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New Directions in Canine Assisted Therapy: Spreading the Wealth

 

As the field of Animal Assisted Therapy (AAT) for children emerges, so does the importance of providing appropriate therapy for all children diagnosed with an autism spectrum disorder. No longer is it ok to simply focus on “curing” autism and ignoring the child as he or she grows; we have discovered we need to work with this child through to adulthood. This is paramount for our children’s best outcomes, but it is also a civil rights issue. All children born to us in our shared society deserve to be responded to appropriately, especially vulnerable children on the autism spectrum, who currently may take many wasted years to identify and treat appropriately, (if indeed this ever occurs at all).

Autism assistance dogs can be a fun and effective part of a child’s early intervention program, but the sad fact is that there are not enough well bred, well socialized and well trained autism assistance dogs for children who face social/emotional challenges such as autism to meet the growing demand. This is a service rich field, requiring weekly appointments for training as well as learning of skills not just for handling their dog, but also for using the dog correctly to achieve the specific therapeutic goals the parents and professionals surrounding the child envision for the assistance dog team. The higher the quality of service, the more expensive it all becomes. This is a hard and sharp fact of this field: North Star is currently struggling but surviving by way of deep volunteerism and small donation power, which I can testify is quite potent as a source of twin support (it has kept North Star going through cash crunches caused by the lingering recession, as small, cutting edge nonprofits are the canaries in the coalmine of our economy.)

For parents of lower income, or those simply resistance to spending their green stuff (or, like myself, alternately in both camps), using rescues or haphazardly bred and raised dogs for work with children without proper and educated guidance can be a tempting but dangerous idea. A child’s disappointment with a placement gone south, perhaps with a bite to tender skin as a parting gift, can easily set a child back on a road we so lovingly paved with good intentions.

Warm feelings are just not enough here for those who choose to view this work on the meta level, where we can see the swelling number of children suffering from social/emotional challenges around the globe. Large numbers like this require big picture thought, and casting a wide but safe net under our most vulnerable children universally will require affordable therapy on a large scale. By breeding assistance pups specifically for soundness, as well as temperament, with intelligent socialization delivered carefully from birth onward for any pup slated to work with a child who faces a challenge, we can avoid expensive inefficiency and delays for children’s early intervention programs as well as painful injuries to the children we hope to serve. This is not a field to cut corners, even and especially when we need to…

Increasing children's availability to Animal Assisted Therapy (AAT) is one way we can reach more children via these evidenced based therapeutic techniques; at North Star we are providing an increasing number of Facility Dogs to schools or other institutions where children spend their time to help them meet their social or emotional needs while also helping to pull together a community within the institution. Therapeutic work can be ready to happen in any space we create for the child and pup to be together, whether a therapist is in attendance or not. Children take what they need when they are in the presence of a well socialized pup, especially when the pup is talented in communicating with the child; understanding this at home helps a parent to enjoy being able to sit and finish their coffee with the social interactions in the room a spectator sport. I have great faith in the charm of the pups I place to know there will be “social capital” galore granted to them in public, as well as naturally occurring benefits from pup to the child on the home front, enough so to keep this work lighthearted and fun.

A decade ago in doing North Star’s work, I thought it was enough that the trainer I selected to work with the family and their North Star dog knew his or her way around the dog in question, but more recently I have come to understand that these trainers that work with “boots on the ground” with the family and the pup in the child’s personal space, and will be taking both a teaching as well as potentially therapeutic role if the trainer is an empathetic sort. Service dog trainers for autism assistance dog placements need to be skilled in working with families and children who face challenges; I have found that most positive trainers I have worked with around the world understand this distinction. We also make an effort to work with our children’s existing professionals to tap into these valuable resources is another example of how this field runs on volunteerism, as these professionals, as with many quality puppy raisers, tend to generously volunteer their time to the child and pup.

