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The purpose of this research is to evaluate the effect of animal-assisted therapy (AAT) on prosocial behavior and emotional regulation in children with developmental delay, behavioral concerns, or autism spectrum disorder. Service dog use in the pediatric population who have these concerns is increasing and more studies are indicated to determine best practice for incorporating canines into traditional therapy sessions to enhance therapeutic outcomes. The hypothesis for this study is that inclusion of the canine will enhance therapy sessions and produce a lasting effect on prosocial behavior and emotional regulation after AAT sessions have concluded.
Investigators are determining if a child's verbality affects interaction with the canine or changes the effect of animal-assisted therapy on prosocial behavior and emotional regulation in autistic children.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A therapy/service canine was used during therapy sessions | Experimental | The canine was included during therapy sessions and the effect of the canine on children with varying verbality was examined both during and after sessions |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| animal assisted therapy | Behavioral | The canine was included in therapy sessions to determine the effect of the canine on prosocial behavior and emotional regulation in autistic children with varying verbality. |
| Measure | Description | Time Frame |
|---|---|---|
| Targets of interaction during AAT sessions |
| During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Human Interactive behaviors during AAT sessions | Every instance of Social Communication or interactive behavior must engage a target (person, canine, or object). Interactive behaviors that occur between the primary participant and another person (caregiver or therapist) are considered Social Communication. Social Communication can be spontaneous or triggered by the initiation of another person. Interactive behaviors that occur between the primary participant and the canine or control object are considered Environmental Interactions. Subdomains include Talk, Gestures, Look, Touch, Affection, and Prosocial. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Social Communication | Interactive behaviors that occur between the primary participant and another person (caregiver or therapist) were considered Social Communication. Social Communication could be spontaneous or triggered by the initiation of another person. Subdomains include Talk, Gestures, Look, Touch, Affection, and Prosocial. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Environmental Interactions | Interactive behaviors that occur between the primary participant and the canine or control object are considered Environmental Interactions. Subdomains in Talk, Gestures, Look, Touch, Affection, and Prosocial. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michele Kilmer, DNP | University of Arkansas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Arkansas | Fayetteville | Arkansas | 72762 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38386471 | Background | Kilmer M, Hong M, Randolph D, Reichel A, Huetter S, Bowden M, Kilmer C. Animal-assisted therapy in pediatric autism spectrum disorder: A case report. Nurse Pract. 2024 Mar 1;49(3):31-39. doi: 10.1097/01.NPR.0000000000000151. |
| Label | URL |
|---|---|
| Website for the university's autism program | View source |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP_ICF | Yes | Yes | Yes | Study Protocol, Statistical Analysis Plan, and Informed Consent Form | Apr 1, 2023 | Nov 11, 2024 | Prot_SAP_ICF_000.pdf |
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| ID | Term |
|---|---|
| D002658 | Developmental Disabilities |
| D000533 | Altruism |
| D000080103 | Emotional Regulation |
| ID | Term |
|---|---|
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D012919 | Social Behavior |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D056447 | Animal Assisted Therapy |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
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| Emotional Displays | Emotional displays can be captured by assessing the facial expression and/or verbal content of the primary participant. Emotional display codes include Facial Emotional Display such as Smiling and Laughing, Negative Displays, No Display, or Obscured, indicating displays were not codable because they are obscured on the camera. Emotional display codes are not mutually exclusive, as many can occur within the same 10-second coding interval. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Verbal Emotional Displays | Verbal Emotional Displays include positive, negative, or no display. This includes the content of the speech but not the tone of speech or the facial expression of the participant. If audible speech was coded under "Talk," but there are no distinguishable words, we did not code verbal emotional display. Any single statement can be coded as: (1) Positive, (2) Negative, (3) Positive and Negative, or (4) None. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Interfering Behaviors | Interfering Behaviors coded with the OHAIRE encompass behaviors that may impair the individual's ability to participate in and benefit from an activity or interaction. These behaviors include Aggression, Overactivity, and Isolation. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Human canine interaction | The 3-AAT Observation ethogram was also used to code human canine interaction during AAT sessions. The revised ethogram appraises the frequency of six domains of human interaction (Affection, Play, Care, Communication, Comfort, Withdrawal) and 24 subdomains of human behavior that can occur in an AAT session. The ethogram assesses the Frequency, Intensity, and Duration of the interactions between the canine and participants. