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Juni drops by the office for a visit.

This time of year in the wintry Northeast, many of us dream of kindling a fire and curling up with our loved ones (or sometimes just a really good book). And those loved ones absolutely include our furry friends. I grew up with a dog and now have a cat so I can testify to the positive mood power of living with pets. Recently, one of my associates at the Whole Child Center, Dr. Heather Jeney, brought her new puppy in to meet us. The mood of our staff improved dramatically for the hour Juni (short for Juniper) hung out with us. I started to wonder: So much published data supports the healing power of human-human relationships—but what about the value of pet therapy?

After an exhaustive PubMed search, I found several relevant publications.

1. Animal-assisted therapy with farm animals for persons with psychiatric disorders. (Berget B, Braastad BO: Ann Ist Super Sanita. 2011;47(4):384-390)

Norwegian researchers found that animal-assisted therapy with farm animals reduced depression and anxiety symptoms for people with diagnosed psychiatric disorders. Granted, farm animals are not your garden-variety pets but this study suggests that interaction with animals on a regular basis can be therapeutic even for those humans with significant clinical mood disorders. No access to farm animals?  Some therapists in our area keep their dogs in the office with them and report that patients are soothed by their presence.

2.The effectiveness of simulated developmental horse-riding program in children with autism.

(Wuang YP, et al: Adapt Phys Activ Q. 2010 Apr;27(2):113-26)

Horse-assisted therapy, commonly known as hippotherapy (from the Greek hippos), has become increasingly popular for children with neurodevelopmental disorders like autism and cerebral palsy. How would working with horses help these children? 

According the American Hippotherapy Association:

“Hippotherapy is a physical, occupational, and speech-language therapy treatment strategy that utilizes equine movement as part of an integrated intervention program to achieve functional outcomes.  Equine movement provides multidimensional movement, which is variable, rhythmic and repetitive. The horse provides a dynamic base of support, making it an excellent tool for increasing trunk strength and control, balance, building overall postural strength and endurance, addressing weight bearing, and. motor planning. Equine movement offers well-modulated sensory input to vestibular, proprioceptive, tactile and visual channels. During gait transitions, the patient must perform subtle adjustments in the trunk to maintain a stable position. When a patient is sitting forward astride the horse, the horse’s walking gait imparts movement responses remarkably similar to normal human gait. The effects of equine movement on postural control, sensory systems, and motor planning can be used to facilitate coordination and timing, grading of responses, respiratory control, sensory integration skills and attentional skills. Equine movement can be used to facilitate the neurophysiologic systems that support all of our functional daily living skills.”

The Taiwanese study cited above described the effects of a 20-week hippotherapy program on the motor proficiency and sensory integrative functions in 60 children with autism (ages 6 to 8 years). After the 20-week program, children showed significantly improved motor and sensory functions, and this therapeutic effect was sustained for a subsequent 6-month period.

Families with autistic children in my practice at times will supplement therapy programs with hippotherapy, finding that it enhances developmental gains.

3. Can dogs prime autistic children for therapy? Evidence from a single case study.

(Silva K, et al: J Altern Complement Med. 2011 Jul;17(7):655-9)

Though only a single-case study, this fascinating report from Portugal highlights the profound healing role dogs can provide for children with special needs.  The study is described as follows:

“A 12-year-old boy diagnosed with ASD was exposed, at his usual treatment location (the Portuguese Association for Developmental Disorders and Autism at Vila Nova de Gaia, Portugal), to the following treatment conditions: (1) one-to-one structured activities with a therapist assisted by a certified therapy dog, and (2) one-to-one structured activities with the same therapist alone (as a control). To accurately assess differences in the behavior of the participant between these treatment conditions, the therapist followed a strict research protocol. The behavior of the participant was continuously video-recorded during both treatment conditions for further analysis and comparison. Treatment outcomes: In the presence of the dog, the participant exhibited more frequent and longer durations of positive behaviors (such as smiling and positive physical contacting) as well as less frequent and shorter durations of negative behaviors (such as aggressive manifestations).”

I have witnessed this effect in some of my patients as well. Children with tremendous social, behavioral and communication challenges have made great strides with the addition of a therapy dog in their home environment. I often wondered if they were allowed to bring the dog with them to school, how much more could they achieve?  I understand classmates may be allergic or have fears of animals. Perhaps, though, environments could be structured to accommodate these different needs.

3. Canine visitation (pet) therapy: pilot data on decreases in child pain perception. (Sobo EJ, Eng B, Kassity-Krich N: J Holist Nurs. 2006 Mar;24(1):51-7)

This article describes a pilot pet therapy program in the Children’s Hospital in San Diego. Twenty-five children, ages 5 to 18, who underwent surgery, reported less pain post-operatively after canine visitation therapy. While only a pilot study, the data are encouraging and indicate that pet therapy may play a valuable role in relieving distress in hospitalized children.

Dogs in hospitals? At first, the idea seems preposterous. What about infection control concerns? Turns out it’s not really a big deal. Many hospitals have now successfully integrated animal-assisted therapy (usually dogs) into their programming. I’ll never forget the first time I went to check on a child on the oncology unit at our local Children’s Hospital and found not one but two animals in the bed—my patient and her very eager and friendly canine friend. It was the happiest I had ever seen her.

For more information on pet therapy, check out Therapy Dogs International, a “volunteer organization dedicated to regulating, testing and registration of therapy dogs and their volunteer handlers for the purpose of visiting nursing homes, hospitals, other institutions and wherever else therapy dogs are needed.” Founded in 1976 in New Jersey, the non-profit TDI has developed a careful screening and training process, including a canine “temperament evaluation,” and currently has over 24,000 dog/handler teams registered in their service. Another well-respected pet therapy organization is the Delta Society, an international, non-profit, human service organization charged with “advancing human health and well-being through positive interactions with animals.” The Delta Society, founded in Oregon in 1977, focuses on the triangular relationship between pet owners, pets and caregivers. Their website provides links to a wealth of information on the positive effects of animals on human health.

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