Communication during animal assisted therapy with a child with autism should be received with an open mind; this is the time to be quiet and observe your child and the pup and how they interact more than act as a director of the action: watch the pup make polite or impolite overtures to the child, and only correct the impolite ones (while encouraging the child to communicate this appropriately as well.)  Pups should be corrected with a sharp word or hand signal with good timing, with a quick turn around of positive messages about the pup’s kind efforts to relate or obey the next simple command you give. For the child, you can describe what you see and what you wish would happen in the form of a social story book with a plain old photo album serving as the structure; by tapping into the child’s imagination we can work with visual talents that frequently come with autism.

This is gene-environment interaction at its finest, for it incorporates conscious participation of us as environment shapers of a genetic propensity. We can do this forever if we want to: create space for children with autism to be safe with their families, their growing circle of friends, and their canine companions. Creating appropriate environments rich in the possibilities of educating a child socially, emotionally, and educationally wherever this service dog team goes eventually becomes a way of life.

And I can’t let this moment go by without making reference to the arts and how invaluable they are to a child with a communication or social/emotional challenge to help with their emotional expression in nontraditional ways. Music therapy, art therapy, play therapy, and animal assisted therapy are all interesting ways to help the child express emotions and share feelings with others.

They also make life fun, and for kids and pups, that’s where it’s at; but there are times a therapy pup exists to remind a child that life can be, and should continue to be, fun. There are twin boys in Kentucky who come to my mind, four year old boys with one brother, Garrett, very ill as well as on the autism and requiring frequent hospitalizations and the other boy suffering with his brother in the form of intense anxiety. Garrett required an autism assistance dog to work with him, as the public access feature was needed to have North Star Harry accompany him to his many trips to the hospital, which was a place that Garrett was very afraid of; here is a picture of Harry and Garrett during a pre operative visit last week:

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Garrett's twin, Connor, has emotional needs for a therapy dog, but no need for the public access his brother's dog enjoys. This is important to note, as Hope, Connor's North Star dog, also a labradoodle, will require far less training, but still need every bit as much by way of good breeding/socialization as Garrett's dog Harry. (Both Harry and Hope are labradoodles from a high quality lines who have been carefully socialized to date.)   

Here is a clip that features Hope still in training with me at North Star, along with four of North Star Molly's golden pups:

https://www.youtube.com/watch?v=IWY6OU2pdDQ

Assistance dogs with full public access are quite expensive to breed, raise and train just one lucky child at a time, and this is why North Star therapy or facility dogs working in schools or institutions are one way to help children by virtue of animal assisted therapy (AAT) in a scientifically valid way in a way that spreads the therapeutic wealth. Time spent with a kind hearted dog and an empathetic hander is valued by most children, wherever they may fall on the autism spectrum.

In Pennsylvania a first grade teacher Mrs. Skaskli raised a new North Star pup in her classroom this year, a handsome golden named Buddy; I visited them recently to interview her and the school psychologist, to learn what effect Buddy had on the school and its members, both student and staff. They both told me of the many students and teachers/therapists who would stop by to say hello or take Buddy for walks; the school psychologist said Buddy was often used as a motivator and reward for many children in the school by their teachers in simple, relaxed, and inexpensive but still therapeutic ways. The pup also helped to pull children with special needs deeper into the social community of the school.

Therapy dogs can also do valuable work on the home front, as we can structure this time in ways that have therapeutic goals and evidence based research behind to back it up. Admittedly this research is still thin, but a growing body of studies, including my own, are supporting the concept of autism assistance dog as valuable therapeutic and educational tool for a child on the spectrum at home as well as in school. 

This year I am completing my MA in Educational Psychology at UConn, and in one of my classes I designed a project.to help a North Star boy named Conner, who is a six years old and on the high functioning end of the autism spectrum, with the help of North Star pup, Bruschi,.Buddy's brother. We had been working with this North Star family for many months to prepare them for Bruschi’s arrival to work with Connor and during this time had several conversations about possible goals that they had for Connor had which Bruschi might help him to develop. 

Conner's parents told me that he had developed resistance to completing the homework hour they have been trying to establish for him since he began first grade. They wanted Conner to develop fresh enthusiasm for a new and improved homework hour concept based on positive rewards, which they hoped to establish into a well-accepted routine in a household where academics are considered important.

