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| FEATURE STORY | 02/15/2006 |
| Author: Teddy Durgin | |
| Blending Assistance Dog Training with Therapy for Disabled | |
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| "In general, OTs have become more creative and do more program development. That's because funding is not as great as it used to be. Many funding sources provide either consultation or a nominal number of visits and expect individuals to make a lot of progress. But this is the art of living, of doing what you want to do, and you have to be able to help your clients to achieve that in a very small window of time. So, the therapist's skills have to be higher, the timeline has to be shorter and the treatment plans have to be more creative." So says Melissa Winkle, an occupational therapist at Adelante Development Center Inc. Winkle has certainly been creative throughout her time at the New Mexico-based facility. She and her friend and colleague Jill Felice, the founder of Assistance Dogs of the West in Santa Fe, came up with the idea of having people with disabilities help train assistance dogs as a medium to reach a variety of occupational therapy goals. People would graduate from this program with both the vocational and social skills that would come in handy in such animal-related workplaces as pet stores and grooming facilities. The dogs, in turn, would graduate with better working knowledge of how to serve people with disabilities. In 2004, Adelante helped to make Winkle and Felice's program—believed to be the first of its kind in the nation—a reality. Though dogs have been used in animal-assisted therapy for years, these pups are different. The dogs involved in the program Working Dogs at Adelante, function as living, breathing assistive technology; working one-on-one with individuals to help people with disabilities live and function more easily in their homes, their community, and even their work. Winkle, who graduated Magna Cum Laude from the University of New Mexico's OT program in the spring of 2001, recalls, "One of the problems Jill and I noticed was that many people training dogs could not mimic the movements or limitations of a person with a disability. For example, some might bend over to get an object from a dog. But after a hip replacement, you can't bend. You need the dog to find your hand and place the object you dropped directly into your hand. What we proposed was that it would be better for the dog to learn directly from people with disabilities. Prior research found that one of the problems with placing dogs with people with disabilities is that some people didn't actually have the ability to work with or care for the very dogs that help them. They had a hard time with, or were not able to perform, even the ‘simplest' tasks like feeding the dog or grasping a leash. These are serious considerations to alternative assistive technology placements. In addition, how is a person with a disability going to take care of the dog? Even though the dog is a type of assistance technology, they still have to be able to take care of it and have the ability to get the dog to work upon request. More often than not, people who return dogs can't take care of the dog, don't have support to help them keep up on the commands, don't have the memory or have declining health. We thought it would be really great to develop a program where we had people with disabilities actually helping to train the dogs. In the process we could refine training techniques or make equipment modifications." She continues, "We sat on this idea for a couple of years and decided that when we had the means and the timing was right, we would open a facility together. But as we started to investigate what it was going to take to open up a day program, we realized, if we did that, I would no longer be able to practice occupational therapy. I'd have to push a pencil all the time. Jill and I put our idea on hold and waited for the right opportunity. Shortly thereafter, someone saw the potential and invited us to try a pilot program at the agency he served. Jill and I considered it for about three months before we made the decision to give it a try. We initially thought he might just help us find grants." The man who showed such faith in their idea was Mike Kivitz, CEO of the Adelante Development Center. Adelante is an award winning, non-profit organization that provides a variety of programs for people with developmental disabilities, many of whom benefit from occupational therapy intervention. Now, many program participants benefit from vocational skills training by a person with the neurological, biomechanical and holistic background." The program was developed in response to the fact that many people with developmental disabilities find themselves doing non-skilled and unfulfilling work. This is, in part, because many people in the hiring positions assume they have low or no skills. The fact is everybody has skills and interests—but many have not had the opportunity to identify or explore them. In addition, many have had or currently receive traditional occupational therapy services. Our goal: Help clients identify and explore a variety of animal related interests as a medium for reaching occupational therapy goals." Most people are familiar with guide dogs for people who are visually impaired, and many may have heard of hearing dogs that alert people who have hearing impairments to such noises as a baby crying or a telephone ringing. The Working Dogs at Adelante, however, are trained to perform such tasks as opening and closing refrigerators, freezers and cabinets, loading washing machines and retrieving small items such as pencils or a remote control that a person may drop. The dogs are trained from the time they are puppies, in some cases as young as eight weeks old. In certain instances, older rescue dogs are used. For the most part, the program utilizes Golden Retrievers and Yellow and Black Labrador Retrievers. Winkle, who traces her experience with canines back to her eight years spent as a veterinary assistant, says, "Every now and then, mixed breeds are used. The puppy and dog selection process depends upon more than just the breed; it also depends upon the dog's work ethic. Jill can tell—it is like magic observing her make her selection. Even in a large litter of puppies, Jill will drop items without saying a word, and a pup will go over and pick it up and bring it back without asking—you can bet that they're all about the natural work ethic and the person. At the same time, with dogs at a shelter, you don't typically know their background, so you have to be a little bit more cautious in your selection and with the initial placement. We're very protective of our clients and don't want any bites or injuries. With all of Jill's experience with training, evaluating dispositions and behavioral analysis, she is really good at selecting dogs that can make the cut. I specialize in the people part of the team. Together, we make a really great match between trainers and dogs. The program's success is seen in our student trainers' abilities to convince a dog that retrieving prepackaged food without eating it is a good idea!" The Working Dogs