Driving a Power Chair

Pink Girl was test driving a power chair at this past week's visit. First her therapist tried to get her to walk over to the chair. She encouraged her to walk River - one of his leashes draped over her walker while I held the shorter one. Not much cooperation, so she was "helped" to get there.

Power chair driving is way more fun. I think this was only her second time in the chair and as this is not her personal chair, some adjustments had to be made. Finally she was off and moving. Still learning to steer, but clearly enjoying herself, she headed down the hallway. She was able to raise her self up to look in the pool window; later she could lower herself to give River a drink - these are the kinds of things we tend to take for granted.

River was not at all fazed by the chair 's movement or sound, gotta love his adaptability - we did have to keep an eye on his tail - as she moves so much faster, the chance of it getting caught increases. We found it helpful to tell her to aim the joystick at River and his bright yellow vest (yes, he finally has one). This helped to keep her straight and encouraged her to sit upright and minimized bumping the wall as we headed down the hallway.

Pink Girl Makes a Tunnel

Leaning into a large exercise ball, the therapist encouraged her to straighten her arms, making a tunnel for River to go "under" between her and the ball. He was happy to comply and Pink Girl laughed as his tail tickled her when he zipped through. That idea I learned at the last KPETS roundtable was successfully put into action at this session. We also did the usual: having her hold the hula hoop (with Amanda on the other side) for him to jump, a crawling competition, squeezing his water bottle to give him a drink, having River "play/paw" the piano - which always must be followed by Pink Girl's more melodious piano efforts. Walking wasn't as successful - we offered walking him on leash, chasing his tail with the walker wheels, tricks as a rewards for steps, distracting conversation (guess River's age) but there were more tears than steps.

River wore his new KPETS bandana embroidered with his name. She admired that, but did try to use the bandana to pull him which I tried to discourage. She hasn't done that with other bandanas. There were sweet moments, too - she enjoyed a few kisses and she gave him a hug. Overall much of the session was positive; as her therapist said - she really "goes up and down" in mood and degree of cooperation.

April Schreiber Trial Visit

We did a one time visit with a child described as "very involved" as in no speech, little independent movement. He was,according to his mother,having a bad day, but overall he had more interest in River's ballon than the dog. So we gifted him the balloon and visited with another child who very much enjoyed River's company during his therapy. His mother took a KPETS card and I think would have requested us. In reality, her son was fairly well motivated to cooperate and not in big need of River - my assessment, but we haven't heard anything. And maybe I'm wrong and AAT could be used for other than motivation to participate,maybe would have an effect on rate of progress or attempting new things. My limited experience can't evaluate that.

I'm not sure what kind of a system would work - to inform therapists about AAT and using KPETS teams - to let them know specifics of how and when AAT can be helpful. What criteria determines if AAT would be useful and then, should there be specifics to match a team to the situation? It's an nteresting area that deserves more study.

I wonder if having teams available on a regular basis at Schreiber would provide a chance to demonstrate that - or is that too random and maybe an in-service type program would be more effective?

March Arrives, Schreiber Visit

River's friendly competition when he visited at pediatric physical therapy today - he soars at "over" the hula hoop, but she bested him in crawling "under" and the most "roll overs". Her reward- a vanilla milkshake; River settled for dog biscuits.

According to her therapist, this was one of Pink Girl's best sessions, as far as her being cooperative. It varies considerably session to session and even minute to minute during a session. We hadn't seen her frequently; it's been 3 weeks and weather and illness conspired to keep it to only one visit each month in Dec and January.

Her mom was helping her stretch over a "jelly bean" when we arrived and we positioned River on the mat in front of her so she could reach out and pet him. I think she enjoyed when Amanda hit "the spot" and he did that reflexive back leg scratching. She was eager to demonstrate rolling over for him and was even enticed to roll both directions (one is more difficult for her, so she prefers the easier).

Megan dashed in from the pool to start the session. She had Pink Girl sitting upright on a low bench to brush River. Grasping the soft plastic brush is a challenge for her and she preferred to just pet him. He prefers to sit or lay down, so both Amanda and I help him maintain a stand for this. Pink Girl did put a bit of weight on his back, using him to help her stand upright. This was not the therapist's goal - or ours, but I don't think he was hurt at all; she is a tiny thing. She had along a favorite pink teddy bear today that her mother explained had been in her isolette when she was a newborn ( premie at 26? weeks) and the bear was bigger than her. River kept wanting to play with it. We'll have to bring a stuffed toy of his along next time. We should try to dress him up a bit, too, a bandana at least, as she is always attired in coordinated outfits with cute hair accessories. Maybe that's just done by her mother, but they both might enjoy seeing River accessorized, too.

