Forum di Psicologia - Blogs - Debra Buttram

Animal Assisted Prog for adults w/ chronic psycho-physical/psychiatric disablities

Debra Buttram — Mon, 02 Feb 2009 15:51:35 GMT

ABSTRACT:
An Animal Assisted Programme for adults with psycho-physical and/or psychiatric disablities in a chronic phase
Debra Buttram, Marcello Galimberti - AIUCA, Via IV Novembre, 26 - Bosisio Parini (LC), Italy aiuca@aiuca.org , Wilma Ratti, Claudia Robustelli - Casa di Cura Villa San Benedetto, Albese con Cassano (CO), Italy

The programme described here is involves 13 adults (6 female, 7 males) ranging in age from 30 to 50 years, all affected by organic deficiency such as cognitive development disorder (medium to severe), alcoholic dementia, cerebral stroke or psychiatric disorders, psychosis and anomalus behavioural problems. The two female professional special needs educators that work in the programme also work daily with the clients who are residents in mental health institute.
The programme, funded by the institue itself, began in January 2006 and continues at the time of writing with 1 hour weekly sessions in which a Pet Partners® team (one male handler/one 8-year female dog) is active in the group. The overall goals are to move the concentration of the residents from their own personal needs and discomfort, potentialise individual resources, channel frail and unstable emotions and uncontrolled impulsiveness so that they may assume and carry out finalised work.
In the presence of the dog, the residents show a natural sense of nurturing, leading to their activation in various tasks related to the dog�s care, tasks that they initiate and constantly and continually perform. Certain subjects, normally very passive to esternal stimulation and inhibited in their relational and comunicational capacities, have reached very positive results. It seems that touching, petting and taking care of the dog has awoken in them strong emotions tied to past personal experiences which leads them to seek out interaction with others, often the educators or the handler, in order to share the pleasure of recounting their experiences.

Particularly meaningful is the case of T., 35 year-old female affected cognitive developmental disorder, psychosis with persecutory ideation and aggressive impulses. The presence of an animal in the ward gratifies her affectively, concretely offering her a dimension in which she can share with the other residents.This led the educators to intervene with more specific objectives in order to help her modify aspects of her behaviour that are not functional in this context, enabling her to extend this in other moments of daily life in the institute. Other positive influences noted:
- willingness to help others carry out tasks regarding the dog�s care;
- respect for the needs and timing of the others;
- modification in communication with clear and precise expression;
- increased capacity to control her emotivity,
- increased ability to enjoy the moment, suffering less of the psychotic fixations leading to increased well-being and decrease in aggression.

The strong points of the programme are the definition of a starting point in which the affective-relational needs of the residents find a place and the temporal continuity during which behavioural developments and changes are noted. There is no pre-defined point of arrival, only the relationship with the dog and the reaction of the residents. Mutual understanding and agreement between the handler and the educators, investment of objectives and intentions in a projectual synergy towards assuring the well being of both the dog and the residents has been fondamental to the outcome.

ORAL PRESENTATION
IAHAIO 11th International Conference (Tokyo, 6-9 October 2007) ]]>

ABSTRACT: Animal Assisted Therapy with traumatised children in comunal living setting

Debra Buttram — Mon, 02 Feb 2009 15:49:20 GMT

Animal Assisted Therapy (AAT) with traumatised children living in a comunal setting
Debra Buttram, Marcello Galimberti -, AIUCA, Via IV Novembre, 26 - Bosisio Parini (LC), Italy aiuca@aiuca.org A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza , Sara Brunetti, Cristina Tarabusi - : Centro Assistenza Minori, Milano, Italy

This AAT programme was started in October 2005 with the goal to implement, and further understand, the potential of AAT programmes for children not affected by organic pathologies, but with affective-relational and behavioural problems due to early traumatic experiences. The children in question suffer profound affective deficiency and attachment disorders that often are manifested by affective and cognitive inhibition and hyperactivity.

Funding for the programme is in part by donation of a charity organisation and in part by the local provincial government.

The specific objectives of the programme are:
- to help the children to enter in contact with their own emotions, in function of their individual problems and therapeutic objectives, indivualised by health and educational professionals of centre;
- to define a more specific intervention methodology for such work.

