on deterioration in cognitive function. We examine the relationship of pet, dog, cat ownership, and dog walking to changes in cognitive function among 637 generally healthy community-dwelling older adults (185 pet owners) aged 50-100 years (M = 68.3, SD = 9.6) within the BLSA. Cognitive assessments every 1-4 years over 1-13 years (M = 7.5, SD = 3.6) include the California Verbal Learning (Immediate, Short, Long Recall); Benton Visual Retention; Trail-Making (Trails A, B, B-A); Digit Span; Boston Naming (Naming); and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, deterioration in cognitive function with age was slower for pet owners than non-owners (Immediate, Short, Long Recall; Trails A,B,B-A; Naming; Digit Symbol); dog owners than non-owners (Immediate, Short Recall; Trails A,B; Naming; Digit Symbol); and cat owners than non-owners (Immediate, Short, Long Recall; Naming), controlling for age and comorbidities. Among dog owners (N = 73) walkers experienced slower deterioration than non-walkers (Trails B, B-A; Short Recall). All ps ≤ 0.05. We provide important longitudinal evidence that pet ownership and dog walking contribute to maintaining cognitive function with aging and the need to support pet ownership and dog walking in design of senior communities and services.

Supporting Social Inclusion in Neighbourhoods of Adults with Intellectual Disabilities: Service Providers' Practice Experiences

Deinstitutionalisation has increased the likelihood of adults with intellectual disabilities residing in neighbourhoods either in staff-supported accommodation or in their family home. However, it raises the question of whether national policies on disability have translated into practice actions by service providers that result in positive social inclusion outcomes for individuals. This study examined the practice initiatives supporting social inclusion in neighbourhoods in specialist state-funded service providers for adults with intellectual disabilities. Using a mixed methods design, CEOs/service leaders of 40 organisations completed an online survey. Follow-up interviews were completed with a randomised sample. Shifting towards new service models and strategic links with mainstream organisations were most often mentioned as furthering social inclusion goals. A wide range of service initiatives were reported, with positive outcomes alongside a range of challenges. Service providers play an important role in providing individualised supports that foster local engagement. However, the service context is complex and service leaders have reported many challenges that may impede progress on social inclusion.

Pilot of a dog-walking program to foster and support community inclusion for people with cognitive disabilities

PURPOSE

To evaluate a dog-walking program (called "Dog Buddies") designed to address the need for evidence-based programs that create opportunities for people with cognitive disabilities to be more socially included in mainstream society. The research question was: Does community dog walking foster social interaction for people with cognitive disabilities?

MATERIALS AND METHODS

Single-case experimental design was used with four individuals (three with intellectual disability; one with Acquired Brain Injury (ABI)) recruited via two disability service providers in Victoria. Target behaviours included frequency and nature of encounters between the person with disability and community members. Change was measured from baseline (five community meetings with a handler but no dog) to intervention period (five meetings minimum, with a handler and a dog). Semi-structured interviews, audio-recorded and transcribed verbatim, provided three participants' subjective experiences of the program.

RESULTS

Dog Buddies increased the frequency of encounters for all participants. The presence of the dog helped to foster convivial encounters, community members were found to be more welcoming, and some participants were recognised or acknowledged by name over time in the intervention phase.

CONCLUSIONS

The dog-walking program offered a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities.IMPLICATIONS FOR REHABILITATIONThe co-presence of people with disabilities in the community with the general population does not ensure social interaction occurs.Both disability policy, and the programs or support that is provided to people with disabilities, needs to have a strong commitment to the inclusion of people with disabilities in mainstream communities.Dog Buddies is a promising example of a program where the presence of a pet dog has been demonstrated to support convivial, bi-directional encounters of people with cognitive disabilities and other community members.Dog-walking offers a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities.