Standing for her and holding the hoop for River is always a favorite. She likes to mix it up with him doing "over" and "under". He won't always wait for the command. Megan(therapist) got her to show River both crawl/under and crawl/over. She got compliments on her crawl versus River's; he likes to pop up. She really seemed to enjoy showing River her crawling and rolling prowess today.

Next, she did a bit of walking too, some with a walker and they also tried a "cane" (it had a tripod base). The "chase River's tail" scenario works only a little with her. I think the walk to a certain point and rest while he does a trick for you went a little better. There was a distraction when another therapist brought over a little girl in a stroller to see River (she was a bit shy of him), but I think it made Pink Girl want River's attention back on her. She didn't quite make it to the water fountain, so she got to see River have a drink from his bottle, while she was happily slurping down her milkshake.

Four visits in Three Days, written after the fact

Tuesday - Schreiber Pediatric - PT visit with Pink Girl, she most enjoyed holding the hula hoop for him to jump while she worked at standing up straight.

Wednesday - Acadia Rehab with Ump followed by home visit to MIL, both preceded by River's agility lesson with Karen that morning equals one very tired dog.

Thursday - New visit for a reading program at Wickersham Elementary School. we were in an auditorium seated on the edge of the stage, with another team on the opposite side. I had brought along a blanket as asked, to have specific spot for us to sit. The school was extremely warm. River needed a water break and he wanted to lie on the cooler floor of the auditorium rather than the blanket by the end of our hour. The response to the dog varied; one boy who approached him eagerly had a large dog at home. One girl was utterly terrified of him. I sat between them( instead of River int he middle as usual), she still startled if he even shifted position. She watched his tricks from a distance, took the card we gave her and all but bolted out of there. Most were somewhere in between, fascinated but a little cautious. I think we saw about 5 students. They had short books, read pretty quickly and didn't want to linger. The other team with older class, longer books, I think had 3 students. We will be going weekly, but they will be rotating through different classes, so no one will be returning. From what I've read, most reading to dog programs see a benefit to encouraging readers because the dog is unconditionally accepting. These kids seemed to be adequate readers, perhaps this was a reward, for the novelty? I am even more interested in learning about the READ program now. It seems to be that seeing the same kids would be more helpful to them and even more of an incentive, and more effective as we build rapport with them.

Busy dog week - Sunday was intro to agility with Wendy, Monday - rally class with Wendy; Saturday we'll be at the Gifts That Give Hope Fair stumping for KPETS - he gets Friday off.

The following week is Thanksgiving week, so we had no visits planned. As it turned out, we did end up going to see MIL, who is now in a hospital bed ( she was in a wheel chair our previous visit, had been managing with a cane before that, and walked freely at our first encounter). Amanda came along this time and we brought Noche as well. Both dogs behaved amazingly well; at one point we had them on either side of her in her bed and she had a hand in each one's fur. That was really what she wanted and it brings tears to my eyes recalling it. I am so glad we could provide that simple gift.

Three Visits in 2 Days

Schreiber with Pink Girl on Tuesday, Acadia with Ump Wednesday at 1, then to see my friend's MIL later that same afternoon. River had some brief downtime inbetween and handled it just fine. Neither visit was very physical, unlike the repeated hula hoop jumping he did at Schreiber this week. I do try to be conscious of not burning out my dog; so far he has handled our schedule without a problem.

Pink Girl continues to be challenging, often cooperating only minimally or only briefly during an already short, 30 minute session. Holding the hula hoop seemed to work well for the position Megan wanted her in - either a straight stand or a variation. She was willing to signal Amanda by blinking at her to have her tell River "over", but she wouldn't say it herself. She did get credit for teaching River "under". When the hoop was just a bit high, he "cheated" and went underneath, so after that we gave Pink Girl a choice of which she wanted him to do and this seemed to engage her for a bit.

She didn't want to brush River but enjoyed squeezing his water bottle to give him a drink. It took a lot of encouragement to get her to walk using her walker - walking with or chasing River's tail were not incentives today. She doesn't respond to his tricks the way Speaker did. He was willing to walk a distance and pick a trick. I'm not sure what else might work to motivate her if walking is the goal. Megan would like us to come again in 2 weeks, so I guess we must be useful somehow.

Ump enjoys weekly visits. Seeing River is important to him and he never tires of repeating " He's a good dog." Besides conversation, reviewing what he can recall about River, his therapist encourages him to do tricks with River, trying to use both verbal and hand signals. When they don't match ( often), River usually favors the physical commands over the verbal. Ump is happy with whatever River does and rewards him with a treat - including some that he made with his therapist. River noticed the presence of those treats in a plastic bag as soon as we entered the visiting area and convinced the humans that he deserved to enjoy quite a few.