Seven children ranging from 4 to 6 years (four females and three males),all residents of a public residential centre that hosts abandoned minors as well as minors removed by juridical decree of the courts from multiproblematic families were involved in the programme. Initialy the children were placed in one of three small groups, homogenous by age, individual particularities and characteristics of their disorders. Later we realised that individual sessions were preferable and changed to that format.
During the 40-minute weekly sessions, three professional figures are present - two female psychologists (one therapist, the other observer) and one Pet Partners® team (one 5-year old female dog/male handler and one 4-year old male dog/male handler). Each child interacts with one dog at a time according to the child�s behaviour and the objectives identified by the equipe.

The setting is a medium-sized room with a large floor mat, a large wall mirror, toys for the children and the dog, paper, coloured pencils, water, etc. During the sessions, the child is free to interact with the dog, the handler helping the child to comprehend the animal�s behaviour and comunication and offering concrete support in the dog-child interaction. The therapist interprets the actions and behaviour of the child, helping him to understand emotions that imerge. The observing psychologist collects salient elements of the interaction, subsequently elaborating them together with the therapist.

The methodology applied has proved effective and over time (the programme is still underway at the time of writing), it has been noted that the children have shown greater ability to:
- recognize and communicate their own needs, thoughts and emotions;
- differentiate between self and other;
- accept physical contact with another;
- approach the symbolic area (design, game);
- contain their aggressiveness;
- canalise their hyperactive tendencies in structured, intentional games;
- reduce behavioural isolation and affective withdrawal.

In generale, within a similar setting and utilsing a methodology as described here, we believe that traumatised and affection deprived children might form an affective relationship with an animal which can become a privileged channel through which to express trauma and interiorise therapeutic messages.
We are pleased with these results and believe that the field is deserving of ulterior work and research.

ORAL PRESENTATION
IAHAIO 11th International Conference (Tokyo, 6-9 October 2007) ]]>

Abstract: A master of science course on animal assisted activity + therapy (aaa/aat)

Debra Buttram — Mon, 02 Feb 2009 15:46:36 GMT

A MASTER OF SCIENCE COURSE ON ANIMAL ASSISTED ACTIVITY AND THERAPY (AAA/AAT): AN ANSWER FOR THE FUTURE?
Diverio S.1, Quartesan R.2, Buttram D.3*, Galimberti M.3* and Weber H.,4
1 Dipartimento di Scienze Biopatologiche e Igiene delle Produzioni Animali e Alimentari, Facolt� di Medicina Veterinaria, Via S. Costanzo 4, 06126 Perugia 075-5857642-46 silvana.diverio@unipg.it
2 Dipartimento di Medicina Clinica e Sperimentale, Facolt� di Medicina e Chirurgia, via del Giochetto, Padiglione WW, Perugia
3 AIUCA, Via IV Novembre, 26, 23842 Bosisio Parini (LC), corresponding authour: email: aiuca@aiuca.org web: A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza
4 Il Telaio, via Fabrianese 14, 06134 Ripa, Perugia
In our country there is an increasing number of AAA/AAT programmes implemented by private and public institutions. However, notwithstanding their high level of personal motivations, AAA/AAT professionals (therapists, planners, educators, etc.) often lack specific and focused professional expertise, and also well designed and scientific methods for assessing the efficacy of their programmes. In the attempts to fill this gap, Animal Assisted Programmes have been included as a collateral discipline in few University Masters and different private training courses are being held within the national territory. However, such a wide spectrum of offers is leading to difficulty in the recognition of corresponding professional knowledge and level of competence acquired.
As of October 2006, a dual-faculty one-year Master of Science Course in �Animal Assisted Activities and Therapies (AAA/AAT)� has been established by the Faculty of Veterinary Medicine and the Faculty of Medicine and Surgery at this university. In our country, it is the first public institutional course realised in the field. This MSc course is a collaborative project between the university professors, Pet Partners® team instructors and team evaluators of the Delta Society� representatve in our country and the Coordinator of Equine Rehabilation Programs of the Cooperative.
The MSc Course has been addressed to a maximum of 25 participants represented by postgraduate students and professionals of different disciplines (public health, rehabilitation, education, psychology and psychiatry, human and veterinary medicine) whose expertise is usually strictly integrated in team working on AAA/AAT programmes. Since the animal handler is a fundamental unit in such teams, a few non-graduate partecipants, who want to become animal handlers, have been allowed as auditors.
The MSc Course has been developed on a 1500 hours programme, as follows: teaching and practical training (400), training stage (240), final dissertation (260) and individual study (600), all aimed to increase specific professional areas of knowledge. It has adopted an innovative approach in involving the student�s dogs as real participants, providing opportunity to form and evaluate them and their human handler by the standards and guidlines of the Pet-Partners® Programme utilised in this country.
Upon finishing the MSc Course, the students should be able to plan, implement and assess AAA/AAT projects and to acquire the abilities to coordinate them and work in a team with scientific and professional methods. The MSc Course establishes a new standardized programme of professional training which :
- Is well recognized by public institutions, such as our provincial government which funded this first year;
- Will promote higher qualified AAA/AAT programmes, leading to greater improvement in social and public health programmes;
- Offer a higher level of functioning, safety and well-being in AAA/AAT programmes, for all involved: institutes, professional operators or therapists, clients, handlers and, last but not least, the animals.

