What Effect To Therapy Animals Have On The Social Abilities Of Children With Disabilities
Animals (Basel). 2021 Jun; 11(6): 1741.
Furnishings of Dog-Assisted Teaching on Physical and Chatty Skills in Children with Severe and Multiple Disabilities: A Pilot Study
Luis Lucio Lobato Rincón
1Brute-Assisted Intervention Office, King Juan Carlos University, Móstoles, 28933 Madrid, Spain; se.cjru@otabol.oiculsiul (50.L.L.R.); moc.liamg@modallocinad (D.C.-M.)
2Section of Psychology, King Juan Carlos University, Alcorcón, 28922 Madrid, Spain
Beatriz Rivera Martín
1Animal-Assisted Intervention Office, King Juan Carlos Academy, Móstoles, 28933 Madrid, Spain; se.cjru@otabol.oiculsiul (L.L.L.R.); moc.liamg@modallocinad (D.C.-1000.)
3Section of Advice and Sociology Sciences, King Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain
María Ángeles Medina Sánchez
4Department of Statistics and Information Science, Universidad Complutense, 28040 Madrid, Spain; se.mcu.datse@anidema
Santos Villafaina
fivePhysical Activity and Quality of Life Inquiry Group (AFYCAV), Faculty of Sport Sciences, Academy of Extremadura, 10003 Caceres, Spain
Eugenio Merellano-Navarro
6Grupo de Investigacion EFISAL, Universidad Autónoma de Chile, 3460000 Talca, Chile; moc.liamg@onallereme
Daniel Collado-Mateo
aneAnimal-Assisted Intervention Office, King Juan Carlos University, Móstoles, 28933 Madrid, Kingdom of spain; se.cjru@otabol.oiculsiul (L.Fifty.L.R.); moc.liamg@modallocinad (D.C.-M.)
sevenEye for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain
Polly Yeung, Academic Editor
Received 2021 May 1; Accepted 2021 Jun eight.
Abstract
Elementary Summary
Animate being-assisted interventions take benefits in unlike populations, such equally children with cerebral palsy or autism spectrum disorder. In this regard, homo–beast interaction leads to dissimilar physical, cerebral, and emotional benefits in the child. Therefore, this pilot written report aimed to evaluate the furnishings of a dog-assisted pedagogy programme on the postural, oculomotor, linguistic, and autonomy dimensions in children affected by severe and multiple disabilities. A total of 14 children aged 3–12 years and affected past intellectual and physical disabilities participated in 12 sessions of the dog-assisted plan where participants had to play with dogs. Children who participated in the study improved their postural control, center-motor coordination, expression of sensations and feelings, spontaneous interaction, autonomy, and conviction.
Abstract
Animal-assisted interventions accept shown promising benefits in different populations such every bit children with cerebral palsy or autism spectrum disorder. Homo–animal interaction leads to different physical, cognitive, and emotional benefits in the child. The aim of the current pilot study was to evaluate the effects of a domestic dog-assisted didactics program on the postural, oculomotor, linguistic and autonomy dimensions in children affected past astringent and multiple disabilities. Fourteen children aged 3–12 years and afflicted by intellectual and physical disabilities participated in a dog-assisted plan consisted of 12 sessions. The intervention involved different types of activities, exercises, and games with the dogs. A strict protocol to ensure animal wellbeing and avoid any type of stress or fatigue was followed. Children who participated in the report improved their postural control, middle-motor coordination, expression of sensations and feelings, spontaneous interaction, autonomy, and conviction. However, these results must exist taken with caution due to the lack of a control group and the heterogeneity of the participants.
Keywords: animal-assisted intervention, animal-assisted educational program, dogs, disability
1. Introduction
Animal-Assisted Interventions (AAI) tin exist defined as structured interventions that include animals to achieve a specific goal, such as improving concrete or mental health (Animal-Assisted Therapy or AAT), enhancing cognitive part or social skills (Fauna-Assisted Pedagogy or AAE), or just increasing motivation and with recreational purposes (Animal-Assisted Activities or AAA) [ane]. The scientific basis derives from the benefits of human–animal interaction, which has been previously described and is based on the facilitation of the social interaction and the presence of a source of non-judgment back up [2,3]. This human–animal interaction is circuitous due to the involvement of 2 complex organisms (a homo and an fauna) interacting dynamically and existence a source of big variability [4].
