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Results of the research on the impact of the integration of service dogs into the families of children with autism spectrum disorders (ASDs).

We are happy to present to you the content from the press conference held on April 15, 2013, during which we presented the results of the research on the impact of the integration of service dogs into the families of children with autism spectrum disorders (ASDs).

Experience of a Scientist at Mira: Contribution to Research, Practice, and Training Marcel Trudel, Associate Professor, Department of Psychoeducation, Faculty of Education, University of Sherbrooke.

The project in collaboration with the Mira Foundation is innovative in several ways. First of all, we’ll address the scientific benefits because this is the first research looking at the variations in salivary cortisol both in the parents and in the children with an autism spectrum disorder (ASD) for a prolonged period of four months. Moreover, this assessment approach had never been used with families from population samples. The transactional and ecological design that emerges from the study is that the service dog influences the family dynamic as much as it does the individual child. Considering the mission of the Mira Foundation, the project also had the objective of providing perspective on the value of service offered to families of children with an ASD. For example, what conditions can optimize the impact of a service dog? Thirdly, the context of cooperation between the research team and the Mira Foundation has significant benefits for the training of parents, as well as for the students. For the latter, the impact was significant because it offered a field laboratory for university students, which contributed to the integration of knowledge with the requirements of practice. Many master’s dissertations and doctoral theses were completed during the project. Finally, it must be emphasized that the context of cooperation notably contributed to the implementation of the “Schola Mira” project, which has the mission of supporting families of children with an ASD.

The Results of the Research on the Impact of the Integration of Assistance Dogs into Families of Children with an Autism Spectrum Disorder. Stéphanie Fecteau, Psychoeducator, PhD in Education.

The research adopted an approach focusing on an ecological analysis of families with a child with an ASD. In addition to measures of salivary cortisol, the instruments chosen considered distinct and complementary areas: 1) behavioural difficulties exhibited by the child, 2) the anxiety experienced by the parent, and his or her history in terms of attachment relationships, and 3) the parental stress experienced, the family environment, the current parent-child attachment and the educational practices preferred by the parent. Generally, when looking at the adversity experienced by the parent, we detect the presence of a high degree of stress (64%) associated with the parental task with reference to the thresholds criteria established by the creators of the instrument. Furthermore, we observed that the severity of ASD in the child is associated with a higher stress level reported by the parent. However, we don’t identify a relationship between the severity of the behaviours of the child and the changes in cortisol. In terms of the regulation of the parents’ salivary cortisol, the results show a more pronounced activation of cortisol in the control group compared to the experimental group. But if we compare it to the expected regulation in a healthy adult, the morning activation of the whole group is well below this norm (38.89% compared to 50-75%). This indicator is known to be a biological marker associated with significant stressors. It would also reflect a specific response of the body associated with adrenocortical activity in the context of adversity. Indeed, low morning activation is associated with the experience of significant chronic stress. Finally, the stress experienced by the parent seems to have a significant impact on his or her perception of the relationship that the child has with the service dog (the more the parent experiences high stress from the relationship with the child, the less the parent will positively evaluate the relationship of the child with the dog).

As a whole, the results of our study support the international data concerning the experience of significant stress by parents of children with an ASD, and it highlights the importance of offering them support in their task.

Salivary Cortisol in the Family and Coregulation: An overview of the Impact of Service Dogs on the Family. Marcel Trudel, Associate Professor, Department of Psychoeducation, Faculty of Education, University of Sherbrooke. Frédéric Picard, Laval Hospital Research Centre, Sainte-Foy, and Faculty of Pharmacy, Laval University.

Let us first recall that the assessment protocol adopted in the study includes two groups of families with an ASD child. The first group is composed of families that received a service dog, and the second is a control group. The latter is composed of families on the Mira Foundation’s waiting lists who will be assigned a dog during the following year. The research results relate to the impact of the service dog on measures of salivary cortisol (stress hormone), demonstrating that families who have received an assistance dog show less stress on the biological level than those in the control group. The analyses done by Dr. Picard indicate that the cortisol indices integrating data over the entire duration of the experiment are more attenuated in the group that had received an assistance dog as compared to the control group, and this applied equally for the parents and the children. The impact is detectable in the samples collected both in the morning and at night. When we take into account the degree of hormonal activation indexed by calculating the difference between the first two data samples taken in the morning, we notice that the cortisol response upon wakening was significantly higher among parents and children in the control group.