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Affection | Affection is defined by positive behavior occurring between participants and the canine during scheduled play time incorporated into each session. Affection has two subdomains: Laughing and Petting. Intensity of Affection ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Laughing | Laughing is defined as the participant laughing while playing with the canine. Audible laughter may be quiet or loud and with or without vocalization. The minimum requirement for vocalized laughter is one laugh. The minimum requirement for non-vocalized or silent laughter is two laughs with body movement such as shoulders moving to distinguish laughter from heavy breathing or sniffling. None (0) indicates the participant did not laugh. Very Mild (1) indicates the participant smiles widely showing teeth but does not audibly laugh. Mild (2) indicates the participant audibly once or inaudibly by moving shoulders up and down at least one time. Moderate (3) indicates the participant audibly two times or more or moves shoulders up and down more than twice. Severe (4) indicates the participant laughs more than 5 times or moves shoulders up and down more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Petting | Petting is defined as the participant physically pets the canine while playing in a positive context and manner. Intensity of Petting ranges from None (0) to Severe (4). None (0) indicates the participant did not pet the canine during play. Very Mild (1) indicates the canine's skin and fur are lightly grazed when petted by participant. Mild (2) indicates light but clearly flush with the skin/fur of the canine. Skin and fur are lightly stretched/ shifted. Moderate (3) indicates more vigorous petting, fast back and forth, and skin/fur are visibly stretched/ shifted. Severe (4) indicates petting is very rapid, quicker back and forth, skin is very stretched, and fur is very shifted | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Play | Play is defined by the participant and canine interacting in a specific activity to promote socialization. Play has three subdomains: Fetch, Hide and Seek, and Puzzles. Intensity of Play ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Fetch | Fetch is defined as the participant throwing an object, such as a ball or frisbee, in order for the canine to retrieve the object and bring the object back to the participant. This activity occurs during the scheduled play time of each session and can occur inside the clinic or outside in a grassy area in the back of the clinic. Intensity of Fetch ranges from None (0) to Severe (4). None (0) indicates the participant did not play fetch with the canine. Very Mild (1) indicates the participant played fetch for less than 10 seconds. Mild (2) indicates the participant played fetch for 10-30 seconds. Moderate (3) indicates the participant played fetch for 30-60 seconds Severe (4) indicates the participant played fetch for over 60 seconds | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Hide and Seek | Hide and Seek is defined as the participant playing hide and seek with the canine, either hiding themselves for the canine to find or hiding an object, such as a ball or treat, for the canine to find. This activity occurs during the scheduled play time of each session and can occur inside the clinic or outside in a grassy area in the front or back of the clinic. Intensity of Hide and Seek ranges from None (0) to Severe (4). None (0) indicates the participant did not play hide and seek with the canine. Very Mild (1) indicates the participant played hide and seek for less than 30 seconds. Mild (2) indicates the participant played hide and seek for 30-60 seconds. Moderate (3) indicates the participant played hide and seek for 60-90 seconds. Severe (4) indicates the participant played hide and seek for more than 90 seconds. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Puzzles | Puzzles is defined as the participant hiding a treat in a puzzle for the canine to solve in order to get the treat. Puzzles may occur during the scheduled play time or during the scheduled seated work time during the sessions. Intensity of Puzzles ranges from None (0) to Severe (4). None (0) indicates the participant did not play puzzles with the canine. Very Mild (1) indicates the participant played puzzles for less than 30 seconds. Mild (2) indicates the participant played puzzles for 30-60 seconds. Moderate (3) indicates the participant played puzzles for 60-90 seconds. Severe (4) indicates the participant played puzzles for more than 90 seconds. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Care | Care is defined as prosocial interactions initiated by participants to assist the canine. Care may occur during the scheduled play time or during the scheduled seated work time during the sessions. Care has two subdomains: Brush and Walking. Intensity of Care ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Brush | Brush is defined by the participant using a brush to stroke the canine's coat. Brush may occur during the scheduled play time or during the scheduled seated work time during the sessions Intensity of Brush ranges from None (0) to Severe (4). None (0) indicates the participant did not brush the canine's coat. Very Mild (1) indicates the participant brushed the canine's coat for less than 30 seconds. Mild (2) indicates the participant brushed the canine's coat for 30-60 seconds. Moderate (3) indicates the participant brushed the canine's coat for 60-90 seconds. Severe (4) indicates the participant brushed the canine's coat for more than 90 seconds. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Walking | Walking is defined as the participant walking the canine while holding the canine's leash. Walking may occur during the scheduled play time or during the scheduled seated work time during the sessions. Walking can occur inside the clinic or outside in a grassy area in the front or back of the clinic. Intensity of Walking ranges from None (0) to Severe (4). None (0) indicates the participant did not walk the canine using a leash. Very Mild (1) indicates the participant walked the canine using a leash for less than 30 seconds Mild (2) indicates the participant walked the canine using a leash for 30-60 seconds. Moderate (3) indicates the participant walked the canine using a leash for 60-90 seconds. Severe (4) indicates the participant walked the canine using a leash for more than 90 seconds. