Trisha Markle and Dr. Gary Burlingame, Psychology

This study is currently still in progress. We are in the final stages of a pilot study that was supported by this ORCA grant. A new and funded version of the study will begin in January based upon the findings of the pilot. As noted in our IRB, our pilot study was conducted as a quality improvement project at Utah State hospital (USH).

One of the goals of this project was to fill the gap in animal-assisted therapy research. Although studies on its efficacy have been conducted, most of them are qualitative and do not follow a rigorous design. Also, there is a lack of studies conducted with the seriously mentally ill (SMI) population. The SMI population is precisely our population of interest. Previous research has shown that AAT can increase social interaction. We are attempting to determine if this is true for a SMI pediatric population at USH.

Our sample consists of three children at Utah State Hospital who have been diagnosed with reactive attachment disorder, inhibited type (RAD) by a board certified psychiatrist. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (American Psychiatric Association, 2000) reactive attachment disorder (RAD), inhibited type is characterized by a “persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions” (p. 130). Onset occurs before 5 years and is a result of chronic emotional neglect, physical neglect, or persistently transitory attachment figures. Inattentive symptoms are evidenced in several different behavioral markers such as extreme avoidance of interactions (e.g., no eye contact, no initiation of interactions), opposition to nurturance (e.g., avoidance of physical contact, lack of reciprocation to calming interaction), or a hyper-vigilant state (e.g., increased arousal, scanning the environment for danger).

We decided to use a single-subject multiple-baseline across subjects design. This design is a powerful tool to use when the number of subjects is limited and detailed data on each participant is desired. It also allows for causal inferences when conducted in an integral manner. There are three children participating in this quality improvement project. AAT was conducted twice a week for ten weeks for each child. In order to eliminate historical confounds to the best degree possible we staggered the start date of the beginning of the intervention between the children. Child 1 had at least two weeks of baseline, child 2 had at least three weeks of baseline, and child 3 had at least four weeks of baseline.

The content of the therapy sessions includes having the children view photographs of canines exhibiting what are referred to as “calming signals”. These signals include actions such as yawning, shaking off, lip licking, and several others. It has been shown that dogs exhibit these behaviors when they are stressed and/or nervous as a way of communicating with other dogs and humans. These calming signals are taught to the children who then learn to recognize them in the canine present at the AAT session. Children are also shown photographs of human facial expressions and are taught what emotion they correspond to.

Each therapy session was video-taped and coded by trained raters for the behaviors of interest. The raters were trained and then checked for inter-rater reliability. They all achieved reliability at or above a criterion level: r =.80. The preliminary data is promising for some of the variables. Specifically, the results show a potential novelty effect. We have seen that at the introduction of AAT there is an initial spike in social behavior variables such as smiling and looking into the faces of others. There is a slight decline after this initial spike as the AAT sessions continue. This could be due to the novelty of the therapy sessions when they first begin and increasing familiarity with them as they continue. An example of this is shown in figure 2.

After the intervention is completed for each child we will be comparing data on the behaviors of interest from the baseline period to the data derived from the AAT sessions. The behaviors of interest include social behavior that the children engage in.

Receiving an ORCA grant for this project allowed me to focus my time and energy on the research without jeopardizing my academic standing. It also allowed us to purchase equipment that was vital to the success of this research. Finally, the ORCA study essentially became a pilot study that attracted funding from the Waltham Foundation to conduct a second, more comprehensive study. I’m very appreciative of the support BYU provided.

References

• American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: corporate author.