We tin observe many examples about the benefits of AAT in physical and psychological health [5,half dozen] in patients with multiple sclerosis [7], older adults [eight], autism disorder [9,10], children with attention-deficit/hyperactivity disorder [11], cerebral palsy [12], chronic pain [13], dementia [14], or cancer [xv]. Furthermore, AAE have shown benefits on the development of social and communicational skills [ten,xiv], prisoner reintegration [sixteen], reading skills [17], motivation [18], enjoyment [19], empathy [xx], or happiness [21].
Based on the large list of potential benefits, AAI could be a useful strategy to improve overall health while, at the same time, the patient is having an enjoyable fourth dimension. Although the reported educational benefits (empathy or social skills, for instance) are useful for almost everyone, they may be especially appropriate for children. In this regard, AAE may be considered a useful tool for children with developmental disorders and multiple disabilities. In this case, the animal is a source of continuous stimuli that leads to different physical, cerebral, and emotional reactions from the kid, which, consequently, promotes the improvement of useful skills and behaviors. Among others, studies have shown improvements in social behavior, exact communication, ability to follow instructions, and eye contact [22,23,24]. A recent review showed an comeback in social interaction in children with autism spectrum disorder in 22 studies later on an AAI [25], in add-on to an increase in positive emotions with this aforementioned population. Furthermore, another review also pointed out that AAI is useful to enhance gross motor function, social performance, upper limb dexterity, residual, and mental wellness in patients with motor, neurological, or developmental disorders who need neurorehabilitation [26].
In sum, previous research has shown that AAIs for children lead to a list of benefits in different levels, including physical evolution (improvement in gross motor function, residual, or dexterity), enhancement of social and communicative skills, as well as cognitive and emotional development. These benefits may be achieved through an enjoyable and motivating program, which is especially important in children and, concretely, in those kids with severe and multiple disabilities that are usually receiving many treatments from the health service.
Therefore, the nowadays pilot study aimed to evaluate the effects of the AAE program "One dog ane happy child" on the psychomotor, social, and cerebral development (past enhancing the postural, oculomotor, linguistic, and autonomy dimensions) in children afflicted past severe and multiple disabilities. Given the multidimensional benefits of AAI in children and the close connexion between motor dimensions and emotional wellbeing in childhood [27,28], benefits in the motor and affective sphere were expected later the application of the program.
2. Materials and Methods
two.1. Pattern
This is a quantitative observational airplane pilot written report. Information technology included a baseline observation and within-session observations during each of the AAE sessions. Procedures were approved by the bioethical research commission of the hospital (number 19/194).
It is of import to note that the present written report had to be prematurely canceled after 12 sessions due to the Country of Alarm decreed in Kingdom of spain on 15 March 2020 and the health circumstances due to the SARS-CoV-ii pandemic.
2.2. Participants
This pilot written report included a full of xiv children, aged 46 to 150 months, with different physical and intellectual disabilities. They were distributed according to their functional capacities in 3 subgroups of iv or 5 children in order to increase the homogeneity of the groups. Each subgroup attended the AAE sessions twice a month.
Participants were recruited by the Ana Carolina Diez Mahou Foundation. This was a not-profit organization with the aim of improving the quality of life of children with neuromuscular disorders. To participate in the report, the inclusion criteria were: (a) more than than 3 years of age; and (b) functional autonomy (be able to move apart). Exclusion criteria were established as: (a) The existence of astringent medical conditions that makes the intervention unsuitable (such as the utilize of survival devices like ventilators); (b) the existence of allergies that could affect the child'south wellness; and (c) not having the written informed consent signed by their parents.