ORAL PRESENTATION
IAHAIO 11th International Conference (Tokyo, 6-9 October 2007) ]]>

The effects of AAT on the interaction abilities of children with autism

Debra Buttram — Mon, 02 Feb 2009 15:44:16 GMT

The effects of Animal Assisted Therapy (AAT) on the interaction abilities of children with autism

Cecilia Carenzi1, Marcello Galimberti2, Debra Buttram2, Emanuela Prato Previde1
1Istituto di Psicologia � Universit� degli Studi di Milano, via Tommaso Pini 1 � 20134 Milano, Italy
2AIUCA, Via IV Novembre 26, 23842, Bosisio Parini (LC), Italy, A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza, aiuca@aiuca.org

From Boris Levinson�s accidental discovery that the presence of an animal can be positive for problematic children, further studies have lead to different types of intervention, including Animal Assisted Therapy and Activities.

Although there is increasing interest regarding this argument, also noted in Italian institutions, research conducted with rigorous methodology finalized to understand the mechanisms of AAT are extremely limited.

Aim of this research was to asses the effects of AAT on children affected by Pervasive Development Disorder (PDD), developing an observational methodology to test the efficacy of AAT intervention.

The study was conducted between January- and June of 2004. 5 children (4 males,1 female) ranging from 3-5 years of age, all diagnosed with PDD (F84.0 according to the system of classification ICD10) participated in the study. Each child was involved in the weekly individual sessions in which the actors were the child, the female psychologist and one Pet Partners� team (one 6-year old male dog/female handler and one 3-year old female dog/male handler, according to the child�s needs identified by the treatment equipe). Observations were carried out in a medium-sized room, containing a mat, some equipment for playing with and taking care of the dog and a hidden videocamera for behaviour recording.
A pre test session was conducted to obtain a base-line evaluation and to collect data about specific area of interest; post test session was carried out at the end of the programme to evaluate the effect of the programme and mainly of the interaction with the dog.

Pre test and post test sessions were structured ad hoc and consisted of a period of interaction without dog presence, followed by a period of interaction with dog presence. Each session consisted of an interaction game and the reproduction of an unfamiliar action demonstrated by the psychologist.

The behaviour of each child was scored from videotapes, and the behaviour of interest for autistic children were recorded in terms of frequency and/or duration. A single case methodology was utilised.

From the analysis of all the encounters, a clear trend in children behaviour was not evidenced, due to the fact that each encounter had peculiar characteristics. We found that the dog�s presence had positive effects on:
� the children�s capacity for interaction;
� the duration of the interactions, which was longer in dog�s presence;
� the ability to complete actions requested by the psychologist.

The overall differences between pre-test and post-test sessions were limited; however differences between the encounters in presence of the dog and those in absence of the dog were evidenced.
Further research is needed to obtain a deeper understanding of the effects of dog presence on autistic children behaviour.
ORAL PRESENTATION
IAHAIO 11th International Conference (Tokyo, 6-9 October 2007) ]]>

Abstract: Animal assisted education in a socio-educational centre for adults

Debra Buttram — Mon, 02 Feb 2009 15:41:58 GMT

ANIMAL ASSISTED EDUCATION IN A SOCIO-EDUCATIONAL CENTRE FOR ADULTS WITH SEVERE PSYCHOPHYSICAL DISABILITIES
Debra Buttram, Marcello Galimberti of AIUCA - Associazione Italiana Uso Cani d�Assistenza, Via IV Novembre 26 - 23842, Bosisio Parini (LC), Italy A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza
and Egle De Capitani of Centro Socio Educativo, Associazione Genitori ed Amici degli Handicappati, Via Paladini 3 - 23891 Barzano (LC), Italy

Persons affected by severe psychophysical disabilities who have already terminated their normal scholastic activities frequent the Socio-educational Centre. They remain under the centre�s care for all their adult life from the age of 14 years. The diversity of age, disability, etc creates a need in the educational staff to search for new and different stimulus in order to permit both staff and clients to cultivate motivation for working in educational and relational areas, therefore obtaining a higher level of individual well-being. Individual Educational Plans (IEP), based on individual needs and educational goals, are prepared for each client and activities are planned in order to arrive at the specified objectives. One activity undertaken with some of the more difficult cases is Animal Assisted Education (AAE).

