Physiological and behavioral effects of animal-assisted interventions on therapy dogs in pediatric oncology settings

Amy McCullough, Molly A. Jenkins, Ashleigh Ruehrdanz, Mary Jo Gilmer, Janice Olson, Anjali Pawar, Leslie Holley, Shirley Sierra-Rivera, Deborah E. Linder, Danielle Pichette, Neil J. Grossman, Cynthia Hellman, Noémie A. Guérin, Marguerite E. O'Haire

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Over the past two decades, animal-assisted interventions (AAIs), defined as the purposeful incorporation of specially trained animals in services to improve human health, have become increasingly popular in clinical settings. However, to date, there have been few rigorously-designed studies aimed at examining the impact of AAIs on therapy animals, despite a notable potential for stress. The current study measured physiological and behavioral stress indicators in therapy dogs who participated in AAI sessions in pediatric oncology settings, while also examining the psychosocial effects for patients and their parents. This manuscript describes the study's canine stress findings. A total of 26 therapy dog-handler teams were paired with newly diagnosed children with cancer at five children's hospitals in the United States. These teams provided regular AAI visits to the child and his/her parent(s) for a period of four months. The teams completed a demographic form, the Canine Behavioral Assessment & Research Questionnaire (C-BARQ), and a self-report survey to document the types of activities that occurred during each session. Canine saliva was also collected at five baseline time points and 20 min after the start of study sessions for cortisol analysis, and all study sessions were video recorded to document the dog's behavior via an ethogram measure. Data showed no significant differences in salivary cortisol levels between baseline (0.51 μg/dL) and AAI sessions (0.44 μg/dL; p = 0.757). Higher salivary cortisol was significantly associated with a higher number of stress behaviors per session (p = 0.039). There was a significant relationship between stress and affiliative session behaviors (p < 0.0001), indicating that dogs who exhibited more stress behaviors also exhibited more affiliative behaviors. The dog's most commonly coded session behaviors were oral behaviors, such as lip licking, and tail wagging. The only C-BARQ factor that was found to have a significant association was stranger-directed fear; higher scores on this factor were significantly associated with the dog exhibiting fewer affiliative behaviors in sessions (b = 2.12, p = 0.042). Results: show that therapy dogs did not have significantly increased physiological stress responses, nor did they exhibit significantly more stress-related behaviors than affiliative-related behaviors, while participating in AAIs in pediatric oncology settings. There was a significant relationship between canine cortisol and behavior, thus strengthening the argument for the use of cortisol in canine well-being research. This study discusses the importance of further investigation to confirm these findings, and to enhance therapy dog involvement in hospital settings.

Original languageEnglish (US)
Pages (from-to)86-95
Number of pages10
JournalApplied Animal Behaviour Science
StatePublished - Mar 1 2018


  • Animal welfare
  • Animal-assisted intervention
  • Behavior
  • Salivary cortisol
  • Stress
  • Therapy dog

ASJC Scopus subject areas

  • Food Animals
  • Animal Science and Zoology


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