2.3. Data Drove Techniques and Measurements
Due to children included in the electric current report were repeatedly evaluated and tested by the medical staff, while their parents were usually stressed and affected past the health and the needs of their children, the measures aimed to minimize the touch on on their daily living. Therefore, the selected tool was an Observation Scale used to analyze the children's behavior during the sessions. This scale was designed past the inquiry team with the opinion and collaboration of a pool of experts in the fields of education, psychology, sport sciences, communication, and occupational therapy. The scale was very uncomplicated, and the observers had to value the frequency a beliefs appeared during sessions from 1 (the desired beliefs never occurs) to five (the desired behavior always occurs). It was recorded in each session past a fellow member of the enquiry team without interrupting the normal rhythm of the session. In that location were 2 observers throughout the intervention period: Hello and LJ.
The calibration comprised the following ten items that could be classified in the following sub-scales:
-
Postural control: Level of management of the body'south ability to maintain correct alignment of its trunk axis, facilitating the work of all joints and torso segments, and coordinating the various muscular tensions to balance posture.
-
Oculomotor coordination: Level of coordination of torso movements with vision. This sub-scale is comprised of 3 items: (a) Ane-handed ball grip and throwing, (b) two-handed ball grip and throwing, and (c) reception of an object in different situations.
-
Language and communication: Level of expressive ability ranging from simple vocalizations to the expression of thoughts and feelings through words. In this case, 4 items are measured: expression of sensations, expression of feelings, spontaneous interaction, and verbal advice.
-
Autonomy: Degree of independence and initiative when performing everyday behaviors and trouble-solving. This dimension was comprised of 2 items: autonomy (the child conducts the activities of the session without aid) and conviction (the kid shows conviction in the activities, knowing what they have to exercise and how).
The characteristics of the program conducted in this pilot study were outlined beneath, taking into account some methodological considerations proposed by experts in the AAI field and trying to eliminate the bones weaknesses that sometimes ascend in this type of project [29,xxx,31]. Furthermore, within the broad spectrum of animals used in AAE interventions, our intervention was specifically an feel of Dog Assisted Education.
2.4. Intervention
The intervention was an AAE program conducted by ii AAI experts (one teacher and one psychologist). It was a goal-oriented, planned, and structured intervention focused on the development of psychomotor, social, cognitive, and communicative skills of children with special educational needs.
The AAE program was conducted twice a month for 45 min and took place at the Foundation's facilities and also at the Rey Juan Carlos University Clinic, with each family choosing the setting co-ordinate to the proximity to their habitation.
The therapeutic team was composed of two technical trainers and an AAI expert. The therapeutic staff had been involved in academic training either equally an adept or as a technician (handler) in AAI, and their experience ranged from 3 to 12 years. The entire team was ever present during the session.
The activities were designed trying to avert the extenuation of participants. In plow, xiv sessions were planned, only 12 sessions were carried out for each group, equally they had to be canceled due to the COVID19 pandemic. In whatever instance, such a number of sessions is usually the most common number of sessions in this type of program [25,32].
Each session had a clear construction and timing, although slight adaptations or changes could be included in some sessions. The first role consisted of the greetings between the different members of the group. Then, the side by side role unsaid the feeding with different commands (seated, laid downward, offering the manus, playing with canine cognitive toys) and the grooming. The tertiary role was based on different games and physical activities with the dog. The activities of this part can exist seen in Tabular array 1. The fourth part included a relaxation period where contact with the dog was encouraged, working with the tactile sensations. Finally, the group said adieu to the animals and professionals.
Table 1
Example of activities included in the dog-assisted education plan "One dog, i happy child".
| Activity | Description |
|---|---|
| Walking the dog | The activity consisted of handling a canis familiaris and drive it through a excursion with pikes and hops. |
| Take hold of the ball | The activity implies the launch of balls with dissimilar textures and colors in order to follow the instructions in each trial. |
| Color's isle | The kid must guide the domestic dog to the cone colored with the aforementioned color that the bill of fare extracted past him/her. It is convenient to encourage the group to help the kid during the chore. |
| Game of tissues | This activity consisted of using two colored tissues (green and carmine) and, depending on the textile raised by the technician, move along with the dog through the classroom (green) or freeze and stay tranquillity (reddish). Attending and social functions are activated with this task. |
| Game of emotions | The emotions expressed by dogs must be recognized by the children using stuck cards with dissimilar faces. |
All sessions were designed to fulfill grouping and private objectives, including group cohesion and interactions betwixt members, also as to specific and private needs, which were consequences of their physical and/or intellectual disabilities.
