The Role and Impact of Animals With Pediatric Patients

Anna Tielsch Goddard, MSN, BS, RN, CPNP-PC; Mary Jo Gilmer, PhD, MBA, RN-BC, FAAN


Pediatr Nurs. 2015;41(2):65-71. 

In This Article

Animal-facilitated Therapy

Animal-facilitated therapy (AFT), also referred to as "pet therapy," is the overarching term that refers to both animal-assisted activities (AAA) and animal-assisted therapy (AAT) (Urbanski & Lazenby, 2012). AAA and AAT are sometimes used interchangeably in the literature, but significant differences exist. Table 1 provides a comparison summary of AAA and AAT. AAA refers to activities that involve pets visiting the patient or client, often use the same activity, and do not use specific treatment goals. Detailed notes on the AAA visit are often unnecessary, and the visit content is spontaneous (Pet Partners, 2012b). In contrast, AAT can be a significant part of treatment for people with a physical, social, emotional, or cognitive diagnosis through the use of an animal (Rossetti & King, 2010). AAT requires stated goals for each session, and the treatment is often individualized to the patient. Progress notes in the patient's chart should be recorded after each session, and visits are usually scheduled with a predetermined length of time based on the patient's needs (Pet Partners, 2012a). Pet Partners provides examples of AAT on its website. For instance, a therapist may have a child manipulate buckles, clasps on leashes, or collars in order to improve the patient's fine motor skills. Additionally, a therapist may have a child open a container of treats and feed small pieces of food to the cat in order to work on the child's ability to sequence events. The more general animal-assisted activities may include volunteers taking their dog or cat to a nursing home to visit or bringing an animal to a children's facility to "play" with the patients. AAT visits are performed by volunteer services and are a cost-saving intervention to the hospital (Marcus, 2012).

AAT Goals

A variety of goals may be incorporated into AAT and focus on physical, mental, educational, or motivational objectives. Physical goals may include improving fine motor skills, wheelchair skills, or balancing while standing. Mental health goals may range from increasing verbal interactions among group members, increasing attention skills, developing recreation skills, increasing self-esteem, to reducing anxiety and loneliness in a child. Educational goals are often based on increasing vocabulary or improving knowledge of concepts (e.g., color, size). Finally, examples of motivational goals refer to improving a child's willingness to be involved in group activities, improving interactions with others, or simply exercise (Pet Partners, 2012b). See Table 2 for examples of potential AAT interventional goals.

AAT Dogs

The most common AAT animal is the dog. AAT dogs have rigorous requirements that are often set forth by the Pet Partners. The dogs must undergo initial temperament tests, obedience class training for basic commands, and then additional AAT training for appropriate behavior in a facility (Pet Partners, 2012a; Rossetti & King, 2010). The dogs must be able to ride on elevators; be calm around wheelchairs, walkers, or other ambulation-assistance devices; and not be sensitive to loud noises (e.g., alarms, IVs, children screaming or speaking loudly). The dog must not startle around the sudden and sometimes erratic movements of children in the rooms or hallways. The dog must be of good physical health, current on all vaccinations, and have yearly veterinary health checks (Marcus, 2012; Pet Partners, 2012a). Certifying agencies, such as Pet Partners, provide insurance for dogs if they have passed and abided by the certification program (Marcus, 2012). See Figure 1 for example of therapy dogs that are certified through Pet Partners and practice in the Dallas-Fort Worth metroplex at the local area Children's hospitals.

Figure 1.

Source: Photograph © Paws Across Texas, Inc. (PAT). Used with permission. The author allows reprint permission and copyright release.
Note: Paws Across Texas, Inc. (PAT) is a nonprofit community service organization established in 1986 providing animal-assisted therapy with certified PAT therapy dogs in multiple diverse populations throughout the Dallas and Fort Worth metropolis in Texas.

Studies show that the presence of AAT dogs does not increase zoonotic infections. One study on the effects of AAT in an elderly population in a long-term care facility (N = 1,690) reported no zoonotic infections when the AAT dogs visited over a five-year period (Banks & Banks, 2002). Another pilot study performed at a children's hospital to look at the potential occurrence of infection with AAT showed no difference in the rates of hospital infections over one year of weekly dog visits. There were also no known occurrences of microorganism or contagious illness transmission by the dogs (Caprilli & Messeri, 2006).