Attention-Deficit/Hyperactivity Disorder (ADHD) is the most commonly occurring neurodevelopmental disorder in the United States, with current prevalence between 8% and 11% (Visser et al., 2014). Evidence-based interventions include stimulant medications and psychosocial treatments but these practices are not always feasible or acceptable due to adverse side-effects, cost, availability, and poor treatment adherence and these children remain at significant risk for poor life outcomes. ADHD is considered to be a result of a physiological disruption of select catecholaminergic systems (e.g. dopamine, norepinephrine) and related under-arousal of cognitive functions of the pre-frontal cortex involved in executive functioning (EF; Godinez et al., 2015). Research indicates that AAI with dogs is effective for improving social-behavioral outcomes related to EF deficits (Schuck, et al., 2018a; 2018b). The mechanisms by which AAI improves outcomes for this group and mediators of these outcomes, however, is not yet understood. These gaps in understanding hinder progress in the application of AAI, and limit the acceptability and availability of this integrative health care practice. Our bio-social mechanistic hypothesis contends that dogs elicit physiological responses related to arousal of EF systems, thereby enhancing response to treatments. Furthermore, candidate individual differences potentially mediate outcomes. This work will explore these hypotheses by: 1) replicating findings from our previous AAI RCT, 2) exploring physiological responses to AAI over time, and 3) ascertaining if individual differences during AAI mediate primary and/or exploratory main outcomes. We suspect AAI will result in enhanced social-behavioral outcomes and improved diurnal patterns of HPA and ANS activity for these children. Furthermore, we suspect acute physiological responses to AAI (markers of HPA & ANS) and social interaction quality (child/child and child/dog) will mediate main outcomes. To explore these hypotheses, we will conduct an exploratory parallel-group randomized controlled clinical trial with 48 young children with ADHD, participating in psychosocial intervention with or without AAI using our manualized AAI model developed and found successful in our prior work. This work will yield the first information on candidate mechanisms thought to play an important role in AAI for children with ADHD, thus laying foundations for development of a fully powered, multi-site randomized clinical trial aimed to better inform approaches and promote acceptability and availability of AAI for children with special needs. Animal Assisted Intervention with Dogs for Children with Attention Deficit/Hyperactivity Disorder; Exploring Candidate Physiological Markers of Response to AAI
SSCHUCK_R21_20-033 PROJECT NARRATIVE This project explores physiological mechanisms thought to underlie the positive effects of AAI for children with ADHD and posits that interaction with dogs during treatment improves social-behavioral and physiological outcomes and that individual differences in bio-markers and interaction style mediate outcomes for this group.