The first year was left as an experimental activity with a one-hour weekly session for a group of 4 individuals. Given the results achieved, in the second year we increased to two one-hour weekly sessions with one group of three and one individual program. At the current year we have three sessions, one of which is one hour with one individual and the other two sessions are 45 minutes of which one is individual and the other a group of two clients. The program is directed by the educational staff and given support by three specially prepared and evaluated handler-dog teams, registered Delta Society� Pet Partners�.

The AAE program has permitted us to work towards objectives, which are difficult to achieve otherwise. Indeed, we have verified that certain clients who experience severe relational problems (closure to reality, obsessions, isolation) are diverted from isolation through spontaneous interactions with the dog. The presence of the dog facilitates both client-educator and client-handler interactions. Within the setting, our clients find strong motivation for dialogue, with the dog often stimulating discussions. What is particularly important to us is the fact that this motivation is carried forward into other moments as the clients tell others (friends, educators, parents, etc) about their experiences with �their� dog.

Some individuals work on verbal communication, implementing vocabulary and improving pronunciation through speaking to and about the dog, giving commands, etc. For individuals without verbal communication, facilitated communication with representative images is implemented in order to allow the individuals to express what they desire to do (pet, walk with the dog, offer water, etc) increasing capability for decision-making, bettering observational and communicative skills, increasing their possibilities to have control and therefore enhancing their self-esteem.

Petting, brushing, holding the leash during a walk, playing with the dog also permits friendly collaboration for physical movement for improved posture or motor ability.

AAE gives us the possibility to work towards specific goals in a relaxed, serene and cheerful relational environment.
POSTER PRESENTATION
IAHAIO 10th International Conference (Glasgow, 6-9 October 2004) ]]>

ABSTRACT: AAT in Physical Therapy - ambulatory rehabilitation

Debra Buttram — Mon, 02 Feb 2009 15:40:23 GMT

Animal Assisted Therapy in Physical Therapy for ambulatory rehabilitation following amputation of a lower limb: A clinical case.
Giovanni Bigatello, Alessandra Lukacs, Alessandra Terragni of Fondazione Ca� Industria ONLUS, Via Brambilla 61 - 22100, Como, Italy and Debra Buttram, Marcello Galimberti of AIUCA - Associazione Italiana Uso Cani d�Assistenza, Via IV Novembre 26 - 23842, Bosisio Parini (LC), Italy A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza

One of the most difficult challenges in rehabilitative therapy is ambulatory re-education for an elderly person with an artificial lower limb. Lengthy and difficult programs combined with pain caused when walking with the prosthesis, produces satisfactory outcomes in few cases. Positive end results become even more difficult to achieve when the client is recovered in a nursing home; lack of interest and prospects, a sense of abandonment and reduction in self-esteem allow the client to retain such a program useless. With these pretences, the case presented seems particularly significant in which an elderly female achieves an excellent level of recuperation through the implementation of Animal Assisted Therapy (AAT) in support of a traditional Physical Therapy (PT) program.

Clinical case: In July 2002, E.C., an 83-year-old female, was recovered in the nursing home after the November 2001 amputation of her lower right limb at thigh level due to a vascular disease. Upon entrance in the institute, E.C. manifested decisive intention to walk again, even without prosthesis, and was immediately placed in a PT program for ambulatory rehabilitation. Notwithstanding E.C.�s intention to undergo rehabilitation, hostile behaviour towards the physical therapists involved in the program, rendered collaboration precarious and therefore also the efficacy of the rehabilitation itself. When asked if she would like to participate in a particular program in which dogs are involved, she accepted enthusiastically and was immediately inserted in a program of AAT.

The AAT program, conducted in the institute by two female physical therapists, was planned together with and is carried out with two specially prepared and evaluated handler-dog teams, registered Delta Society� Pet Partners�. The dog involved is a 6-year-old mixed breed female; one handler is male, the other is female. During the AAT sessions, E.C. is actively involved in taking care of (brushing, walking, getting water for, etc) and playing with (hide-and-seek games, etc) the dog. During the weekly sessions in which the dog is involved, E.C. is enthusiastic and collaborative. In other PT sessions, sometimes her old hostility emerges.