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Communication | Communication is defined as words spoken by the participant directly to the canine. Communication may occur during the scheduled play time or during the scheduled seated work time during the sessions. Communication has three subdomains: Name, Command, and Verbal Affirmation. Intensity of Communication ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Name | Name is defined as the participant saying the canine's name. Name must be directed toward the canine and not the caregiver or therapist. Intensity of Name ranges from None (0) to Severe (4). None (0) indicates the participant did not say the canine's name. Very Mild (1) indicates the participant said the canine's name once. Mild (2) indicates the participant said the canine's name 2 - 3 times. Moderate (3) indicates the participant said the canine's name 4 - 5 times. Severe (4) indicates the participant said the canine's name more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Command | Command is defined as the participant stating a command in order for the canine to do a trick or obey the participant. Command may occur during the scheduled play time or during the scheduled seated work time during the sessions. Intensity of Command ranges from None (0) to Severe (4). None (0) indicates the participant did not say a command. Very Mild (1) indicates the participant said one command. Mild (2) indicates the participant said commands 2 - 3 times. Moderate (3) indicates the participant said commands 4 - 5 times. Severe (4) indicates the participant said commands more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Verbal Affirmation | Verbal Affirmation is defined as the participant saying verbal affirmations directed toward the canine. Verbal Affirmation may occur during the scheduled play time or during the scheduled seated work time during the sessions. Intensity of Verbal Affirmation ranges from None (0) to Severe (4). None (0) indicates the participant did not say verbal affirmations. Very Mild (1) indicates the participant said one verbal affirmation. Mild (2) indicates the participant said two verbal affirmations. Moderate (3) indicates the participant said verbal affirmations 3 - 5 times. Severe (4) indicates the participant said verbal affirmations more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Comfort | Comfort is defined as prosocial behavior occurring between participants and the canine. Comfort codes behavior occurring during the scheduled seated work time of each session. Comfort has ten subdomains: Head, Face, Back, Belly, Ears, Hugs, Kiss, Treat, Floor, and Laying. Intensity of Comfort ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Head | Head is defined as the participant touching the top of the canine's head during seated work time. Intensity of Head ranges from None (0) to Severe (4). None (0) indicates the participant did not touch the top of the canine's head while seated. Very Mild (1) indicates the participant touched the canine's head once while seated. Mild (2) indicates the participant touched the canine's head twice while seated. Moderate (3) indicates the participant touched the canine's head 3 - 5 times while seated. Severe (4) indicates the participant touched the canine's head more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Face | Face is defined as the participant touching the canine's face during seated work time. Intensity of Face ranges from None (0) to Severe (4). None (0) indicates the participant did not the canine's face while seated. Very Mild (1) indicates the participant touched the canine's face once while seated. Mild (2) indicates the participant touched the canine's face twice while seated. Moderate (3) indicates the participant touched the canine's face 3 - 5 times while seated. Severe (4) indicates the participant touched the canine's face more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Back | Back is defined as the participant touching the canine's back during seated work time. Intensity of Back ranges from None (0) to Severe (4). None (0) indicates the participant did not the canine's back while seated. Very Mild (1) indicates the participant touched the canine's back once while seated. Mild (2) indicates the participant touched the canine's back twice while seated. Moderate (3) indicates the participant touched the canine's back 3 - 5 times while seated. Severe (4) indicates the participant touched the canine's back more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Belly | Belly is defined as the participant touching the canine's belly during seated work time. Intensity of Belly ranges from None (0) to Severe (4). None (0) indicates the participant did not the canine's belly while seated. Very Mild (1) indicates the participant touched the canine's belly once while seated. Mild (2) indicates the participant touched the canine's belly twice while seated. Moderate (3) indicates the participant touched the canine's belly 3 - 5 times while seated. Severe (4) indicates the participant touched the canine's belly more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Ears | Ears is defined as the participant touching the canine's ears during seated work time. Intensity of Ears ranges from None (0) to Severe (4). None (0) indicates the participant did not the canine's ears while seated. Very Mild (1) indicates the participant touched the canine's ears once while seated. Mild (2) indicates the participant touched the canine's ears twice while seated. Moderate (3) indicates the participant touched the canine's ears 3 - 5 times while seated. Severe (4) indicates the participant touched the canine's ears more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Hugs | Hug is defined as the participant physically hugs the canine during seated work time. Intensity of Hug