2.v. Brute Wellbeing
The back up dogs were of mixed breed. Both dogs were female, and their diverse basal action rate was taken into account in order to participate in the activities [33]. These dogs followed strict zoonosis protocols, including behavioral, claret, urine, and feces analyses. Deworming, rabies, and tetravalent vaccinations were also required. Fauna welfare was also ensured by the Animal Assisted Intervention Office of the Academy. A strict ethical protocol included some points to warrant animal welfare. First, the handler must live with the domestic dog in the aforementioned house and, as pet and owner, they must accept a strong common bond to ensure that the handler adequately identifies and interprets the emotions of the dogs during the intervention and avoid whatsoever kind of stress or fatigue. In this regard, all activities could be interrupted if the handler notes that the domestic dog was not comfortable. Second, the selection of the dog and handler was based on the temperament, adaptability, motivation, and willingness to engage in the sessions. 3rd, the temperature of the facilities was always controlled to avoid very hot or very cold environments. Fourth, the dog was limited to iv sessions/week with at least 20 min between-session rest in case at that place were 2 sessions on the same day. Furthermore, domestic dog-training sessions must not exceed 4/twenty-four hours and must last less than 10 min each i. The dog must be fed earlier training in order to avert hunger and must always have access to freshwater. Each session starts with a at-home welcoming and ends with a calm goodbye. All this process was supervised past the caput and academics of the Brute-Assisted Intervention Role of the University.
two.vi. Statistical Analysis
Statistical analyses were performed using SPSS statistical software (IBM). Ways and SD for each variable in each session were computed to depict the changes forth the intervention. Linear mixed model analyses were conducted to analyze the influence of time and postural control on the rest of the indicators related to heart-motor coordination, language and communication, and sociability and autonomy.
Mixed models allowed us to estimate stock-still effects and random effects. In our study, each individual was measured for the aforementioned indicators over 12 sessions. This was modeled by introducing a random constant in the mixed models analyzed. In this sense, linearity was causeless because it was understood that the effect of moving from session i to session 2 was the same as the effect of moving from session ii to session 3. In turn, it was understood to be mixed because the observations of the variables were not independent just replicated of xiv individuals. The significance level chosen was as 0.05.
three. Results
Main characteristics of each participant are summarized in Tabular array 2. A total of 10 boys and four girls were included in the study. All of them had in common the diagnosis of a disorder that caused concrete and intellectual disability. The mean age was 88 months, and the SD was 35 months.
Table two
Main descriptive characteristics of the participants.
| Participant | Sex | Age (Months) | Condition |
|---|---|---|---|
| ane | K | 55 | Transposition of the great vessels. |
| 2 | Yard | 120 | Mowat-Wilson syndrome |
| iii | Thou | 91 | Kabuki syndrome |
| 4 | F | 150 | FoxG1 syndrome |
| five | Thousand | 137 | Peripheral neuropathy |
| 6 | M | 54 | Stroke |
| 7 | One thousand | 75 | Cerebral Palsy |
| viii | M | 67 | Kallman syndrome |
| nine | F | 78 | Cerebral Palsy |
| 10 | F | 46 | Cerebellar hypoplasia |
| xi | M | 120 | Angelman syndrome |
| 12 | Grand | 122 | Congenital disorders of glycosylation |
| 13 | F | 61 | Propionic acidemia |
| fourteen | Thousand | 56 | Physical and intellectual disabilities but diagnosis not provided by his parents |
Figure 1 shows the mean and SD of each postural control (1A) and centre-motor variables (2A–C) in each session. Mixed model results showed significant improvements in all these four variables (p < 0.01).
