'Having the dog as part of our family gives us hope': Experiences of the impact of assistance dogs on the occupational engagement of children with autism and their families

BACKGROUND

Autism is a developmental disorder characterised by changes in social, communication, and behavioural performance. Assistance dogs can support children with autism to engage in everyday occupations. Despite more children being partnered with assistance dogs, there is limited research regarding the impact of assistance dogs on the occupational engagement of children with autism and their families, and further research is needed to fully understand the impact of this type of support within the Australian context.

OBJECTIVES

To explore caregiver-reported experiences of an assistance dog on the occupational engagement of children with autism and their families.

METHOD

Using a qualitative approach, semi-structured interviews were undertaken with six caregivers of seven children with autism, who each had an assistance dog. Interviews ranged from 45 to 60 minutes in duration. Data were transcribed verbatim and thematically analysed. Trustworthiness was maximised through independent recruitment, research team discussions, member checking, and a researcher reflective journal.

FINDINGS

Three themes were identified: participation in everyday occupations prior to and after partnering with an assistance dog, increased engagement in everyday occupations, and impact of the assistance dog on the family unit. Assistance dogs were reported to progress children from community 'isolation' to 'freedom'. Participants reported the dog increased children's capacities through positively influencing completion of routines, increasing independence, and improving therapy engagement. Assistance dogs were viewed as supporting the whole family's occupational engagement. Some challenges were identified with the introduction of the assistance dog to the family unit, and with animal maintenance costs and time demands, public access rights, and limited government funding.

CONCLUSION

This research identifies benefits and challenges for children who partner with autism assistance dogs. It provides insights to inform assistance animal referral, assessment, and support of assistance dogs in Australia for children with autism and occupational therapists working with them.

Investigating Dog Welfare When Interacting with Autistic Children within Canine-Assisted Occupational Therapy Sessions: A Single Case Study

Human-animal bond is defined as the mutually beneficial relationship between humans and animals. Recent years have seen increasing research regarding the benefits of interaction with animals for autistic children. However, there continue to be limited studies exploring the impact of this interaction on the welfare of therapy dogs. As part of a pilot randomised control trial assessing the efficacy of canine-assisted occupational therapy with autistic children, this project assessed welfare markers of the therapy dog involved. A total of twenty-one saliva samples were taken from the therapy dog to assess cortisol, alpha amylase, and oxytocin concentrations at home and throughout the treatment days. Additionally, six hours of therapy session videos were analysed for stress indicators of canine behaviour. No significant differences were found between days spent at home and treatment days for any of the biomarkers or stress indicators. Results suggest that the therapy dog involved did not experience increased stress resulting from interaction with the autistic children throughout the therapy sessions. This study supports the need for further research regarding therapy dog welfare when interacting with autistic children including an increased sample size of therapy dogs and therapists.

Nature-Based Pediatric Occupational Therapy: A Scoping Review

AIMS

Our purpose was to explore the scope of nature-based interventions used in pediatric occupational therapy and identify gaps in existing literature.

METHODS

This scoping review was guided by Arksey and O'Malley's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. We searched CINAHL, PubMed, PsycINFO, Web of Science, Embase, MEDLine, and gray literature, and we hand-searched included articles' references. We included studies published through June, 2021 that were in English, described a service provided by occupational therapists, with a population with at least 50% of participants ages 0-21 years, with nature as a primary context and treatment modality. Studies were excluded if they only described animal-assisted therapies or human-made structures.

RESULTS

A total of 12 articles (two reporting quasi-experimental studies; 10 gray literature) met inclusion criteria. Articles described a variety of interventions, but there was a lack of rigor in included articles and no clear conceptualization of nature-based pediatric occupational therapy.

CONCLUSIONS

Despite practitioner interest in the topic, there are two primary gaps in the literature: lack of a clear conceptualization of nature-based practices for occupational therapy and lack of articulation of the unique contribution of occupational therapy to nature-based practices.