And then we visited where the only treats I allowed were Cherrios given by the kids - and River was just as willing to work for those. MIL seemed much the same to me, although she described herself as " in her last days." She was still eager to talk " dog" and pet him and watch as her grandchilden played with him. I hope we'll be able to see her again.

Oct 19 Schreiber Visit

Amanda and I took River to see Pink Girl today. First we had to run the gauntlet of preschoolers lining the hallway - River enjoyed a brief petting session there on the way to Physical Therapy. Pink Girl was already stretching with her mom, draped over a padded bolster, so we moved River nearby to say hello. Her greeting was tentative, so I wasn't certain of today's mood. River was decorated with a pumpkin/jack o'lantern bandana and I had brought an orange balloon, to work the seasonal theme. She practiced some standing both with the balloon ( for him to bat at) and holding the hula hoop for him to jump - we did coax her to give the "over" command a few times. I had also brought along the tunnel for the first time and Amanda set it up and I had River demonstrate going through it and jumping over it. Pink Girl was seated at this point and the tunnel was aimed at her diagonally so that when River exited it, he was popping out right in front of her. She pulled back when he came through and Megan used this reaction to have her practice sitting up straight. With a little adjustment- too close made her throw herself too far backwards, this was effective for quite a few tunnel trips. Totally unplanned, but it worked. She did a bit of brushing River and then was whisked off to OT. New schedule will bring us together again in 2 weeks.

Visiting in the hallway as we left, chatted briefly with a family that is hoping to get a dog from Susquehanna Service Dogs for their son, discussing the training process and following their blog. I just love the connections that get shared because of the dog.

Another Lesson Learned - Check the Cell Phone

Guess this one should be obvious, but I needed a reminder. Arrived at Schreiber on the dot of 10:30 today, but there was no sign of Pink Girl, who is usually early. Well, she had canceled and Schreiber had left a message on my cell phone. No one had answered the home phone, so they tried the cell without leaving a message at home. I guess we were both in the shower and somehow my cell had turned off, so.....

We were able to briefly visit with the preschoolers who spotted River in the hallway. They seemed to enjoy petting him and since we had his tunnel along, he showed off how he likes to run through that and several of them demonstrated their tunnel skills as well.

Acadia Visit with Crossed Signals

The first crossed signals were mine. It's great to maintain an Outlook calendar. So easy to update from emails and my Ipod Touch. Now if I would just check it before heading out. OK, so I missed that our appointment was changed by an hour, due to a field trip and we showed up at the usual time. To be fair, I had scanned my calendar, just missed the change from 1- 2 . Luckily, we live quite close, so we zipped home and I went back a bit later. River was a little confused, but adapted quickly. Amanda didn't return as she wasn't feeling that perky to start and was fading, so I took River solo.

The other crossed signals I wanted to detail are the ones that Ump gives River. Ump often says one command, while giving the hand signal for a different one. He might be saying "roll over" while signalling "spin" - then River usually does "spin". Or he often waves his arm to the side, somewhat like "play dead" but says something else, like "Ready?" while River is sitting. Sometimes River is confused, but mostly he follows the body language or hand signals.

Today Maggie (therapist) asked Ump if he realized that his words and signals don't match and also asked if he would like to to work on that. She said it might be hard. He said he had not realized it and "ok" to working on it. So, as she was walking us out,we discussed how to tackle this.

My suggestion is to have one of us demonstrate and model the verbal command and hand signal for just one trick and then have him try it - just that trick. We often show him a few and then give him a chance to work with River, choosing what he wants him to do and I realized this may be confusing. Maybe a specific sequence and a smaller menu of choices would help.

Considering what to start with; "Roll over" and "play dead" are favorites of both River and Ump, but both sometimes need the "down" command first and then are directional - that is, River only rolls over to his left and goes on his right side to play dead, so those are more complicated. I think we should try "sit" and then "beg". From there we could add "catch it" for rewarding him. Sit and beg have clear hand signals - the hand moves in the same direction as River is to move, and "catch it" just involved a toss.

I say just, but have realized in other situations, that I am making an assumption there about throwing ability. The kids at Schreiber have not been able to do a toss that River can catch. Although, hmm, he might be able to catch a treat if they just drop it straight down from high enough - the way he catches ice cubes. We'll have to test that out. I think that Ump, on the other hand, does have the coordination and strength to toss a treat that River can catch most of the time.

