Assistive Dogs as an Employment Support for Individuals with Autism Spectrum Disorders

1. Assistive Dogs as an Employment Support for Individuals with Autism Spectrum Disorders Presented by: Andrew Clemons Kelly Kort, MA, NCC Sandra Hulme, M.Ed. Darlene Groomes, Ph.D., CRC, LPC Gary Mesibov, Ph.D. APSE 2013 Indianapolis, Indiana

2. Agenda and Basic Housekeeping • Brief introductions • Review research study and findings • Gallery walk (50 minutes) • Three discussion break-outs, 15 minutes each, rotate • Writing out input, disputes, and brainstorming with multidisciplinary research team • Reconvene large group (15 minutes) • Texting and Notecard Questions/Comments • 517-896-9807 • Email takeaways to participants within two weeks

3. Exploring Interactions with Dogs through OUCARES Programming • Our purpose • Adolescents with ASD • Decrease stress • Increase pro-social behavior • Encourage adaptation to disability • Whether innovative • Outcomes from a social skills program • Dog interacting with one group

4. Research Specifics • Fourteen adolescent participants (12 males, 2 females; mean age= 13; mean school grade level= 7th) were randomly assigned to experimental and control groups • Both groups received six one-hour sessions (once per week, over six weeks) • Researchers designed the social skills curriculum; the content for both groups was identical • Delivery fluctuated due to the use of different instructors and utilization of the dog

5. Research Specifics • Participants and their families completed measures: • Introductory Questionnaire • Multidimensional Anxiety Scale for Children (MASC) • Adaptation to Disability Scale-Revised (ADS-R) • Autism Social Skills Profile (ASSP)

6. Findings • Qualitative analyses • Themes analysis identifies themes of self-assuranceand openness toward others • Ongoing coding analysis indicates increased occurrence of pro-social behaviors in the experimental group compared to control group • Preliminary results suggest that HAI may provide a means of helping adolescents and family members to employ pro-social behaviors

7. Benefits • Social skill-building/enhancement experiences • Exposure to dog • Social interaction • Desensitize and teach tolerance to those who state apprehension around dogs • Professional service providers observed use of dogs as safe and effective for OUCARES programming

8. Benefits • Improved levels of emotional well-being from this experience during a time in development when peer interactions typically challenge mental health outlook • Parents/guardians, too, benefit from the engagement that they had with their child • Magic benefited from human contact, healthy treat rewards, and attention.

9. Risks and Challenges • Child could respond negatively to the dog or another child in the group. • The long-haired German Shepard, Magic, is a certified assistance dog, trained through For Better Independence Dogs in Mason, Michigan • https://www.facebook.com/Forbetterindependence • Beth and Gary Spanski

10. Text Questions and Comments: 517-896-9807 Gallery Walk • Three topical interest areas, 15 minutes at each • HAI Integrated Employment Programs and Quality of Life • HAI and Its Applications for Individuals Living with Autism in Integrated Employment and Transition Settings • Quality Mechanisms Needed in an HAI Integrated Employment Program • Lead facilitator will provide a brief context, info on slides • Participants to dialogue, debate, deliberate • Facilitator to scribe information • Moderator will note time to shift • Facilitator of different interest area will shift • Reconvene in larger group with “audience speaker” highlight 15 minutes each

11. HAI Integrated Employment Programs and Quality of Life • Implications of social skills on overall well-being • WHO definition (1998) • Quality of life reflects the perception of individual’s life, in the context of their culture and value system, that their needs are being satisfied and that they are not being denied opportunities to achieve happiness and fulfillment, regardless of physical health status, or social and economic conditions. • HAI stimulates social interaction and social competence • Advances in neuroscience have provided us with valid research into how the social brain works • The mechanisms by which oxytocin and vasopressin contribute to human social behavior • The role of oxytocin and vasopressin in autism spectrum disorders • Correlations between basal oxytocin levels and the strength of social and bonding behaviors

12. HAI Integrated Employment Programs and Quality of Life • Oxytocin and vasopressin are emerging as targets for treatment approaches • Prosocial effects of intranasal application of oxytocin • Oxytocin released during certain types of HAI • Potential link between HAI effects and the oxytocin system • Oxytocin and HAI effects largely overlap as documented by research in both humans and animals • Offers an explanation of the effects of HAI • Advantages of using HAI to increase oxytocin levels • Non-medical interventions • Additional benefits

13. HAI Applications • For individuals living with autism • Integrated employment • Transition settings • “Individuals with autism are generally not provided with the skills necessary to successfully move from school to post-secondary education, integrated employment (including supported employment), adult services, independent living, or community participation” • How to attain, maintain, & retain employment • “A review of the current literature on outcomes for adults with ASD indicates that, independent of current ability levels, the vast majority of adults on the spectrum are either unemployed or underemployed and, further, that large numbers of adults with autism remain without any appropriate services.” (Gerhardt, P.F. & Lainer, I., 2010)

14. HAI Applications • Utilization of animals as a potential adaptive strategy • Occupational Therapy • View as an assistive technology • Alternative service/device • “To be effective in this expanding practice area, occupational therapists must understand how persons with physical disabilities use their service dogs as an adaptive strategy and what factors affect the success of this strategy.” • Increased development of independence, employable skills, and psychosocial functioning • “Service dogs provide common ground, bridging the differences that may cause social isolation and facilitating a renewed sense of connection with others.” (Camp, M.M., 2000)

15. HAI Program Design Considerations • ADA titles I (employment) and III (public access) definitions and regulations. • Information on documentation and employer’s role from the Job Accommodation Network (JAN). • HAI: anxiety management, social skills, and behavior assistance. • Individualization: accommodations suited to the neurodiversity of the individual and the unique employment environment. • Cycle of design, implementation, and evaluation: creating a cycle of service improvement.