Understanding the occupational role of dog ownership through the lens of attachment theory: A survey study

Introduction:

Incorporation of animal-assisted services is an emerging field of occupational therapy practice. While the owner–dog relationship is an important component supporting positive outcomes, pets also represent an added responsibility, with pet care a little-understood role for occupational therapists. The present study drew on attachment theory to investigate associations between owner attachment pattern, care of the dog, relationship with and closeness to the dog and perceptions of the dog’s personality.

Method:

Participants ( N = 97) completed an online survey using standardised measures.

Results:

Quality of the relationship with the pet dog was associated with the level of care provided to the dog, with stronger relationships associated with higher levels of care. While owner attachment pattern was not directly linked with the care provided to the dog, it was related to distress at being separated from the dog and perceptions of the dog’s personality.

Conclusion:

The present study supports existing findings that an attachment bond is present between owner and dog, and that this bond is linked with the care provided to the dog. Occupational therapists may facilitate the developing relationships between dog owners and their dogs, as well as supporting care of the dog, to optimise outcomes for both.

Terapia ocupacional assistida por cães: uma revisão de escopo da literatura brasileira

Resumo Terapeutas ocupacionais têm praticado a Terapia Assistida por Animais (TAA) incorporando cães em suas intervenções. A produção de conhecimento nacional sobre a Terapia Ocupacional Assistida por Cães foi analisada por meio de uma revisão de escopo. Esta investigação buscou obter respostas sobre quais populações têm sido focalizadas na Terapia Ocupacional Assistida por Cães no Brasil, quais os objetivos e resultados terapêuticos, de que forma o cão atuou neste processo, qual o treinamento necessário aos cães e qual a formação requerida ao terapeuta ocupacional para realizar tal terapia. A busca ocorreu nos periódicos nacionais de Terapia Ocupacional e na biblioteca Scielo.br por meio de descritores e critérios de inclusão. Não foram encontrados estudos da terapia ocupacional tendo cães como assistentes, mas sim sobre o cuidar de animais como uma ocupação humana e um papel ocupacional (n=4). Um estudo referiu a terapia ocupacional como uma das profissões que, no contexto estrangeiro, realiza a terapia assistida por cães com pessoas com deficiência e/ou sequelas físicas ou mentais, sendo os objetivos e resultados terapêuticos de reabilitação física ou cognitiva. A revisão revela que a produção nacional é incipiente, sobretudo se comparada à literatura estrangeira, que relata sobre a Terapia Ocupacional Assistida por Cães e informa sobre as populações, objetivos e resultados terapêuticos, a formação e competências necessárias ao terapeuta e o treinamento requerido ao cão. Reafirma-se a necessidade de estudos e de produção de conhecimento nacional para o embasamento teórico e diretrizes para a prática da Terapia Ocupacional Assistida por Cães no Brasil.

"The connection just happens": Therapists' perspectives of canine-assisted occupational therapy for children on the autism spectrum

INTRODUCTION

The inclusion of a therapy dog has been suggested as a means of facilitating therapy engagement for children on the autism spectrum within occupational therapy sessions. The aim of this study was to seek an understanding of possible benefits and challenges of this practice from the perspectives of occupational therapists, trained in canine-assisted therapy.

METHOD

This study adopted an interpretive descriptive design. Six therapists participated in a semi-structured, telephone interview to describe their experience of working as canine-assisted occupational therapists with children on the autism spectrum. An inductive thematic analysis was used to analyse the data.

RESULTS

Two overarching themes emerged. The first captured how therapists incorporated their therapy dog into sessions to accelerate children's initial motivation to engage within the therapy process. Specifically, therapists discussed how involving their therapy dog facilitated the development of a secure relationship, supported autonomous task involvement and increased children's sense of confidence. Second, they identified challenges inherent in their practice, such as the therapist's ability to maintain a goal-directed focus when including a therapy dog. Beyond the challenges within their own practice sessions, therapists reflected on issues thought to impact the occupational therapy profession since starting practice as a canine-assisted occupational therapist.

CONCLUSION

Findings from this study contribute to the current understanding of how occupational therapists incorporate therapy dogs into their practice with children on the autism spectrum. The specific challenges noted by the therapists highlighted the importance of canine-assisted occupational therapy being viewed as an advanced scope of practice within Australia and, therefore, the need for training and practice guidelines to be established.