Pediatric emergency departments could turn to dogs to reduce anxious kids and parents alike, potentially offering an alternative to medications, new data suggest.
The randomized clinical trial of 80 children, published in JAMA Network Open, found that roughly 10 minutes with a therapy dog and its handler—alongside standard mitigation from a certified child-life specialist—was followed by “modest but significantly greater” reductions in child-reported anxiety and parent-reported perceptions of child anxiety, as compared to child-life therapy alone.
More specifically, 46% of children in the therapy dog group showed a decrease in anxiety scores compared to 23% in the control group. A decrease was defined as a 2.5-point drop in reported anxiety on the 0- to 10-point FACES scale 45 minutes after baseline.
“Virtually all children experience some degree of psychological stress as patients in the emergency department, and about 15% suffer such stress that they require an intervention to allow care processes to continue,” Jeffrey Kline, M.D., an associate chair of research at Wayne State University School of Medicine and the study’s principal investigator, said in a release.
“We found that implementation of therapy dog visits has the potential to reduce fear and anxiety in children and their parents and improve their overall emergency department experience, which has the potential to improve outcomes in a low-cost, low-risk way,” he said.
Fewer children who spent time with a therapy dog were given medications such as midazolam or ketamine than the controls (35% versus 18%), though the difference between the groups was not statistically significant and therefore would require more research to be conclusive.
Both study groups saw greater, but similar, anxiety score declines after two hours. Researchers also measured changes in children and parents’ salivary cortisol, a physiologic measure of stress, and saw substantial but similar reductions across the groups over time.
Prior studies have found stress, pain and depression improvements among adult ED patients, but this week’s study is the first to explore therapy dogs among pediatric patients, the researchers wrote.
They also noted that chemical sedation in the emergency department has been shown to be more common among children with psychiatric conditions and that they saw improvements among 12 such children in their sample from the canine therapy on par with their peers.
“Nonpharmacologic methods to reduce pediatric pain and anxiety have included reliance on parental presence, art or music therapy, and distraction with varying degrees of effectiveness,” they wrote in the journal. “The introduction of a familiar animal, such as a dog, previously certified by a rigorous process as friendly, tolerant and warm can communicate a natural sense of safety, coherence and comfort to a child that may exceed what can be expressed by emergency care clinicians, whom children often perceive as strangers.
“Our data provide initial evidence that the handler and therapy dog adjunct can further augment the goal of minimizing pain and anxiety without the use of chemical or physical restraint,” the study authors wrote.
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