Recall, however, that in the general population, the activation of cortisol follows a circadian rhythm and is more active early in the day, which helps to provide the energy required to undertake the day. However, an overly significant and recurrent activation could generate fatigue and could lead to long term problems. These early results have been reviewed in order to take into account the more dynamic and interactive context of the interrelationship between parent and child. Little work thus far has explored this conception of a form of coregulation or synchrony between biological systems and relational or social systems. Saxbe (2010) is an exception, as she addressed this issue, but in the context of a study on satisfaction in couple relationships in connection with the impact of workplace stress. Given the sometimes unpredictable characteristics reported in many research studies on children with an ASD, we should expect a weak coregulation of cortisol between the parent and the child. However, the results of the analyses performed by Dr. Trudel do not support this hypothesis. In fact, in the control group there is significant covariation in cortisol levels between the parent and the child in the morning and at night. In addition, there is a strong interdependence of cortisol (based on the calculation of the correlations) between the dyads at different times of measurement. This result is interpreted as reflecting a two-way influence between the parent and the child in the activation of the hormonal system associated with cortisol. Amazingly, we don’t find this interrelationship between the parent and the child in families that have received a service dog. It is as if the presence of the animal has induced an interruption or change in rhythm at the level of coregulation between the endocrine systems of the two individuals. Thus, any social attention from the parent to the child and vice versa, would become less intense after the arrival of the service dog. In short, the animal would help alleviate the cycle of day-to-day functioning characterizing the parent-child dyad because the attention of each becomes less exclusive. The effect observed in the study suggests that each family member is able to have more moments of respite in the relationship after the arrival of the dog.

The results of this research project for the Mira Foundation have allowed for the development of several areas of activity: a) in diversifying the services offered to families (training workshops for parents, intervention services to help the parent in the care of the animal and its use with the child) 2) in developing a coding grid to estimate the degree of attraction of the child for the dog before the allocation thereof, 3) in developing an assessment protocal to target the needs of the child and of the family in terms of the interest for the animal and of the functioning of the animal.

Groundwork for the Future for the Families and Children Living with a Pervasive Developmental Disorder (PDD) or an Autism Spectrum Disorder (ASD). To Innovate and Advance on the Results of Research and Application Noël Champagne, Psychologist, MIRA Foundation

Since its inception in 1981, MIRA has innovated in the field of placing guide dogs with visually handicapped individuals. This innovation focuses on teaching the individual orientation and mobility before they are given a guide-dog. For example, the individual must learn to get around on a sidewalk by identifying sounds from cars and follow them in parallel to maintain a straight line. To do this, MIRA partners with the Nazareth and Louis-Braille Institute. This partnership has existed for more than thirty years.

Along the way, MIRA has consolidated a high quality herd of dogs and has developed a method of work related to the breeding, raising, evaluation, and training of the dogs under the guidance of its founder, President and CEO, Éric St-Pierre.

In 1990, MIRA initiated and developed the first research on visually impaired and blind children and guide dogs. This study targeted youth of less than 15 years of age. Since 1991, MIRA has been implementing a program placing guide dogs with these youth. Today, in 2013, MIRA continues providing this program in Quebec and in other provinces of Canada, and is also now offering the program in Europe – mainly in France (Mira Europe), and in the United States (Mira USA) – mainly on the East Coast.

In 1993, MIRA devoted itself to the development of a program placing service dogs with individuals living with a physical handicap. The implementation of this program sparked the interest of many rehabilitation school researchers. Researchers at the University of Sherbrooke, Laval University, and the University of Montreal have strengthened evidence in the field. In addition, the Minister of Health and Social Services (MHSS) of the government of Quebec, through its Agence d’évaluation des modes d’intervention, has conducted evaluative research on this program and has recommended that the MHSS recognize that service dogs, in the context of MIRA, are an effective tool to help overcome the handicaps of individuals with restricted mobility.

