PC1012: The Impact of Therapy Dogs on Anxiety and Emotional Management in the Pediatric Emergency Department

Background: Therapy dogs have been found to reduce anxiety in patients in various pediatric healthcare settings, but their use has not been extensively studied in the pediatric emergency department (ED).

Objectives: To determine the change in emotional management in children aged 4-12 years after a visit from a therapy dog and certified child life specialist (CCLS) handler, as measured by observed CEMS scores (Children’s Emotional Management Scale), and to determine the change in perceived level of child anxiety reported by caregivers before and after the visit, as measured by the Subjective Unit of Distress (SUD) score.

Methods: We conducted a prospective observational study at a large, urban, emergency department in a freestanding children’s hospital from May to July 2021. Children aged 4-12 years with at least mild anxiety as measured by a SUD score > 30 were eligible. Children were considered ineligible if they had evidence of active infection, were transferred from an outside facility, presented for burn care or dog bite injury, had recent history of neutropenia or oncologic process, were triaged as ESI category 1 or 2, if the patient or caregiver with a fear or allergy to dogs, or if they had already undergone a procedure. Participants received a 10-minute visit with CCLS and therapy dog. Modified CEMS (accounting for mask use) and SUD scores were recorded immediately prior and after intervention by our research team and caregiver, respectively. Participants were enrolled until a predetermined sample size was met. Differences between scores before and after the intervention were assessed for the overall sample and stratified by age group, using a paired Wilcoxon signed-rank test.

Results: 95 patients were approached, no families refused participation, and 41 met inclusion criteria and were enrolled. Demographics are described in the Table. No patients received psychoactive medications prior to the intervention. Overall results are reported in the Figure. Modified CEMS scores significantly decreased after the intervention in children (p < 0.001). There was a significant decrease in perceived anxiety of children via SUD score after the intervention (p < 0.001). Improvement of the child’s emotional management was not associated with age and score differences were significant for each age group (p < 0.001 – p = 0.024). Mean duration of intervention was 9.10 (3.58) minutes; mean ED length of stay was 3.33 (1.50) hours.

Conclusion: An encounter with a therapy dog and CCLS handler significantly improves emotional management and decreases anxiety in pediatric patients in the ED setting. As we have previously shown that caregivers perceive therapy dogs as calming for their child and praised the intervention, these results support future prospective randomized comparative trials involving therapy dogs in managing pediatric distress in the ED.