Fortnightly means and SD for postural control (1A) and the iii eye-motor variables: communicable and throwing a ball with two hands (2A), communicable and throwing the ball with one single hand (2B), and reception of different objects (2C). Significant improvements were observed in all variables (p < 0.01).
Figure ii shows the hateful and SD of the items from the dimension "Language and communication." These variables were the expression of sensations, expression of feelings, spontaneous interaction, and spoken interaction. Results showed a statistically pregnant comeback (p < 0.01) in all variables simply spoken interaction (p = 0.511).
Fortnightly means and SD for the variable "Language and advice," including expression of sensations, expression of feelings, spontaneous interaction, and spoken interaction. Significant enhancements were observed in all variables but spoken interaction.
The last 2 variables were autonomy and confidence. Results for these two variables are reported in Figure 3. Mixed model results showed a significant improvement for the two variables (p < 0.01).
Fortnightly means and SD for the "autonomy" and "confidence" variables. Meaning enhancements were observed in the ii variables (p < 0.01).
4. Give-and-take
This pilot study aimed to evaluate the furnishings of a domestic dog-assisted education program on the motor and communicative skills, as well as on the autonomy and confidence of children affected by different disorders that caused intellectual and concrete disability. The findings of this pilot study indicated that, later on the 12-session programme, children who participated in the program improved their postural command, centre-motor coordination, expression of sensations and feelings, spontaneous interaction, autonomy, and confidence. These improvements could be extremely relevant for their development and daily living.
Although the current study is focused on the benefits in the children, it must exist considered that every intervention involves a two-way relationship betwixt the dog/s and the homo/s. One relevant attribute of AAI is ensuring animal wellbeing. Previous studies reported that dogs could experience stress during AAI sessions [34,35], negatively impacting different aspects such as their immunological responses or leading to behavioral changes [36]. In this regard, dogs working in AAI should have the right of admission to solid wellness, welfare, and wellbeing practices [37]. Our study is in line with the moral imperative of valuing dogs as sentient beings and, therefore, a strict ethical protocol was followed during all the process, from the selection and training of the dog to the interaction with the patients in the sessions. This protocol was controlled by the caput and academics of the Animal-Assisted Intervention Office of the University. This protocol is not limited to the physical health of the animal through vaccines or blood, urine, and carrion analyses, but also includes some points to ensure brute welfare, as can be read in the methods department. Previous studies have shown that dogs in well-planned and carefully designed AAT may exist even positively affected when comparing their state before and later on the session [38,39]. This was a priority in the current report, but animate being welfare was only controlled through the observation of the handler and the Office staff just not systematically checked using objective, validated tools. Thus, future studies may include tools to objectively ensure creature wellbeing.
One of the main benefits of domestic dog-assisted interventions is the comeback in social skills and communication, which is extremely useful in individuals with reduced social abilities, such as those with autism spectrum disorders [ten]. The results of the current report are in line with those obtained past Becker, Rogers, and Burrows [32], who observed that, after 12 weeks of domestic dog-assisted intervention, children aged eight-14 improved their social skills but not language evolution, which was the simply unmarried measure that was not meaning in our study.
Although there were mixed results, AAI take shown improvements in the gross motor function, coordination, functional skills, or social interaction of children with cerebral palsy [26,40], which were in line with the results of the electric current study. Yet, it must be noted that AAT in this population usually involves horses instead of dogs [26,40]. One example of canis familiaris-assisted intervention in cerebral palsy was the report conducted by Elmacı and Cevizci [xx]. They found that children with cerebral palsy learned to cope with their anxieties and fears, improving their abilities to use their bodies, their empathy, and their advice skills. Although there were some points in mutual, there were important differences betwixt interventions with dogs and horses. First, hippotherapy involves the manual of motion from the horse to the rider, while in dog-assisted interventions, the movement is facilitated by the canis familiaris but generated by the participant. Thus, the interaction with the horse is different, and the cause of the benefits may also be different compared to the interaction and the benefits from the dog-assisted interventions. One of the principal advantages of domestic dog-assisted interventions is the potential to be conducted in small, indoor or outdoor, urban or rural places, which enables the utilization in hospitals, nursing homes, prisons, etc.