So sit, and beg and then catch it are three separate tricks and I think we should really break them up separately and do one at a time. And then do them in a sequence and alwasy repeat them in that sequence. It's somewhat against dog training tenets, because River is likely to anticipate things if we always repeat a sequence, but I think it might help Ump to remember and link the hand signals and verbal commands. I'm eager to hear what Maggie think of the idea, and if approved, see how it goes.

Bring Extra Balloons

That's what I learned yesterday, that I should have had a back up. River doesn't usually pop the balloon - this was only the second time, but he did it in the waiting area this time, before Pink Girl started her therapy. And yes, I have not worked on switching him to "touching" the balloon with his nose; he swatted it with his paw. Ironically, he did do a "touch" first and then switched to a swipe. And his grooming is overdue, too, so his nails might be a tad long - I also scheduled that today.

Pink Girl was having a tough day. She was being floppy and not generally cooperative with her mom beforehand; wouldn't try to walk at all for her therapist. It's hard to remember she is only four. Therapy sessions ask alot of her and it's pretty normal to have some "off" days. She did perk up a bit and survived the measurements they needed to take and seemed to enjoy standing tall and holding the hula hoop for River to jump through.

Even though it wasn't her best day, I was told by her therapist that her behavior with River present was a tremendous improvement over previous sessions when she was much less cooperative and might spend half the time crying. Hearing that is both a reward and an incentive for me.

Who's Got The Treat?

I mentioned that River transfers well. I imagine that most well trained dogs can do this at least to some extent, depending on the behaviors being requested. It has been very handy for us in a variety of visiting situations.

I hand one or a few treats to Speaker and tell him to "Watch Speaker" while pointing to him. He knows to listen to them and mostly does, at least until the treats are gone. I mentioned that Speaker like to have River "Speak!" I don't always give him the treat - sometimes he doesn't like to get his hands messy. But he can give the signal, pointing at River - and I also give it, standing behind him. River usually responds to him, but sometimes needs reinforcement. River seems to know when the person is confident or not. Sometimes he does try to take advantage of this and get treats before finishing a trick and I have to remind him to behave. I guess it's double handling, but needed in some situations.

We also have been visiting at Acadia Neurological Rehab facility. We regularly visit one 50ish man there who has had a traumatic brain injury and we have also filled in for other teams a few times in a group therapy situation.

The gentleman we'll call Ump, has a fondness for baseball as well as dogs. Because of privacy concerns, we usually don't get any background info,so we learn as we go. Our visits with him are more typical of Animal Assisted Activity, because we do a lot of general visiting, conversations about the dog. His therapist does use our visits as a topic of conversation at other times and does try to have him review and see what he recalls. Details like our names, breed of dog, River's age we touch on each week as Ump as memory issues. She also reviews with him some of River's tricks and the commands and hand signals that we use with each.

Usually we chat and visit first for a bit. River is always excited to be there. He waits a bit anxiously in the waiting area, listening for any voices and footsteps as people pass in the hall. I'd like to say he recognizes the therapist and client we visit, but actually, he is eager to greet anyone who acknowledges him.

We try to do just visiting first, because once the treats are out, River focuses on them and doesn't just "visit". After some chatting we usually ask if Ump would like to see some tricks or do some tricks with River - and he always says yes.

Often we (Amanda or I) demonstrate his tricks, using verbal and hand signals and rewarding with treats. Then, with encouragement, Ump will try a few tricks. The interesting part is, we are never quite sure what trick Ump will ask for and he usually confuses the hand signals. Fortunately, River usually responds reliably. He seems to favor hand signals over verbal. River is well trained enough that I am not concerned about him getting confused by Ump's crossed signals, especially since we are not participating in competitions where it might matter. As an example, sometimes Ump decides to walk and seems to want River to heel, but he doesn't necessarily start with River in heel position or even on his left side or use the command we do. Still, River improvises, walking along with him and usually getting on his left during a turn and usually sitting when he stops, although Ump usually seems to think that requires a command. I guess we could try to get them lined up to start and remind him of those details, but they both seem to enjoy it they way they are doing it now.

More Schreiber Details

River learned to bat at a balloon on a ribbon, so we used that with both kids we visited. Sometimes the ribbon is too hard to hold, so we either tie a loop into it or I hold the ribbon above where they are gripping it. River hits it with one or two paws. Sometimes he pulls it from their grip. He has only popped a balloon once so far. It is a bit tricky because they need to hold the balloon out away from their body (so he doesn't paw them) and while the therapists like a straight arm as a goal, the kids can't always quite manage this. I would like to modify his trick and have him "touch" the balloon with just his nose - less likely to scratch anyone that way. He does know "touch" but prefers to "paw" the balloon, so we need a little refresher and practice.