Conner is a very bright boy, but motivating him to learn and pay attention on someone else’s schedule with subject matter seen as irrelevant to him was difficult; he and his parents tended to lock horns over this stalemate, and this year both Keri and Matt decided to take a different approach and motivate him with an autism assistance dog. This canine partnership was not created solely to meet this particular function for Connor, but Bruschi is a versatile tool in the hands of his creative parents and therapists and this was just one function he provided.

When speaking to the children’s mother, Keri, I asked her to specifically describe Connor’s behavior that was most annoying to her during this homework hour, and she cited the distracting questions Conner was prone to ask to get out of having to do his homework, with his rising anxiety level and her shrinking patience becoming more of an issue with every irrelevant question left unanswered.

Matt, Conner’s dad, noted that Conner’s questions seemed designed by him to reduce his anxiety and/or get him out of the uncomfortable task at hand. We decided to have the criteria of behavior we’d target to change to be the number of Conner’s irrelevant (to the assignment at hand) questions in the course of his homework hour, with the data of “irrelevant question asking” collected a week before Bruschi’s arrival, as well as for four weeks afterward to look for any potential uptick in irrelevant questions.

Together, Keri, Matt and I designed a new and improved homework hour schedule, which would look like this: Bruschi would be crated next to Conner as he worked on the first part of his homework assignments and his written work needed to be completed before his reading homework. Conner was told by his parents as well as ABA therapists that if he completed his homework, he could curl up to read out loud with Bruschi on the bean bag chair, an activity he greatly enjoyed, to complete his homework hour. Conner would be able to shift gears and “retire” to the bean bag chair with a book and Bruschi once his other assignments were completed for the duration of his homework hour (with help available upon request by one of his parents on the assignment, but no other questions responded to other than that directly related to the assignment in order to avoid inadvertent reinforcement.)

Here is the data we took for a week prior to Bruschi’s arrival to determine a baseline behavior of Conner’s irrelevant questions during homework hour as well as the week following Bruschi’s arrival and addition to his homework hour :

 

Bruschi was quite effective as a motivator for Connor to complete these assignments quickly, as well as the reward for doing so when he did. I believe that Connor's anxiety was behind his irrelevant question asking, and that Bruschi's presence decreased this (and likely his cortisol levels, this according to research from Canada which showed children's cortisol levels decreased when their assistance dogs came to live with them. 

Time spend reading to Bruschi on the bean bag chair was fortunately something Connor found highly rewarding, and this intrinsic interest on Connor’s part should be noted as this study’s source of power as motivator as well as reward. It is also interesting to note that Bruschi’s entire training during this exercise was a simple down/stay, at first within his crate and then on the beanbag chair with Connor, but to have Bruschi do this reliably and quietly on command was key to this study’s success as well as the way he did it, which was with a very gentle energy and soft approach.

During the written portion of Connor’s homework, Bruschi was crated in Connor’s line of sight, which I believe was a way to keep the power of his motivation front and center. In the future Bruschi can be used as motivator for other goals corresponding to occupational therapy (improving gross and fine motor skills, which can be easily worked into any therapeutic plan) as well as to help to fulfill the important task of getting Connor’s social and emotional needs met. For now, Conner is greatly enjoying time spent cuddling up with Bruschi on the bean bag chair and reading to him, but if in the future this activity loses its motivating power, we can always tweak the activity to better align with Conner’s growing and changing social and emotional needs.

I have requested that Keri and Matt continue to take this data for several more weeks and then take data sporadically into the future so that we can know if Bruschi’s presence as reward for quiet focused attention on his assignments loses his effectiveness, and if so, how we might best tweak this homework hour back to higher levels to maintain the peace as well as pave the way for future success for Conner, despite or perhaps even because of his autism.

Next month will be my last column in this series of ten on new directions in this emerging field of canine assisted therapy.   

  1. Autism
  2. Service animals
  3. therapeutic effects
  4. Therapeutic intervention

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