Sunday, May 21, 2006

Llamas, goats, and animal assisted therapy, Part II

Back in November of last year I wrote about an experience I had providing expert testimony on a land-use case, where a family wanted to keep their pet llamas and goats available for their child who has autism, despite not being able to obtain a variance from the local zoning board. For purposes of background, you can (re)read that story here.

I picked up the latest American Journal of Occupational Therapy this morning and was interested to find an article by Mona Sams, Elizabeth Fortney, and Stan Willenbring. The article describes a pilot study incorporating animals in OT sessions for children who have autism (Sams, Fortney, & Willenbring, 2006).

Basically, the study neasures incidence of language use and social interaction in therapy sessions that incorporate animals vs. therapy sessions without animals. I applaud the effort because this is one of those anecdotal issues where most people agree that animals can be an effective methodology, but there really is a lack of good research on the subject.

Unfortunately, there are some gaping methodological holes - some alluded to in the article and others not. They appropriately mention the non-blind conditions. Also, the primary author may have a business interest that could potentially contribute to bias.

Most significantly, I wonder if incidence of language use and social interactions would increase for any child when they were interacting with animals. The likelihood of vocalization may be greater when you are petting a llama than when you are swinging on a swing. The authors allude to this issue, and it would be interesting to measure this effect more specifically.

The authors make some references to sensory integration theory, but I am not certain that I see the connection. I understand that they were discussing Ayres' concept of inner drive and the inherent sensory aspects of the activities, but this does not necessarily make the intervention 'sensory integration.' That is another topic, I suppose.

In summary, the study is a stepping stone, despite its limitations - and for this the authors should be congratulated. In the future it would be nice to see someone do something with more rigorous conditions. Perhaps someone could try another outcome measure, such as purposeful engagement - the idea being that for the population tested there would be a measurable difference in behavior that might not also be seen if you were to expose typically developing children to the same stimulus condition. Specifically, the levels of purposeful engagement for typical children in different activity conditions (animal play vs. sensory motor play) would be at certain levels that would presumably be equivalent. I would expect that typically developing kids would demonstrate equivalent purposeful engagement across activity conditions.

In the next study, the hypothesis for the testing condition could be "Children who have autism will engage in a greater amount of purposeful engagement during animal assisted therapy than during sensory motor play. Of course, 'purposeful engagement' is the operator that needs definition and measurement parameters.

I mention this because if I had such a study in my hands at the time of my testimony for that case, I would have been able to make an even more convincing argument. Instead, I could only argue anecdotal evidence and discuss the point from a disability rights and policy perspective. Real clinical evidence can make a significant difference in people's lives - and that is why we need to have more of it.



References:

Sams, M.J., Fortney, E.V., & Willenbring, S. (2006). Occupational therapy incorporating animals for children with autism: A pilot investigation. American Journal of Occupational Therapy, 60, 268-274.

1 comment:

Chris said...

File this is the small world and coincidence file: Mona Sams (one of the authors of the article cited) is also a SUNY at Buffalo graduate (class of 1964)! According to a SUNY at Buffalo news source she made a bequest to the occupational therapy department to provide funds for lectures and student research in the incorporation of animals in occupational therapy.

I thought it was interesting and wanted to spread the good news here.