16. Implementation and Evaluation • What goals does the individual have for the workplace? • How can an assistance dog be utilized to promote these goals? • Can HAI be integrated into your organization’s evaluation protocols? • Remembering the cycle: Implementation is tied to evaluation. All program aspects must be evaluated.

17. Optimizing Employment Retention Key Questions: • With all of the positives, why are there still such challenges for workers living with ASD? • How can HAI be utilized to optimize long-term employment success for this individual in this work environment?

18. Optimizing Employment Retention What We Know: • Successful and ongoing employment results from careful consideration of individual characteristics and implementation of proper supports (Hendricks, 2010). • We know that employment improves quality of life (Garcia-Villamisaret al., 2002) – creating a cycle of progress. • Successful employment is the primary aspiration of adults with ASD (Hendricks, 2010). • Employers value the trustworthiness, reliability, and low absenteeism of individuals living with ASD (Howlin et al., 1995; in Hendricks, 2010). • An individual’s strengths, and neurodevelopmental characteristics, may translate into unique job strengths.

19. For More Information Darlene Groomes, Ph.D., CRC, LPC Associate Professor Principal Investigator groomes@oakland.edu 248-370-4237 To continue the DDD: www.vocational-rehab.com “Resources” tab for copy of presentation RPEN blog to continue our discussion and questioning

20. References Beetz, A., Uvnas-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: The possible role of oxytocin. Frontiers in Psychology, 3.doi:10.3389/fpsyg.2012.00234 Bellini, S., & Hopf, A. (2007). The development of the autism social skills profile: A preliminary analysis of psychometric profiles. Focus on Autism and Other Developmental Disabilities,22(2), 80-87. doi: 10.1177/10883576070220020801 Camp, M.M. (2000). The use of service dogs as an adaptive strategy: A qualitative study. American Journal of Occupational Therapy, 55, 509-517. Department of Justice. (2011). Title III regulations. Retrieved from: http://www.ada.gov/regs2010/titleIII_2010/titleIII_2010_withbold.htm García-Villamisar, D., Wehman, P., & Navarro, M. D. (2002). Changes in the quality of autistic people’s life that work in supported and sheltered employment: A 5-year follow-up study, Journal of Vocational Rehabilitation 17(4), 309–312. Gerhardt, P.F. & Lainer, I. (2010). Addressing the needs of adolescents and adults with autism: A crisis on the horizon. Journalism of Contemporary Psychotherapy, 41, 37-45.  Groomes, D. A. G., & Linkowski, D. (2007). Examining the structure of the acceptance of disability scale. The Journal of Rehabilitation, 73(3), 3-9. Howlin, P., Jordan, R. R., & Evans, G. (1995). Distance Education Course in Autism (Adults, Module 3, Unit 3). University of Birmingham, School of Education. Birmingham: UK. JAN: Job Accommodation Network. (2011). Accommodation and compliance series: Service animals in the workplace. Retrieved from: http://askjan.org/media/downloads/ServiceAnimalsintheWorkplace.pdf

21. References Kurtz, A., & Jordan, M. (2008). Supporting individuals with autism spectrum disorders: Quality employment practices. the institute brief. issue number 25. ICI professional development series. Institute for Community Inclusion. University of Massachusetts Boston. Retrieved from: http://search.proquest.com/docview/881466584?accountid=12924 March, J. S. (1999). Multidimensional anxiety scale for children manual. TX: Pearson. Meyer-Lindenberg, A., Domes, G., Kirsch, P., & Heinrichs, M. (2011). Oxytocin and vasopressin in the human brain: Social neuropeptides for translational medicine. Nature Neuroscience, 12, 524-538. doi:10.1038/nrn3044 Modi, M. E., & Young, L. J. (2012). The oxytocin system in drug discovery for autism: Animal models and novel therapeutic strategies. Hormones and Behavior, 61, 340-350. doi:10.1016/j.yhbeh.2012.01.010 Morgan, R. L., & Schultz, J. C. (2012). Towards an ecological, multi-modal approach to increase employment for young adults with autism spectrum disorder. Journal of Applied Rehabilitation Counseling, 43(1), 27-35. Retrieved from: http://search.proquest.com/docview/963777414?accountid=12924 Standifer, S. (2009). Adult autism and employment: A guide for vocational rehabilitation professionals. Columbia, MO: University of Missouri Health System: Disability Policy and Studies, School of Health Professions. Striepens, N., Kendrick, K. M., Maier, W., & Hurlemann, R. (2011). Prosocial effects of oxytocin and clinical evidence for its therapeutic potential. Frontiers in Neuroendocrinology, 32, 426-450. doi:10.1016/j.frne.2011.07.001 Tareen, R. S., & Kamboj, M. K. (2012). Role of endocrine factors in autistic spectrum disorders. Pediatric Clinics of North America, 59, 75-88. doi:10.1016/j.pcl.2011.10.013 Viau, R., Arsenault-Lapierre, G., Fecteau, S., Champagne, N., Walker, C., & Lupien, S. (2010). Effects of service dog on salivary cortisol secretion in autistic children. Psychoneuroendocrinology, 35, 1187-1193. doi:10.1016j.psyneuen.2010.02.004 Zink, C. F., & Meyer-Lindenberg, A. (2012). Human neuroimaging of oxytocin and vasopressin in social cognition. Hormones and Behavior, 61, 400-409. doi:10.1016/j.yhbeh.2012.01.016