Project Description:
Background:
Joint attention provides the natural basis for language development (Tomasello, 2000). One major challenge in serving children with various disorders e.g. autism, genetic syndrome, cerebal palsy., who have concomitant communication disorders, is creating situations in which an activity occurs where the child is willing to jointly attend with the caretaker.
As speech-language pathologists, we are professionally oriented toward structure in all teaching situations but recently we have also become aware of the need for providing a naturalistic balance in all treatment sessions (Romski, Sevcik, Smith, Barker, Folan and Barton-Hulsey, 2009).
Structured Natural Activities:
To achieve the goal of providing learning in a structured, natural context requires planning that considers many different aspects: The clinician must create a context and identify an age appropriate activity that
Requires communication to proceed (CANNOT be accomplished WITHOUT a message)
Requires/allows partners within the activity
Offers recast opportunities for the therapist
Uses messages which do not require sequential production
Incorporates developmentally appropriate vocabulary chosen to perform different functions
Therapy Dog to the Rescue:
Boris Levinson (1997) summarized his findings of 30+ years of using dogs in therapy with patients, indicating the dog?s presence was a positive focus in beginning communication, allowing defenses to soften, building a rapport and initiating interaction.
Therefore, the idea of incorporating a therapy dog into speech-language therapy sessions has become increasingly common.
The therapy dog program in Hearing & Speech at Children?s National Medical Center, Washington, DC began in 2006. It has involved 3 dogs with special certification from Delta Society: Airedale -Cozmo, Shepherd Mix - Casey & Standard Poodle - Eleanor. The program strictly follows the regulation animal assisted therapy guidelines/requirements involving vaccination and health certifications, grooming before each visit, and on-going active involvement and training in dog behavioral/therapy training groups.
Therapy Session - General Progression Goals for Child & Dog:
Child Dog
Attends to dog and/or therapist Calmly waits and attends to child
Utilizes any message to participate Responds to message ? then waits
Chooses message to direct dog =complex activity Waits / completes longer activity calmly
The following case provides an example of use with a child with severe speech and language disorders. Thiscchild was initially receiving traditional speech ? language therapy (with limited progress and increasing resistance). A plan for including therapy dog Eleanor in the sessions was implemented.
Case 1: Boy (WV) age 5 years. Dx Autism Spectrum Disorder
Verbal goals: intentional requests (e.g. ?I want _?) and reciprocal turn-taking.
Problems:
easily distracted,
always required picture topic displays to cue speech
difficulty transitioning between actions/activities
all behaviors quickly became repetitive e.g. ?I want bubbles? repeated even when he was blowing bubbles.
interruption of repeated behaviors caused negative responses and overall resistance to therapy
W. received ? hr. sessions with therapy dog from 9-30-08 through 8-25-09 weekly for a total of 25 sessions. W. immediately focused on dog and reduced stereotypical self stimulating talk. Sessions began with single word directive ?eat?, ?walk?, ?jump? and required picture cues. Success was measured by production of target word and engagement with activity.
Results:
No issues transitioning between activities.
2 word requests e.g. ?Elle eat? then ?I want to feed Elle?
Produces messages without picture cues:
o Requests: I want walk Elle, Where?s Elle?
o Directive: Mommy feed Elle, Elle jump
o Comment: Stinky feet
In his last session W. spontaneously requested something not his previous topic list: ?Elle ruff??
Target Audience:
Students/Trainees (long or intermediate trainees), Professionals and Para-Professionals, Children/Adolescents with Disabilities/SHCN
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances
