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

Abstract

Objectives determine change in emotional management in children 4–12 years after a visit from a therapy dog and certified child life specialist (CCLS) handler, via observed modified CEMS scores (Children’s Emotional Management Scale), and to determine change in perceived anxiety reported by caregivers, via Subjective Unit of Distress (SUD) score. Methods Prospective observational study at a large/urban ED within a freestanding children’s hospital from May-July 2021. Children 4–12 years with at least mild anxiety (SUD ≥ 30) eligible. Children ineligible: current infection, transferred, presented for burn care/dog bite, history of neutropenia/oncologic process, triaged ESI category 1/2, patient/caregiver with fear/allergy to dogs, or already had undergone a procedure. Participants received a 10-minute visit with CCLS and therapy dog. Modified CEMS (accounting for mask use) and SUD scores recorded prior and after intervention by research team and caregiver, respectively. Results 95 patients approached, no families refused participation, 41 enrolled. After the intervention, modified CEMS scores significantly decreased (p < 0.001), as well as parental perceived anxiety via SUD score (p < 0.001). Mean duration of intervention was 9.10 (3.58) minutes; mean ED length of stay was 3.33 (1.50) hours. 95% of caregivers reported strong satisfaction with therapy dog. Conclusions An encounter with a therapy dog and CCLS handler significantly improves emotional management and decreases anxiety in pediatric patients in the ED. Caregivers perceive therapy dogs as calming for their child and praised the intervention. These results support future prospective randomized trials involving therapy dogs in managing pediatric distress in the ED.