ranges from None (0) to Severe (4). None (0) indicates the participant did not hug the canine while seated. Very Mild (1) indicates the participant hugged the canine once while seated. Mild (2) indicates the participant hugged the canine twice while seated. Moderate (3) indicates the participant hugged the canine 3 - 5 times while seated. Severe (4) indicates the participant hugged the canine more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Kiss | Kiss is defined as the participant kisses the canine on his head or body during seated work time. Intensity of Kiss ranges from None (0) to Severe (4). None (0) indicates the participant did not kiss the canine while seated. Very Mild (1) indicates the participant kissed the canine once while seated. Mild (2) indicates the participant kissed the canine twice while seated. Moderate (3) indicates the participant kissed the canine 3 - 5 times while seated. Severe (4) indicates the participant kissed the canine more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Treat | Treat is defined as the participant giving the canine a treat during seated work time. Intensity of Treat ranges from None (0) to Severe (4). None (0) indicates the participant did not give the canine a treat while seated. Very Mild (1) indicates the participant gave the canine a treat once while seated. Mild (2) indicates the participant gave the canine a treat twice while seated. Moderate (3) indicates the participant gave the canine a treat 3 - 5 times while seated. Severe (4) indicates the participant gave the canine a treat more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Floor | Floor is defined as the participant sitting on the floor by the canine during the seated work time. Intensity of Floor ranges from None (0) to Severe (4). None (0) indicates the participant did not sit on the floor by the canine while seated. Very Mild (1) indicates the participant sat on the floor by the canine once while seated. Mild (2) indicates the participant sat on the floor by the canine twice while seated. Moderate (3) indicates the participant sat on the floor by the canine 3 - 5 times while seated. Severe (4) indicates the participant sat on the floor by the canine more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Laying | Laying is defined as the participant physically laying their body on the canine during the seated work time. Intensity of Laying ranges from None (0) to Severe (4). None (0) indicates the participant did not lay their body on the canine while seated. Very Mild (1) indicates the participant laid their body on the canine once while seated. Mild (2) indicates the participant laid their body on the canine twice while seated. Moderate (3) indicates the participant laid their body on the canine 3 - 5 times while seated. Severe (4) indicates the participant laid their body on the canine more than 5 times while seated. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Withdrawal | Withdrawal is defined as the participant moving away from interacting from the canine. Withdrawal may occur during the scheduled play time or during the scheduled seated work time during the sessions. Withdrawal has four subdomains: Moves Away, Hides, Crying, and saying "No!" to the canine. Intensity of Withdrawal ranges from None (0) to Severe (4). | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Moves Away | Moves Away is defined as the participant physically moving away from the canine to end the interaction. Intensity of Moves Away ranges from None (0) to Severe (4). None (0) indicates the participant did not move away from the canine. Very Mild (1) indicates the participant moved away from the canine once. Mild (2) indicates the participant moved away from the canine twice. Moderate (3) indicates the participant moved away from the canine 3 - 5 times. Severe (4) indicates the participant moved away from the canine more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Hides | Hides is defined when the participant hides their face from the canine, turns their body from the canine, or hides behind an object, such as a table, to get away from the canine. Intensity of Hides ranges from None (0) to Severe (4). None (0) indicates the participant did not hide from the canine. Very Mild (1) indicates the participant hid from the canine once. Mild (2) indicates the participant hid from the canine twice. Moderate (3) indicates the participant hid from the canine 3 - 5 times. Severe (4) indicates the participant hid from the canine more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Crying | Crying is defined as the participant crying, with or without tears, and this behavior must be directed toward the canine. Intensity of Crying ranges from None (0) to Severe (4). None (0) indicates the participant did not cry with the canine. Very Mild (1) indicates the participant cried with the canine once. Mild (2) indicates the participant cried with the canine twice. Moderate (3) indicates the participant cried with the canine 3 - 5 times. Severe (4) indicates the participant cried with the canine more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Saying "No!" | Saying "No!" is defined as the participant verbally stating the word "No!" to the canine to end the interaction. Intensity of "No!" ranges from None (0) to Severe (4). None (0) indicates the participant did not say "No!" to the canine. Very Mild (1) indicates the participant said "No!" to the canine once. Mild (2) indicates the participant said "No!" to the canine twice. Moderate (3) indicates the participant said "No!" to the canine 3 - 5 times. Severe (4) indicates the participant said "No!" to canine more than 5 times. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Frequency | Frequency is defined by the occurrence of one of the interactions listed on the 3-AAT Observation ethogram. Interactions were measured by a tally count of each interaction. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Duration | Duration of the interaction was assessed by rounding either up or down to the nearest 30 second mark and coded as follows.