Animal-Assisted Counseling for Young Children: Evidence Base, Best Practices, and Future Prospects

Increasing numbers of young children are experiencing mild to moderate mental health issues that require support in addition to that typically provided by family members and teachers. The services of professional counselors can be particularly useful when children need help adjusting to and coping with various stressors and situations. Many school counselors and other mental health professionals have found that carefully planned interactions between young children and animals (e.g., guinea pigs, rabbits, dogs, horses) represent an effective alternative/complementary therapeutic modality. Animals may provide an accepting, nonjudgmental presence that focuses young children's attention, motivates them to learn, and encourages participation in planned intervention activities. This article begins by describing the general purposes for counseling with young children and the role that early childhood educators can play in increasing families' awareness of and access to these services in their communities. Next, it defines animal-assisted counseling and reviews the relevant research to build a rationale for including carefully selected animals in mental health support services for children. The third section discusses caveats about involving animals in individual and small group counseling sessions, in classrooms, and in other facilities/programs that work with young children. The article then summarizes best practices in animal-assisted counseling and how they are influenced by variables within the child, animal welfare considerations, different contexts, availability of resources, and interagency collaborations. The conclusion is a statement on the future of animal-assisted counseling for young children and how it supports the goals of humane education.

Perspectives on facility dogs from pediatric hospital personnel: A qualitative content analysis of patient, family, and staff outcomes

An increasing number of children's hospitals feature full-time resident facility dogs, which are specially trained to work alongside pediatric healthcare professionals to improve the patient experience. This qualitative study aimed to describe the role that facility dogs play in the lives of patients, families, and hospital staff. A total of N = 73 pediatric healthcare professionals that worked with 46 facility dogs across 17 children's hospitals in the US completed a set of open-ended questions in an online survey. Responses were analyzed via a conventional thematic analysis and organized into themes and sub-themes. Facility dogs were described to benefit pediatric healthcare professionals' daily lives through improving stress and wellbeing, staff relationships, and job-related morale. Negative impacts included increased burdens and responsibilities in the workplace. Facility dogs were also described to benefit patients and families by helping build rapport, providing a comforting presence and positive resource, and normalizing the hospital environment. In conclusion, facility dog programs were found to be a promising complementary intervention to benefit both staff as well as and patients and families. Future research is warranted to examine short-term and long-term implications of facility dog programs for staff, patient, and family wellbeing.

Interactions between the Public and Assistance Dog Handlers and Trainers

This research aimed to explore the experiences of handlers and trainers of disability assistance dogs in terms of the types of interactions they had with members of the Aotearoa NZ (NZ) public and how these interactions were perceived, interpreted, and managed. A qualitative method, guided by an interpretive approach and social constructionism, was utilised to collect data via semi-structured interviews with six handlers and six trainers of assistance dogs. Data were analysed using thematic analysis with the social model of disability as the theoretical base. Findings indicated that participants regularly faced a complex range of unique interactions due to various factors such as the public's lack of knowledge and understanding of the dog's role and right of access to public places. While participants encountered brief friendly comments about the dog and its role, other encounters involved long conversations, invasive personal questions, interference with their dogs, and denied access to businesses, cafés, restaurants, and public transport. These findings underpin the need to provide more education to the public on the etiquette of engaging with handlers and their assistance dogs and more support for businesses to understand the legal rights of handlers. Through education and support to change societal attitudes and remove structural barriers, disabled people using assistance dogs may be able to independently participate in community life and be fully included without hindrance.

Inclusion and Special Education

The purpose of this paper is to trace the historical trajectory of special education and how societal perspectives influenced the special education movement. It aims to answer if special education and inclusion have achieved their goals for all individuals, especially those with disabilities. A review of historical trends, special education laws, and key constructs showed that there were both positives and negatives aspects. It also revealed that the absence of a clear definition, standards, and objectives for inclusion and least restrictive environment is just one of the roots of the problem. Moreover, the lack of empirical studies on the effectiveness of inclusion and the lack of knowledge and awareness of the provisions of special education laws by stakeholders contribute to the issues surrounding inclusion implementation. Recommendations include that all stakeholders should have historical awareness and discriminative ability, in-depth comprehension of special education laws, and adapting the same definition, standards and clear objectives in implementing inclusion programs.

