Animal-Assisted Therapy &

Occupational Therapy Interventions

Lindsay Spitznogle Morris, OTS

Introduction
Animal-assisted therapy (AAT) can be described as
the use of animals in goal-directed interventions
Offers a number of positive physiological and
emotional benefits
Cognition, physical conditioning, stress reduction,
improved morale

Research Question:
If utilized during occupational therapy interventions,
what impact does animal-assisted therapy (AAT)
have on therapy outcomes?

Significance to Occupational Therapy

AAT has been thoroughly studied, although not in the realm of
occupational therapy
If introduced thoughtfully, AAT as a modality may facilitate
communication and engagement in meaningful occupations
The investigation of the impact of AAT on occupational therapy
outcomes could offer alternative and effective modalities for
therapists to consider
AAT is an adjunctive therapy that can successfully work in
conjunction with OT to achieve client goals (Howell-Forbes, E. &
Marxen, K., 2014)

Research Process
Databases used: Google Scholar, MEDLINE (EBSCO), OT Search
Search terms used:
occupational therapy AND animal assisted therapy
occupational therapy AND animal assisted therapy AND interventions
occupational therapy interventions AND animal assisted therapy

Inclusion criteria:
Peer-reviewed articles from 2000-present; articles surrounding AAT

Exclusion criteria:
Non peer-reviewed articles; articles older than 2000; therapies not relating to
AAT

Evidence
Nine articles were reviewed for this
scholarly agenda
Themes of articles included:
therapists perceptions of AAT,
benefits of the human-animal bond,
pet ownership as a meaningful
occupation
Searches returned results focused on
populations including autism, cerebral
palsy, dementia, individuals with
mobility challenges

4 qualitative studies
3 literature reviews

3 quantitative studies
1 pilot study with quasi-experimental
design
1 RCT
1 single subject with alternating treatments
design (with control)

1 mixed-methods study
Single subject

1 systematic review

Evidence
The following three articles were selected as the best evidence:
Filan, S. L. & Llewellyn-Jones, R. H. (2006). Animal-assisted therapy for dementia: A review
of the literature. International Psychogeriatrics, 18(4), 597-611.
Literature review of controlled trials

Howell-Forbes, E. & Marxen, K. (2014). Animal-assisted therapy: A dogs influence on

occupational therapy outcomes of a child with cerebral palsy. Unpublished masters
thesis, University of Puget Sound, Tacoma, Washington.
Pilot study; mixed-methods, single subject design

Sams, M. J., Fortney, E. V., & Willenbring, S. (2006). Occupational therapy incorporating
animals for children with autism: A pilot investigation. American Occupational Therapy
Association, 60, 268274.
Quasi-experimental design (no control)

Article #1: Animal-assisted therapy for dementia: A review of

the literature
Study objectives
Filan, S. L. & Llewellyn-Jones, R. H. (2006) conducted a literature review to
investigate whether AAT provides a measureable beneficial effect for individuals
with dementia

Methods
A review of controlled trials found through the following databases:
Medline, PsychInfo, and CINAHL

Keywords used were a combination of animal-assisted therapy or pet and

dementia
References from Barker et al. (2003) were used to identify additional relevant
works published

Article #1: Animal-assisted therapy for dementia: A review of the

literature
Outcomes
Several studies have evaluated the impact of AAT on the dementia
population
Following interaction with a dog, residents exhibited significantly less agitated
behaviors
Not related to the severity of dementia

More social behaviors in the presence of a dog

Heart rate was significantly reduced immediately following AAT sessions
Nutrition has been shown to improve following AAT

AAT is a beneficial psychosocial intervention for individuals with

dementia

Article #2: A dogs influence on a child with cerebral palsy

Study Objectives
Howell-Forbes, E. & Marxen, K. (2014) conducted a pilot study to compare
outcomes of traditional OT and OT which also utilized AAT, in consideration of
selected treatment goals for a 3-year-old child with cerebral palsy

Methods
A mixed methods research design with a single subject methodology was utilized
Two phases of treatment were studied:

Baseline treatment phase of traditional OT, with the child participant acted as her own control
Intervention treatment phase of OT enhanced with AAT

Following treatment, semi-structured interviews with the OT and the childs mother
were conducted

