AAI Activities for Speech & Language Treatment

I met my first therapy dog when I was volunteering at the New Mexico Preschool for the Deaf – the dog was named Jackson and he belonged to one of the audiologists at the preschool. This started my interest in using a therapy dog in my future treatment.

The first thing to know about therapy dogs is that they’re not service dogs – here’s a great article that explains the difference. In summary, while service dogs require extensive (and expensive) training to help people complete daily tasks, therapy dogs require little training and there are few requirements for them to participate in organizations.

My speech therapy dog, Zooey, is also not an emotional support animal – she has training to actually do her job. You can find details for her training below.

But first here are some basic rules for using Animal-Assisted Intervention (AAI):

  1. Have a “safe space” for the animal where he/she can go to when feeling stressed/unwell. In Zooey’s case, I got this dog gate and set up a dog bed under my desk. I tell any child who works with Zooey that this area is her safe space and that only she or I can go through the gate. You can see Zooey’s safe space in the photo below.
  2. Prepare the animal. For Zooey this included visiting the office without patients, training to be calm in the office (without patients at first), and lots of social time around children.
  3. Prepare the patients. I teach each child who works with Zooey her rules (no sitting on Zooey, no practicing karate around Zooey, and only Zooey is allowed in her “safe space”). For some we even use this social story about meeting new dogs.
  4. Don’t use AAI with a patient who is afraid of the animal. I’ve had patients who were a little afraid of Zooey – for these kids I kept Zooey in her gated area until they requested she joins us.
  5. Don’t use AAI with a pet who is afraid of the patient. I had one particular patient who had Attention Deficit/Hyperactivity Disorder (ADHD) and impulsively sat on Zooey, despite all my best efforts (including the social story above) to teach them not to. Since then Zooey gets scared with other children who move too quickly. I’m careful to screen which children might work well with Zooey and rearrange my or Zooey’s schedule if it’s not working out.
Here you can see the changes I make to my office when Zooey isn’t working (left) and when she is (right). This is her “safe space.”

Once I got all these in place I started teaching Zooey ways to help me during treatment in the following areas…

Expressive Language

This treat puzzle is one of my favorite ways to work on expressive language.

This is the easiest way to implement AAI. You simply have the animal do things (or wait until they do things) then use common techniques such as communication temptations to get the child to talk or language stimulation to increase the use of target structures.

Like many naturalistic interventions, I usually have to “go with the flow” with this one. I can use the commands Zooey knows (sit, stay, lay down, shake, etc.), but most of the kids are more excited by the things Zooey does spontaneously, like sleeping and snoring. My favorite way to work on expressive langauge with Zooey is to give her this treat puzzle. Then she can “have at it” while I target phrases (“She got it“), irregular past-tense verbs (“She ate it”), bound morphemes (“She opened it”), asking questions (“Did she eat all of them?”), and answering questions (“What’s she doing?”). My favorite way to work on children using prepositions is to have them hold Zooey’s collar while the kids tell me where to hide treats (“On her bed,” “Under the table,” or even “On the green chair”).

Receptive Langauge

These sorting bowls really come in handy for receptive langauge!

AAI receptive langauge activities are as varied as receptive langauge goals. When working on single-step directions I set out color sorting bowls and tell the patient which bowl to put each treat into. When working on prepositions I hold Zooey’s collar while telling the child where to put each bowl (“…on the chair” or “…under the table”). When working on multiple-step directions I do either the sorting bowl or preposition activity (or mix both) in steps. I can do the same for temporal directions (“Before you put a treat in the red bow, put the bowl under the table”) or conditional directions (“If Zooey has blue eyes then put a treat in the red bowl”).

Pragmatic Language

“Do you think Zooey wants to play with the ball or the toilet paper roll?”

Most kids start greeting Zooey before they start greeting me. It’s an interesting example of dogs being helpful for kids with social struggles. Once kids the get hang of following my eye gaze I can use Zooey as the target. For this I have Zooey stay while the kids (or their parent) hide their eyes and I hide a treat. The child then has to follow Zooey’s eye gaze to find the treat.

When working on the Zones of Regulation we can talk about dogs’ different zones and use pictures to add to my Zones poster. We can also talk about what to do when a dog is in each zone, which is mostly “stay away from an unfamiliar dog who is not in the green zone.”

When working on Theory of Mind skills Zooey is a great example for having unexpected likes/dislikes. For example, Zooey has no interest in regular dog toys, but loves toilet paper rolls. Since this is unexpected for lots of kids I can bring out a ball and a toilet paper roll and help a patient tune into Zooey’s eye gaze to see that she’s not actually interested in the ball (like all the children think she will be) – she wants the toilet paper roll!

Zooey also helps kids learn about the more advanced Theory of Mind of understanding what others can/cannot see. For this activity I have kids hide a treat under a color sorting bowl while Zooey watches, then hide Zooey’s eyes while the child moves the treat. When Zooey goes to the original bowl to get the treat we talk about how Zooey couldn’t see us move the treat so she didn’t know where it was. This activity also works for the even more advanced Theory of Mind skill of false beliefs. For this we talk about how Zooey thinks the treat is still under the first bowl so she’ll look under there and we can even have more than 2 bowls out and talk about how we can point to the new bowl the treat is hidden under to influence her to look under it instead of the first bowl.

Reward & Regluation

Zooey is also used as a reward and calming influence for kids who aren’t working on the above skills. This wasn’t trained as much as it’s Zooey’s natural demeanor – true to her true Basset Hound and Great Pyrenees genes, she’s usually calm and friendly.

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