E.C. was fitted with a provisional prosthesis in November 2002 and with her definitive prosthesis in December 2003. The use of the prosthesis, allowed a change in the exercises and interaction with the dog (throwing toys, clapping her hands to recall the dog, etc), which allowed for further progress and significant improvement in balance. The mechanism of equilibrium has become automatic and E.C. has acquired a sense of security necessary to achieve an excellent level of autonomous, not only functional, walking.

We maintain that AAT contributed in a decisive manner rendering possible the close collaboration necessary for the positive outcome of this long (one and a half year), complicated rehabilitation program, which, upon writing in February 2004, is still progressing.

POSTER PRESENTATION
IAHAIO 10th International Conference (Glasgow, 6-9 October 2004) ]]>

ABSTRACT: Animal Assisted Activity/ Education: Increased communication possibilities

Debra Buttram — Mon, 02 Feb 2009 15:38:08 GMT

Animal Assisted Activity and Education: Increased communication possibilities for persons with severe psychophysical disabilities
Debra Buttram**, Marcello Galimberti** - Monica Radealli* -*Centro Socio Educativo, of Lecco, La Vecchia Quercia Cooperative, 23900 Lecco, Italy - **AIUCA, 23842 Bosisio Parini (LC) Italy A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza

Clients of the Socio-educational Centre are affected by severe psychophysical disabilities, most characterised by a strong closure towards the external world, often induced by their lack of interpretational and communicative instruments. Their communication is a combination of variations in muscular tone, sounds, vocalisations and gestures. The grave difficulties of the centre�s professional educators in finding appropriate stimulus for many clients, together with awareness that a dog�s use of non-verbal body language might be similar to some of the individuals, led to implementation of Animal Assisted Activity (AAA) and Animal Assisted Education (AAE) programs.

In 1997, only three clients were involved, but due to positive results and increased possibilities of communication were recognised, the number of persons involved increased. As of February 2004, 10 (9 females and 1 male with varying disabilities and ages ranging from 15 to 38 years) of the 24 persons frequenting the centre are involved. Four female special needs professional educators and specially prepared and evaluated handler-dog teams (Delta Society� Pet Partners�) work in the program with two educators and at least one team in each 90-minute weekly session. The handler is male and the dogs are male and female golden retrievers.

Depending on individual capability, we work on different levels of communication. Physical contact with the animal helps relax body tone, lowering anxiety and in turn facilitating reality exploration and self-perception. The potential of communication through the use of their own body is amplified through direct contact with the body of the dog. Feeling soft warm hair, hearing rhythmical breathing or a bark are strong incentives that can motivate desire for attachment and nourish a sense of self.

These rich relational experiences require new communicative codes and instruments for interaction with the dog; gestures are refined to become commands to which the animal responds, therefore building self-confidence and self-esteem. Facilitated communication using representative images, another valid tool, permits some to express their own desires and preferences. Individuals capable of verbal communication, learn new vocabulary inherent to the dog (objects, body parts, commands). The desire for non-mediated communication favours the capacity of functional self-expression with attention to posture and facial expressions.

Work procedures are educational: observation, planning, verification and remodulation. Improvement in psychophysical health brings improvement in quality of life, strengthening the activities and reinforcing communicative tools. Results are monitored using Service of European Quality ISO 9001:2000 evaluation instruments and video registration.

Given the positive results, virtually unobtainable previously, we believe AAA/AAE programs to be an indispensable means of allowing similar individuals to be immersed in a world of exchanges with others, to be recognised and accepted. ]]>

ABSTRACT: AAT with a 21-month-old child with psychomotor developmental disorder

Debra Buttram — Mon, 02 Feb 2009 15:33:31 GMT

ORAL PRESENTATION
IAHAIO 10th International Conference (Glasgow, 6-9 October 2004)

Animal Assisted Therapy with a 21-month-old child affected by severe psychomotor developmental disability and relational isolation
Debra Buttram***, Marcello Galimberti***, L. Cohen** Maria Capello*, - *Centro Assistenza Minori and **Unit� Operativa di Neuropsichiatria dell�Infanzia e dell�Adolescenza, Milano, Italy - ***AIUCA, 23842 Bosisio Parini (LC), Italy

K. was placed in a public residential centre for minors at the age of 5 months after being removed from his family due to their severe ineptness for parental duties based on a judicial ruling. Both parents are very limited cognitively and the mother is affected by personality disorders.