Article #2: A dogs influence on a child with cerebral palsy

Outcomes
Semi-structured interviews with the OT and childs mother provided
information regarding the subjective experiences of AAT during OT
treatment sessions
Four major themes emerged
1. Increased enjoyment and participation in therapy activities when the dog was
present
2. Greater improvement of skills when dog was present
3. Incorporating AAT into OT was challenging for the therapist
4. AAT would be improved by planning and coordination between the OT and
the dog handler

Article #2: A dogs influence on a child with cerebral palsy

Outcomes, cont.
With the dog present, the child demonstrated significant increases in
vocalizations during treatment sessions
Incorporation of the therapy dog appeared to result in increased
motivation, confidence to engage in activities, and increased
performance of skills outside of therapy
Challenges in incorporating AAT
The presence of the dog can distract the child from interacting fully with the
therapist
The OT must be comfortable in directing the handler and the dog to achieve
optimal positioning and activities to facilitate the best therapeutic interactions

Article #3: Occupational therapy incorporating animals for

children with autism: A pilot investigation
Study Objectives
Sams, M. J., Fortney, E.V., & Willenbring, S. (2006) conducted a pilot
study to investigate language use and social interaction in children
with autism, who received two forms of OT:
OT utilizing standard techniques
OT incorporating animals

The study aimed to begin testing the effectiveness of OT for children

with autism that incorporates animals

Article #3: Occupational therapy incorporating animals for

children with autism: A pilot investigation
Methods
Participants included 22 children (ages 7-13) with autism who were receiving
school-based OT services
Per week, on average, each child received one session of traditional OT and one
session of OT with animals
Therapeutic activities in both sessions were focused on sensory integration,
language use, and sensory and motor skills
During sessions, the participants were observed by trained research assistants and
instances of language use and social interaction were recorded on a behavioral
rating form

Article #3: Occupational therapy incorporating animals for

children with autism: A pilot investigation
Outcomes
Average number of behaviors per minute were compared between
standard OT sessions and OT sessions with animals
Significantly more use of language and greater social interactions occurred in
the OT sessions which incorporated animals
The means for use of language per minute and social interactions per minute
were higher during the OT sessions when animals were incorporated

References
Barker, S. A., Rogers, R. S., Turner, J. W., Karpf, A. S. & Suthers-McCabe, H. M. (2003). Benefits of interacting with companion animals.
American Behavioral Scientist, 47, 9499.
Crowe, T. K., Perea-Burns, S., Sedillo, J. S., Hendrix, I. C., Winkle, M., & Deitz, J. (2014). Effects of partnerships between people with mobility
challenges and service dogs. American Journal of Occupational Therapy, 68, 194202. http://dx.doi.org/10.5014/ajot.2014.009324
Filan, S. L. & Llewellyn-Jones, R. H. (2006). Animal-assisted therapy for dementia: A review of the literature. International Psychogeriatrics,
18(4), 597-611.
Hightower, R. M. (2010). Assessment of occupational therapists attitudes and knowledge of animal-assisted therapy. Masters and Doctoral
Projects, The University of Toledo, Toledo, Ohio.
Howell-Forbes, E. & Marxen, K. (2014). Animal-assisted therapy: A dogs influence on occupational therapy outcomes of a child with
cerebral palsy. Unpublished masters thesis, University of Puget Sound, Tacoma, Washington.
McCune, S., Kruger, K. A., Griffin, J. A., Esposito, L., Freund, L. S., Hurley, K. J., & Bures, R. (2014). Evolution of research into the mutual
benefits of human-animal interaction. Animal Frontiers, 4(3), 49-58.
McLellan, K. E. (nd). Dogs as an intervention for behavioral symptoms of older adults with dementia: A systematic review. Unpublished
masters thesis, University of Puget Sound, Tacoma, Washington.
Sams, M. J., Fortney, E. V., & Willenbring, S. (2006). Occupational therapy incorporating animals for children with autism: A pilot
investigation. American Occupational Therapy Association, 60, 268274.
Velde, B., Cipriani, J., & Fisher, G. (2005). Resident and therapist views of animal-assisted therapy: Implications for occupational therapy.
Australian Occupational Therapy Journal, 52, 43-50.
Zimolag, U., & Krupa, T. (2009). Pet ownership as a meaningful community occupation for people with serious mental illness. American
Journal of Occupational Therapy, 63, 126137.