Stigma, Acceptance and Belonging for People with IDD Across Cultures

Purpose of Review

This review explores recent literature (from 2017 onwards) to identify current developments related to reducing stigma and increasing acceptance for people with Intellectual and Developmental Disabilities (IDD) in their communities across diverse cultures.

Recent Findings

We identified literature related to experiences of stigma for people with IDD and their families across diverse cultures, as well as current and potential interventions and approaches for promoting acceptance.

Summary

Although the literature confirms that stigma is still a major barrier to acceptance and inclusion for people with IDD regardless of culture, there appears to be progress in terms of using diverse approaches to support acceptance and belonging. Researchers are also increasingly acknowledging the importance of culture and context in the experience and mitigation of stigma. There remains a need for researchers and practitioners to include people with IDD in identifying and prioritising interventions that promote belonging within their communities.

Companion dog acquisition and mental well-being: a community-based three-arm controlled study

Background

Dog ownership is suggested to improve mental well-being, although empirical evidence among community dog owners is limited. This study examined changes in human mental well-being following dog acquisition, including four measures: loneliness, positive and negative affect, and psychological distress.

Methods

We conducted an eight-month controlled study involving three groups (n = 71): 17 acquired a dog within 1 month of baseline (dog acquisition); 29 delayed dog acquisition until study completion (lagged control); and 25 had no intentions of acquiring a dog (community control). All participants completed the UCLA Loneliness Scale (possible scores 0–60), Positive and Negative Affect Schedule and Kessler10 at baseline, three-months and eight-months. We used repeated measures ANCOVAs to analyse data with owner age and sex included as covariates. Post-hoc tests were performed for significant effects (p < 0.05).

Results

There was a statistically significant group by time interaction for loneliness (p = 0.03), with an estimated reduction of 8.41 units (95% CI -16.57, − 0.26) from baseline to three-months and 7.12 (95% CI -12.55, − 1.69) from baseline to eight-months in the dog acquisition group. The group by time interaction for positive affect was also significant (p = 0.03), although there was no change in the dog acquisition group.

Conclusions

Companion dog acquisition may reduce loneliness among community dog owners. Our study provides useful direction for future larger trials on the effects of dog ownership on human mental well-being.

Trial registration

This trial was retrospectively registered on 5th July 2017 with the Australian New Zealand Clinical Trials Registry (ACTRN12617000967381).

Enhancing social inclusion of young adults with intellectual disabilities: A systematic review of original empirical studies

BACKGROUND

Social inclusion is regarded as an important determinant of health, particularly for young adults with intellectual disabilities. However, only a limited number of reviews report on the findings of original empirical studies on social inclusion of young adults with intellectual disabilities. This review provides a succinct synopsis of original empirical studies on social inclusion among young adults with intellectual disabilities for the period between January 2013 and January 2019.

METHODS

Studies were drawn from three electronic databases: ScienceDirect, PubMed and PsycINFO. In addition, hand searches were carried out in several international journals focusing on intellectual disability research. The review included both qualitative and quantitative studies. In all, 24 key studies met the inclusion criteria for this review. The Methodological Quality Checklist developed by Downs and Black (Journal of Epidemiology Community Health, 1998, 52, 377) was used to independently assess study quality, and the Cochrane Collaboration Intervention Clinical Appraisal Form was used to extract data and outcome measures for each study.

RESULTS

Among the key findings, structured and organized social inclusion interventions were reported to create better opportunities to engage in social interactions and improve social skills. Moreover, evaluating outcomes on the two core quality-of-life domains, that of interpersonal relationships and community participation, were reported to facilitate positive outcomes for social inclusion of young adults with intellectual disabilities.

CONCLUSION

There is a need to do an in-depth exploration of the potential impact of facilitators that promote social inclusion of young adults with intellectual disabilities, by conducting rigorous empirical investigations.