Upon entrance in the centre, K. manifested clear deficiency in many areas ranging from emotional and relational to psychomotor skills as compared to what he should normally be able to develop. Notwithstanding a program rich in relational and environmental stimulation plus special psychomotor program, after one and a half years, K. displayed ever more evident signs of isolation with a progressive arrest in psychomotor skills; K. did not walk, did not talk and manifested stereotypical behaviour.

With the belief that a certain rapport might be established with a dog, offering motivation to K., a program of Animal Assisted Therapy (AAT) involving a specially prepared and evaluated handler-dog team (registered Delta Society� Pet Partners�) was established. The program was elaborated by different professional figures including the centre medical director, child neuropsychiatrist, psychologist, professional educator, psychomotor specialist and a dog handler. During the weekly 50-minute sessions, only the psychomotor specialist, professional educator and Pet partner team were present. The dog handler is an adult male and the dog is a 2 and a half-year-old female Golden-Labrador mix chosen in particular for her adeptness in interacting with K. in a completely spontaneous, free and safe manner.

Some of the results documented in this program are:
- a definite decrease in isolation - participation through eye contact, observation and reaction to the environment;
- more relaxed and varied facial expressions, less sullen and gloomy;
- a relational openness initially manifested through seeking contact with the dog and eventually transferred towards the adults present;
- an important conscious use of his body in exploring the environment and the passage from poor, non-functional movement to more evolved motor ability - from a sitting position, K. moved to crawling and eventually walking upright.

We believe that interaction with the dog, particularly stimulation through body contact, offered K. profound sensations and emotions that reactivated his interest in the outside world. For a child of this developmental level, an animal is somewhere between object and human being and therefore often considered as an �animated object�, allowing a gradual evolution of sentimental and emotional investment which can eventually be transferred from animal to humans.

AAT programs are being started with other children in the centre. ]]>

Abstract: Animal assisted therapy in alzheimer patients

Debra Buttram — Mon, 02 Feb 2009 15:30:53 GMT

7th International Geneva/Springfield
Symposium on Advances in
Alzheimer Therapy
03-06 April 2002 - Geneva, Switzerland

ANIMAL ASSISTED THERAPY IN ALZHEIMER PATIENTS: PRELIMINARY IMPRESSIONS OF A PILOT EXPERIENCE IN ITALY
G Bigatello, D Buttram, M Galimberti, P Fresca, A Ghibaudi Istituto Geriatrico Ca' d'Industria, Como and AIUCA, A.I.U.C.A. - Associazione Italiana Uso Cani d'Assistenza Bosisio Parini (LC), Italy

Animal Assisted Therapy (AAT) has shown beneficial effects in patients with Alzheimer Disease (AD). In particular, a reduction in disruptive behavior and mood disorders as well as an improvement in social behaviors have been observed. Starting with these observations, in January 1999 we began programs with the Associazione Italiana Uso Cani di Assistenza (AIUCA) (Italian Association for the Utilization of Assistance Dogs) to involve, in collaboration with our staff, appropriately prepared and selected dog-handler teams in our nursing home. Having observed an improvement in the general disposition and welfare of the patients who underwent preliminary treatment, in January 2000 we extended AAT to some of our most severely debilitated patients (UCLA Scale > 24, MMSE < 16), generally in sessions of one hour twice a week. During the 1 hour twice weekly session, which are held in a dedicated room, each of the 19 patients part of our Alzheimer Special Care Unit (ASCU) is encouraged to pet, brush, give treat to the dog, and walk them at the leash. They are also asked to recall memories and experiences with animals. Any resident who does not welcome contact with the dog, is gently guided out of the meeting room. Of 19 patients, only one female has shown no desire contact with the dog, 4 - 5 residents have seemed indifferent and all the others have manifested a definite enjoyment. Since we only recently started using on a regular basis the short version of the Severe Impairment Battery to evaluate our patients' response to the AAT, our present results are anecdotal. Nevertheless, we observed a decrease in behavioral disturbances, an improvement in their mood and at times pertinent verbal interaction. From these preliminary comparisons we believe that AAT deserves evaluation and possibly utilization in patients with AD.

References
1. Bigatello G, Lukacs A, Terragni A, Galimberti M, Buttram D. AAA/T in the nursing home: preliminary assumptions and comparisons of a pilot experience in Italy. Interactions: 18 (1): 8-9. 2000
2. Fritz CL, Farver TB, Kass PH, Hart LA. Association with companion animals and the expression of non-cognitive symptoms in Alzheimer's patients. J Nerv Ment Dis 183: 459-463. 1995 ]]>