The tireless efforts of MIRA to present the results to government and political authorities resulted in the implementation of a program covering the costs of placement and care of a service dog for people with restricted mobility by the government of Quebec in 2010. The development of this service dog program also allowed for the implementation of a service dog program in rehabilitation in which the dog is used by professionals (physiotherapists, occupational therapists, etc.) to help individuals in their rehabilitation work.

Over the decades, MIRA has made significant contributions to the improvement of pedestrian and automobile routes (better signals at traffic intersections, audio-signal traffic lights, enlarged signs, etc.). Between 2000 and 2003, MIRA was active in the push to prohibit making right turns at red lights in the province of Quebec. These efforts were successful, and the law was put into place and stayed in effect province-wide until 2013. It remains in effect in Montreal. It was MIRA’s research (the observation of the filmed traffic environment in Drumondville, Joliette, and Sherbrooke) that demonstrated that turning right at a red light is a dangerous practice that risks pedestrian death or major injury, and that disabled individuals have an increased risk of being hit.

In 2000, Doctor Robert Viau, newly gradated with a doctorate in Neuropsychology with a thesis on the blind (blind himself since the age of 8 years and a user of a guide dog), joined our team. Thus began a productive discussion on the use by the visually impaired of guide dogs and the white cane in the process of getting around. Moving around with a guide dog is much more fluid and proprioceptive, while using the cane is much more tactile. Robert had adapted an instrument to measure the cognitive and emotional functions of the functioning blind, more specifically, the stress involved in their movement. During these discussions the notion of an objective physiological and neurobiological measure of stress and anxiety emerged: salivary cortisol. This measure was of much interest from the point of view of the navigation of space for the visually impaired. The measure is also applied to children with an Autism Spectrum Disorder and their parents, who suffer high anxiety and physiological stress. In December 2002, MIRA invited families to participate in a symposium on the needs and lived realities of the parents of children living with a disability and with a MIRA dog. Thus began the groundwork for 10 years of research and application.

In spring of 2003, MIRA developed a first exploratory protocol placing dogs with families of children living with different situations of disability. From the results, it appears evident that the dogs can come to the aid of families who have children with a PDD/ASD. In our discussions, it became clear to us that there were very few research results on the subject of the impact of dog on the lives of PDD/ASD children and their families, and that there was much in the way of knowledge and application to be discovered.

In the autumn of 2003, MIRA began a study of 54 families of children with a PDD/ASD (2003 to 2006). From this study, MIRA gained important knowledge: the dog influences and modulates the cortisol of the child, and decreases stress and anxiety in the child.

This knowledge was consolidated with the results of the study MIRA conducted from 2006 to 2009.This study was fundamental from a scientific point of view because it included (from the beginning) 120 families divided into two groups, with 60 families in the experimental group and 60 families in the control group. Multiple variables were measured, such as stress and anxiety as a function of the salivary cortisol of the children and parents (mainly the mothers). Nearly 10,000 saliva samples were collected and analyzed. We also had to also raise, assess, train and assign 120 dogs during the research period. In the middle of the experiment, during the month of August 2007, Dr. Robert Viau passed away.

During the classes prior to the placement of a dog (which take place over a continuous period of five days at MIRA facilities), the discussions between parents highlighted the isolation and social exclusion they were experiencing. Parents also brought up the major difficulties in accessing services, including diagnosis and intervention services at a young age. During our research, MIRA targeted families with children of between 5 and 10 years of age. However throughout this period we received requests from parents with children of less than 5 years of age, and also requests from parents with children of over 10 years of age.

Since establishing this research, and in studying the current results on the impacts of a dog in the lives of the children and their families, MIRA has implemented a program applying the research results, called "Schola Mira". The program, which is funded by the Marcelle and Jean Coutu Foundation, works to place service dogs with families who have a PDD/ASD child. The last ten years of work have allowed for the establishment of a project built on research results and application. These results have laid the groundwork for the future of families with PDD/ASD children, for MIRA, and for all of MIRA’s partners and volunteers.

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