The electric current pilot report supports the inclusion of AAI, and specifically dog-assisted programs, in the health arrangement. A contempo report showed that the possibility to include AAT in hospital may exist accepted by hospital staff since they are enlightened of the benefits of these programs in children with disabilities such as cerebral palsy, autism spectrum disorder, or acquired brain injury [41]. The growing scientific literature on this field has shown that animals may positively influence human emotion and cognition [2]. Specifically, dogs take been identified as extremely helpful to elicit pro-social beliefs and meliorate the communicative skills of children with disabilities, which is commonly a major trouble [42,43,44].
Several limitations must be considered to adequately translate the results of the current written report. The starting time limitation is the lack of a control group, which prevents us from performing statistical analyses to observe between-group furnishings. The 2nd limitation was the premature terminate of the programme due to the COVID-19 pandemic, which meant the last two sessions were not conducted. The 3rd limitation is the lack of standardized tests to evaluate the changes in the outcome measures equally pre-post measures. This was decided by the researchers along with the families and the staff of the foundation in gild to minimize the evaluations in children who are frequently undergoing medical tests. Future enquiry must confirm the results reported in the current pilot study using standardized measures. The last fourth limitation was the low sample size and the heterogeneity in the diagnosis and characteristics of participants. Although all 14 participants were children affected by concrete and intellectual disabilities, there were relevant differences in functionality and development. Furthermore, the lack of a systematic tool to evaluate the effect of the therapy in the dog may as well exist considered every bit another limitation. Despite all these limitations, the current pilot study provides evidence of the benefits of a canis familiaris-assisted intervention in a sample comprised of children with unlike types of concrete and intellectual disabilities.
5. Conclusions
A total of 12 sessions of dog-assisted instruction led to improvements in postural control, eye-motor coordination, communication, autonomy, and confidence in children with different types of physical and intellectual disabilities. The findings of this study protocol support the inclusion of AAI in the health system but must be interpreted with circumspection due to the lack of a command grouping, the sample size, and the heterogeneity of the sample.
Acknowledgments
The inquiry team would like to thank State of israel González García, the head of the Animal Assisted Intervention Office at the King Juan Carlos University; Javier Pérez-Mínguez Caneda, head of Fundación Ana Carolina Diez Mahou, and Legado Maria de Villota for all the support provided. In addition, nosotros are very thankful to all the AAE experts and technicians who have participated in this project, specifically Henar Íñigo Serna, Demián Philp Torallas, Kim Ellis Naveira, and Luz Jaramillo González because of their commitment and dedication they have shown during their daily work.
Writer Contributions
Conceptualization, L.L.L.R., B.R.One thousand., and Southward.5.; data curation, L.L.L.R. and B.R.M.; formal analysis, 50.50.L.R., B.R.K., M.Á.M.S., and D.C.-M.; funding conquering, Due east.One thousand.-North.; investigation, 50.L.L.R., B.R.Grand., and M.Á.Yard.Due south.; methodology, B.R.Thousand., K.Á.M.S., and D.C.-M.; project administration, L.L.L.R. and Eastward.M.-N.; resources, Fifty.L.L.R. and East.M.-N.; validation, B.R.M., S.V., and D.C.-M.; visualization, B.R.M.; writing—original typhoon, L.L.L.R., B.R.1000., and S.V.; writing—review and editing, M.Á.M.South., Southward.5., Eastward.M.-N., and D.C.-M. All authors take read and agreed to the published version of the manuscript.
Funding
The current study was funded by the King Juan Carlos Academy through the Animal Assisted Intervention Role. The funders had no role in study design, data drove, and analysis, decision to publish, or grooming of the manuscript.
Institutional Review Board Argument
The study was conducted according to the guidelines of the Announcement of Helsinki and approved past the Institutional Review Board (or Ethics Committee) of Infirmary Universitario 12 de Octubre (protocol code: 19/194 and date: 09-04-2019).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
Data would exist available upon reasonable request to respective author.
Conflicts of Interest
The authors declare no conflict of interest.
Footnotes
Publisher's Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230480/
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