Other tricks that we have used are mostly for entertainment value. Sit up, catch it, stand up(on 2 feet),roll over, play dead, spin are all reliable and have hand signals that the kids can mostly manage. Of course, we stand behind them and signal River, too. So far, they don't seem to mind if he is mostly watching us, as long as he does the trick. Usually they walk a distance and get to rest and be rewarded with a trick.

This week we also had Pink Girl brush River, using a plastic "massage' type brush. Her therapists liked that the handle required her to open her hand. ( We also had a narrower handled brush if that was preferred.) They did struggle to get her to use her less preferred hand to brush. Not sure how we can use River to encourage that?

River will listen to whoever has the treats. He transfers very well. We have used this extensively at our Acadia visits; I'll detail that in another post.

Starting Schreiber Visits

Tuesday was our third visit with Pink Girl (to maintain confidentiality, names have been changed). A cute 5 year old with a big smile, who favors flashing shoes, she has always been dressed in adorable outfits, usually with coordinating hair accessories. Even her wheel chair is pink. She starts her interaction with River while we are in the waiting area. Her therapist has a client in the pool just before her and has to hustle to change, so we usually have a few minutes to visit. The very first week, she figured out that River loves his treats - and she loves to feed him. Not so keen on dog slobber on her hands, her method is to drop them on the floor for him. She also knows which leash has control of him and wants that one when she "walks" him with her walker.

Well, let me back up here. She is our second client at Schreiber. The first was a 7 year old boy we'll call Speaker. His therapist had experience working with KPETS therapy teams and we learned quite a bit from her. First, we shadowed Karen , KPETS founder, and her Golden, Sammy. I was a bit in awe of this experienced team - and inspired by them. Amanda and I both decided that River needed to learn of few of Sammy's tricks to make him even more effective as a therapy dog. Sadly, he still doesn't walk backwards or sideways or march like Sammy, but he has a few techniques of his own that have compensated. Karen apparently thought we could handle it, so the next week it was our turn.

It wasn't a total disaster, but there were a few issues, a learning curve for all of us. We found that River's retrieving is not reliable there, but if the ball is thrown a longer distance, he is more enthusiastic about getting it. We learned that Speaker was just as amused when River "misbehaved" as when he obeyed, maybe more so. And keeping Speaker amused so he would cooperate with his physical therapy was the goal.

Sammy had walked sideways when Speaker worked on that; River waited and performed tricks when Speaker moved designated distances. This worked for walker practice in general. And Speaker's favorite trick was River "speaking". The hand signal we use, pointing a finger at him, was one he could easily manage and River responded to reliably and loudly! so much so that Speaker would often jump even when he had given the command - and then laugh - 7 year old boys love loud noises.

His other favorite was to chase River's tail with his walker - trying to catch it under the front wheels. River would sit in front a short distance away from the walker and facing me and we would move a little whenever the wheels got close and repeat as needed. Once Speaker had his surgery and he got faster we had to modify this and switch to the rewarding with a trick after going a distance. So far, Pink Girl, who moves fairly slowly in the walker, doesn't seem as motivated by chasing the tail - maybe it's a boy thing - we'll have to try something else for her.

Speaker really disliked the stretching that the therapists started each session with. We tried having River on the table with him, but petting him wasn't enough of a distraction from the discomfort of being stretched. It was tricky to postition River; he usually put his tail in Speaker's face initially, but this was entertaining to Speaker. Sometimes, River would "speak" when Speaker complained "ow, ow" and that usually earned a smile. We never had one specific technique that was always effective for stretching, but maybe that wasn't going to happen.

Pink girl seems to not mind the initial stretching quite as much. We've only seen her 3 times and intially she wasn't talking much and in a whisper. I think we'll be able to gauge her reactions better as she gets more comfortable with us. She does strech over the physio ball and we position River for her to reach him then.

Holding the hula hoop, usually with Amanda on the other side, has been a good way for her to practice standing up straight and positioning her hands. River jumps through when she is upright, usually waiting for the command. We also did this with Speaker and it was another favorite of his, although he often wanted to see how high we could get River to jump. I explained that River had to be cautious in jumping because the floor there is slippery. I was reminded that it is important for me to have River the correct distance away and lined up with the hoop and to make certain his path is clear(of walkers, etc.) River did once land on a therapist's foot. She was using it to balance herself as she was supporting Pink Girl, so it was in his way. No harm done, but it is my job to catch that beforehand.

This post is getting a bit long, but I wanted to get a few things down in detail. I'll continue in another and hopefully with more as we continue.

I would love to hear from others doing AAT and their specific techniques.