Improvements in aspects of motor skills, physical activity, quality of life and human animal interactions were observed, thus providing preliminary support of positive gains based on participation in an APA-AAI, using the family dog, for a child with CP. To date, the relationship between animal-assisted physical activity participation and motor skill performance has not been extensively examined. Yet, within the paucity of existing literature evidence suggests the presence of a therapy dog is associated with higher performance speeds [19
] and greater adherence to instructions on locomotor (leaping, hoping, crawling) and stability (rolling over and balance beam activities) skill tasks in preschoolers with language-impairment disabilities. Gee et al. [19
] directly examined the effect of the dog’s presence on skill performance, compared to when the dog was absent, suggesting that the inclusion of a dog in adapted physical activity interventions may serve as a strong motivator for greater participation in physical activities among children. The present study aimed to capitalize on this potential motivational mechanism through the inclusion of the family dog, by allowing for continual presence of the family dog at home and during the child’s participation in daily physical activity higher adherence was expected. Although we could not measure whether improvements in physical activity were directly associated with the intervention and the presence of the dog’s participation in physical activities the child was participating in more physical activity following the intervention, as indicated through objective physical activity monitoring. The inclusion of the family dog is novel in an APA-AAI and strong compliance, by the case presented, to the intervention supports the feasibility of this model towards improving aspects of motor skills, physical activity, quality of life and human animal interactions for a child with CP. Utilizing dogs already owned by participants may provide unique advantages that may facilitate broader access to and success of AAI programs. For example, many traditional AAI’s consist of brief interactions with therapy dogs that are owned by an independent handler [42
], requiring participants to schedule one time or regular sessions to engage in the beneficial activities. This imposes time and location restrictions for participants that are ongoing. Conversely, AAI’s that facilitate joint participant-dog training allow the dyad to learn relevant skills and activities that they can continue to practice at home facilitating long-term wellness practices even after the on-site intervention sessions end or decrease in frequency. The use of family dogs may also reduce financial barriers associated with long-term therapy dog sessions or the acquisition of a specially bred and trained service dog that may cost tens of thousands of dollars upon receipt and often takes months to years to acquire [43
]. Especially for AAI’s geared towards children, the ability to work with a known animal may be less intimidating and potentially safer for both the child and animal involved. Both members of the dyad, as well as the guardians, will be more familiar with each other’s body language and the dynamics of past interactions between these individuals. Research suggests that even the presence of an owned dog can have health benefits [44
] and this effect is magnified when a strong bond is shared between the dog and human [45
]. The use of an already bonded dog in interventions may therefore facilitate success or long term compliance in a variety of ways that are not as easily achieved with more traditional AAI approaches. Conversely, while not the case in the current study, downsides to the use of family dogs should also be considered including the possibility that some pet dogs may not be sufficiently motivated, healthy enough, or may fail to learn the behaviors required to adequately engage in intervention activities. It is also possible that regular ongoing sessions with the human AAI facilitators, while potentially costlier and more time consuming, may provide benefits beyond engaging in activities with the dog alone if and when both options are available long-term. Therefore, while the availability of a variety of AAI programs that included animal visits, specially trained service animals and family dogs will likely remain beneficial due to a diversity of participant needs across intervention and therapy contexts, the current data suggests that more research on the inclusion of family dogs in AAI is warranted. More work, in this area should ensue, including adherence of the family dog based on breed, size and temperament. Larger studies, examining this aspect of the program would be helpful. However, the current case study suggests that the inclusion of family dogs from breeds, and even dogs younger than is often typical for traditional AAI visits, may still facilitate positive therapeutic outcomes. Evidence that a one-year old Pomeranian with no prior training history can be successfully utilized in an animal-assisted adapted activity program would suggest that dogs from a much wider range of breeds, ages and sizes may be worth considering for AAI programs; minimally this question warrants further study.
Program adherence is a persistent challenge in most PA promotion programs and can be a major barrier for achieving life-long health benefits [46
]. The home-based adherence of the participant in this study, strengthens the potential for an APA-AAI with the family dog to facilitate adopting life-long healthy physical activity habits [47
], where the family dog may simply act as a prompt for the child to engage in healthy behaviors, like walking. More research in this area is warranted, including the types of activities which might be the most interesting and active for the participants and their family dog. Given the gains in all aspects of health inclusive of aspects of motor skill development, physical activity, quality of life and human animal interactions, the use of an APA-AAI could have far reach in respect to improving these constructs in the lives of children with CP.