| During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Intensity | Intensity of the interaction was coded from None (0) to Severe (4). The mode of the interaction codes was entered to run the analysis. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Talk | Talk is defined as verbal communication that occurs when the primary participant engages in a verbal communicative attempt with a visible target. If the target is unknown or out of frame, we coded this behavior as "No." To qualify as verbal communication, there should be audible sound clearly coming from the primary participant. We used the "three rule." If we could not determine whether the participant was talking after three viewings, we coded this behavior as "No.". If the words being spoken were intelligible, we also coded Verbal Emotional Display. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Gestures | Gestures are defined as a form of social communication that occurs when the participant engages in a communicative attempt toward a target using physical gestures. It includes sign language and any other bodily actions that are used to communicate. The aim of the gesture should be to communicate rather than to accomplish a physical task. For example, pointing to an item on the ground is a gesture, but picking an item up off the ground is not a gesture. Talk and Gesture can be coded at the same time. When that occurred, we selected the target for BOTH codes. Gesture does not include Touch. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Look | Look occurs when the primary participant looks in the direction of a visible target. The participant's gaze should be assessed by the angle or direction of their eyes. Look can only be coded if half of the participant's face is visible (i.e., at least one eye). Regarding canines and control objects, Look should be coded if the participant is looking at any part of the canine or object. Regarding other participants, Look can only be coded if the participant is looking at the face (or general face region) of a caregiver or therapist. If the participant looked in the direction of multiple people, canines, or objects, we coded all targets that could apply. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Touch | Touch was coded if the primary participant comes into physical contact with a target. Touch does not include Aggression. Touch should be coded when any part of the participant's body makes contact with any part of the target. If a participant's clothing was touching another person, we also code this as Touch. Receiving any object by hand was coded as touching another person (caregiver or therapist). Similarly, receiving a control object by hand was coded as touching another person (caregiver or therapist) and the control object. In the case of giving or receiving an object by hand, we also coded this behavior as Prosocial. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Affection | Affection was coded if the participant demonstrates physical affection or emotional warmth (i.e., verbal affection) to other humans, objects, or canines. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Prosocial | Prosocial is defined as non-verbal behavior (i.e., physical action) that is purposefully helpful to another person, canine, or object. | During weekly animal-assisted therapy sessions from enrollment to the end of treatment between 6 to 52 weeks |
| Strengths and Difficulties Questionnaire | The Strengths and Difficulties Questionnaire is a brief behavioral screening questionnaire about 2- to 17-year-olds. It exists in several versions to meet the needs of researchers, clinicians and educationalists. The SDQ ask about 25 attributes, some positive and others negative. These 25 items are divided between 5 scales: Emotional Symptoms (5 items), Conduct Problems (5 items), Hyperactivity/ Inattention (5 items), Peer Relationship Problems (5 items), Prosocial Behavior (5 items). The first four domains are added together to generate a total difficulties score. There are additional questions regarding the impact of the child's behavior concerning the chronicity, distress, social impairment, and burden to others. The initial SDQ is completed by caregivers at the beginning of the study. The follow-up SDQ is completed by caregivers every 4 weeks throughout the study and contains two additional items to evaluate the perceived effect of the intervention. | The initial SDQ is completed at the beginning of the study and the follow-up version is completed every 4 weeks and at the end of the study. |
| Positive and Negative Affect Scale | The Positive and Negative Affect Schedule or (PANAS) is a scale that consists of different words that describe feelings and emotions. The 20-item self-report assesses positive affect (PA) and negative affect (NA). PA is associated with pleasurable engagement with the environment, whereas NA reflects a dimension of general distress summarizing a variety of negative states such as anger, guilt, or anxiety. The PANAS use a 5-point scale for caregivers to select to determine if a concept applies. The final score is derived from the sum of the ten items on both the positive and negative side. Affect states include Interested, Distressed, Excited, Upset, Strong, Guilty, Scared, Hostile, Enthusiastic, Proud, Irritable, Alert, Ashamed, Inspired, Nervous, Determined, Attentive, Jittery, Active, and Afraid. | The PANAS is administered weekly from the start to the end of the study. |
| D000068356 |
| Self-Control |
| D013812 |
| Therapeutics |
| D026741 | Physical Therapy Modalities |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |