Virtually all children experience some degree of psychological stress as patients in the emergency department (ED), and about 15% suffer such stress that they require an intervention to allow care processes to continue. Anxiety is more prevalent and severe in children with psychiatric problems, spectrum disorders and cognitive impairment from prior brain injury. Moreover, parental perception of their child’s fear can amplify the stress response, negatively affecting the child’s recall of the entire ED visit, which in turn can contribute to long-term threat perception and future avoidance of emergency care. Therefore, an urgent and critical need exists for a low cost, low risk method to reduce child and parental anxiety in the ED.
The primary hypothesis is that pediatric patients with moderate to high anxiety will have significantly reduced stress and anxiety after interacting with a therapy dog as an adjunct with a child life specialist, compared with a child life specialist alone. The secondary hypothesis states that the magnitude of reduction in anxiety will be significantly greater in children with known psychiatric problems, autism spectrum diagnoses, or cognitive impairment.
CANINE III is a NCT-registered, two-arm, block randomized trial with one to one matching of patients receiving therapy dogs as an adjunct with a child life specialist, compared with children who receive child life specialists alone. The children will receive a 15-minute visit, with the research team periodically collecting saliva samples to test for cortisol levels, or the level of stress. The study will also test if therapy dogs afford greater anxiety reduction in children with psychiatric complaints, autism spectrum disorder, or brain injury, versus children with none of those conditions.
Children and parents in the therapy dog/child life specialist group will report 20% greater decrease in anxiety compared with children and parents exposed to the child life specialists alone. Children or adolescents with psychiatric complaints, autism-spectrum disorder or brain injury will have a greater reduction in
anxiety with exposure to therapy dogs/child life specialists than those without these conditions.