Abstract
Children on the autism spectrum frequently display difficulties engaging with people and with functional tasks. A pilot, randomised control trial was completed to explore the impact of canine assisted occupational therapy on the on-task behaviours and goal attainment of autistic children when compared to occupational therapy sessions as usual. Twenty-two children between the ages of 4, and 6 years and 11 months, were randomly placed in either the treatment group (n-11) or waitlist control group (n = 11). Results showed that although there was a positive trend for on-task behaviour and goal attainment within the treatment group, results were not statistically significant. These results support the need for further research in the area of canine assisted occupational therapy for autistic children.
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Acknowledgments
The authors would like to thank the parents and children whom volunteered their time to participate within this study. JH was the recipient of the Australian Government Research Training Program (RTP) Scholarship.
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JH, JZ, CD and JC-S developed the study design. JH, JZ, CD and JC-S applied for ethical approval. JH completed the data collection. JH, JZ, CD, JMC and ALT completed the data analysis and interpretation. JH drafted the manuscript. JZ, CD and JC-S critically reviewed the manuscript.
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JH declares that she is the owner and provider of the animal-assisted occupational therapy service provided throughout this data collection process. JZ declares that she has no conflict of interest. CD declares that she has no conflict of interest. AT declares that she has no conflict of interest. JC declares that she has no conflict of interest. JC declares that she has no conflict of interest.
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Appendices
Appendix 1. Canine assisted occupational therapy fidelity checklist
Fidelity Within Sessions
No | Fidelity | Full adherence (2) | Partial adherence (1) | No adherence (0) |
|---|---|---|---|---|
1 | A visual schedule is developed with the child and referred to throughout the session | |||
2 | The therapist references the child’s goal/s to the child and/or parent throughout the session | |||
3 | No use of occupational therapy jargon directed to the child | |||
4 | Verbal instructions used are appropriate to the child’s speech and language ability | |||
5 | The participant’s specific goals are addressed within the session | |||
6 | Intervention activities WHOLE tasks directed towards the child’s meaningful goal, NOT repetition of a SINGLE component, for example, writing a Christmas card when working on letter formation, not writing the letter ‘a’ over and over | |||
7 | Evidence of appropriate grading of the task by the therapist (the child has been provided with the ‘just right challenge’ facilitating their engagement) | |||
8 | Motivational strategies (e.g., providing sense of control through the use of choice, use of visuals, drawing upon the child’s interests) are clearly evident throughout the session | |||
9 | Clear, specific verbal feed-back is provided to the child regularly throughout the session (e.g., great holding pencil, you cut along the straight line all by yourself) | |||
10 | The therapist manages the environment appropriately dependent on the individual child’s needs (e.g., removing visual stimulation) | |||
11 | The therapist positions themselves at the child’s eye-level when communicating (not standing over the child) | |||
12 | The therapist responds to any undesired behaviours presented by the child calmly and without any evidence of agitation | |||
13 | The therapist allows for processing time once instructions are provided before offering additional information or assistance (not quickly repeating the same instruction on multiple repetitions) | |||
14 | The therapist responds appropriately to the child’s mood within the session. Therapist is able to bring her arousal level down when the child begins to go fast. Alternatively, the therapist lifts her arousal level if the child’s arousal level is low in order to facilitate engagement | |||
15 | Home practice is provided during the session to assist with generalisation | |||
16 | The child is prompted to choose a sticker at the end of their session. (control group only) | |||
Total | ||||
Fidelity Within Canine Assisted Occupational Therapy
No | Fidelity | Full adherence (2) | Partial adherence (1) | No adherence (0) |
|---|---|---|---|---|
17 | The therapy dog is actively involved in a minimum of one activity within the session (e.g., a pretend play activity in which the therapy dog is an active participant.) | |||
18 | The therapy dog is passively involved throughout the entire session, prompted by referencing from the therapist (e.g., after we finish your colouring, we can show it to Elsa) | |||
19 | All interactions initiated by the therapist with the therapy dog are related to rapport building or the child’s therapy goal, not just because the child wants to interact with the therapy dog (off-task) | |||
20 | The therapist follows through with all interactions with the therapy dog discussed with the child (e.g., we can give Elsa a treat once we have finished our drawing) | |||
21 | The child encouraged to give the therapy dog their ‘reward treat’ at the end of the session | |||
22 | Discussion of home practice involves discussing with the child what they will show the therapy dog within the next session | |||
Total | ||||
Appendix 2. On-task behaviour analysis (with example)
Video no* | Start/end time | Wait time | On-task behaviour | Other |
|---|---|---|---|---|
Video 1 | 00.00 | 00.00—1.06 | ||
01.06—04.35 | ||||
04.35—05.58 | ||||
05.58—06.08 | ||||
06.08 – 15.24 | ||||
15.24 – 15.50 | ||||
17.41 | 15.50 – 17.41 | |||
Video 2 | 00.00 – 17.41 | 00.00 – 17.41 | ||
Video 3 | 00.00 | 00.00 – 01.42 | ||
01.42 – 02.02 | ||||
02.02 – 02.28 | ||||
02.28 – 02.35 | ||||
02.35 – 02.40 | ||||
02.40 – 03.29 | ||||
03.29 – 05.19 | ||||
05.31 – 05.48 | ||||
05.48 – 06.24 | ||||
06.24 – 06.36 | ||||
06.36 – 07.15 | ||||
07.15 – 08.11 | ||||
08.21 – 17.07 | ||||
17.41 | 17.07–17.41 | |||
Video 4 | 00.00 | 00.00 – 03.01 | ||
03.01 – 03.22 | ||||
Total number of videos | Total time | Total time | Total time | Total time |
4 | 56 min 11 secs | 10 min 11 secs | 44 min 25 secs | 1 min 27 secs |
Appendix 3. Coding Manual provided to 2 coders
ON-TASK BEHAVIOURS |
|---|
Non-verbal behaviours directed towards task completion, including: Looking at the task or person talking Task related touching and/or manipulating Task related gestures, e.g., pointing to an activity or tool Task related showing behaviours, e.g., showing parent work Task related direction of facial expression, e.g., smiling at parent to show pleasure in activity Oriented physically towards the task/therapist/parent Verbal behaviours related to the task, including: 1. Task related talk/questions. 2. Verbal behaviours to communicate pleasure in activity, e.g., laughing *Behaviours do not need to be performed together e.g. the child may be not looking at the therapist however, still engaged in discussion and answering questions appropriately |
WAIT TIME |
1. All behaviours in which the child has not been given a specific task related instruction, e.g., when initially entering the session, when waiting whilst the therapist and parent have a discussion. 2. Non-task related discussion initiated by the therapist or parent, e.g., therapist asking the child how their weekend was. |
OTHER |
If the child was not within the room, e.g., initial greeting by therapist within the waiting room, if the child leaves the room to go to the toilet |
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Hill, J., Ziviani, J., Driscoll, C. et al. Canine Assisted Occupational Therapy for Children on the Autism Spectrum: A Pilot Randomised Control Trial. J Autism Dev Disord 50, 4106–4120 (2020). https://doi.org/10.1007/s10803-020-04483-7
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DOI: https://doi.org/10.1007/s10803-020-04483-7