at Adelante program supports a limited number of task trainers and a larger number of social trainers. The task trainers have primary responsibility for their dogs during the work day, doing everything from toileting and grooming to training and socializing the puppies to help them fulfill their roles as assistance dogs. Each person works on his or her own recreational, educational and vocational goals, and everyone receives occupational therapy. Task trainers attend the program at least 20 hours per week, take responsibility for a specific puppy and work with the animal for a period of six months to a year under the guidance of the assistance dog trainer and OT. When a young dog demonstrates appropriate skills, it is typically moved offsite to Assistance Dogs of the West in Santa Fe for advanced training by people with formal education and experience in assistance dog training. When a dog demonstrates consistent advanced skills, it is permanently placed with a person with a disability. Winkle notes that the most touching outcome is seen when a task trainer permanently releases the leash to another person with a disability in the program's annual graduation ceremony. She claims it can be a "three-tissue" event. Winkle is thrilled with the success of the program thus far. For her, it is the perfect extension of her role as an occupational therapist. Through her work at Adelante and her lectures across the country, she has been able to realize many of the goals she set for herself when she first entered the OT field. Winkle credits Jill Felice and Assistance Dogs of the West for laying the groundwork for her career. "Jill took the time to listen to my ideas and saw value in what I had to contribute. We share a passion for the same field and have different strengths; we work and play well together. " "Individuals with disabilities have a lot of abilities," she declares. "I want to help people see this in themselves and in their loved ones. People can regain functioning or be taught alternative methods of performing daily activities after injuries. People can learn new skills if they are given the opportunity—regardless of age and experience. If you can find out what truly motivates people, then you can use it to help them reach their goals and actually participate in their own lives. The field of occupational therapy is a perfect combination of education and creativity. We are able to evaluate situations and determine where the intervention needs to take place—the environment, the activity, or the person. It is so rewarding to watch our student trainers successfully teach the puppies new skills and hear ‘I did it!' after disbelief of their own ability. It is even better when they observe the puppy of yesterday become an assistance dog as it ‘interviews' with potential owners. They use the opportunity to learn more about perspective taking—how to better train the dog for people with various physical challenges, what the dog may be thinking, and how to teach the people appropriate dog-handling techniques. I am fortunate to be a part of the whole process. I get to see puppies come in and learn skills from my occupational therapy and day program clients. Then I get to evaluate potential recipients and contribute to the placement. Finally, I watch my clients hand over the leash to the new owner in a moving graduation ceremony. At that moment in time, so many lives and ability perspectives are forever changed. Our student trainers have selflessly trained a dog for a perfect stranger. And the strangers' life is changed forever." Assistance dogs have the potential to give people more freedom, more choices and to improve their ability to participate in meaningful activities. In many cases they instill self-confidence and dignity. For example, a dog can be trained to retrieve wrapped food items and drinks from the refrigerator, they can retrieve a phone during an emergency, and they can even assist in sit-to-stand transitions. A variety of research has demonstrated improved approachability when one owns an assistance dog. In addition, research is underway to study cost-effectiveness. For many people in the disabled or aging population, assistive technology and home modifications are no longer viable options. Many live with the challenges associated with fixed incomes and face a variety of funding cuts. Making the effort to really communicate with and understand the specific needs of individuals in your care, Winkle says, is the key to being able to truly help. She hopes that those new to the profession can take a cue from her lead. "You have to have a passion for people, creativity and perseverance," she states, "and the clients' goals come first. We have great limitations in time and resources. You have to treat exactly what they feel is important and ensure that you give them the tools to achieve and maintain all of their goals, not what you think is important. A person may wish to use their wheelchair in lieu of ambulation so they can conserve energy to participate in the activities they really enjoy." Because it is such a demanding profession, Winkle further stresses that an OT also needs to have a personal support system. "One of the most important people in my life is my husband," she says. "He has been the support in my structure for 17 years. He understands and appreciates my passion for what I do and he sees the same future that I do. He knows what is important to me, but he also knows when to remind me to take a break." Looking ahead, Winkle has definite goals for herself, for her involvement with Assistance Dogs of the West and for the Working Dogs at Adelante. She states, "I want to continue to develop this program. I want to continue to educate professionals about assistance dogs via national lecturing tours and symposia across the nation. We're going to continue to work on our assessment tool and a variety of research projects. In addition, we want to educate more assistance dog trainers about the value of including occupational therapists in their organizations. As this program grows, we are working on opening up enterprises. Our original plan included opening up a community of animal related enterprises that would provide people with disabilities more opportunities for vocational and leisure opportunities. For example, there might be an opportunity where our former student trainers use their skills to teach the general public dog obedience skills or to run a doggie daycare. They have what it takes now." The Working Dogs at Adelante program is open to individuals who attend Adelante for day program and occupational therapy services. All potential participants must be referred by their case manager and be interviewed to determine the appropriateness of placement within Working Dogs. Melissa Winkle received a Bachelor of Science degree in Occupational Therapy from the University of New Mexico. She serves on the board of Assistance Dogs of the West, and is the co-creator of the Working Dogs at Adelante Program in Albuquerque, New Mexico. Teddy Durgin is a freelance writer from Baltimore, Maryland, area and is on the Editorial Staff of NEWS-Line for Occupational Therapists & COTAs. | |
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