**1. Introduction**

Positive effects of Animal Assisted Therapy (AAT) on various physical and mental characteristics have been reported worldwide in the last 20 years. More specifically, many studies sugges<sup>t</sup> that Dog Assisted Therapy (DAT) produces positive results in children with various developmental disorders, contributing to their ability to concentrate and to feel motivated for work [1–3]. Furthermore, research investigating effectiveness of AAT in relation to patients' social skills showed that interventions of this type favourably affected communication and social interactions between individuals with intellectual disability [3]. AAT is not only helpful as regards communication and basic activities of daily living. It has also been shown that in children with intellectual disability it may beneficially affect gross motor skills, since it can effectively boost a sense of motivation for exercise [4]. Dog-Assisted Therapy, also

known as canine-assisted therapy or contact therapy, is gaining popularity and is well-tested as a form of complementary treatment [3–5]. Therapy dogs are used in rehabilitation of patients with motor and intellectual disabilities [5]. Contact therapy involving dogs is one of the methods that may be employed to promote the process of rehabilitation and recovery. Dogs are effectively used in treatment of individuals with disabilities or concentration and attention disorders because they favourably affect the psychophysical and socio-physical domains. Interaction with these animals reduces anxiety, simulates sense organs, increases vocabulary resources, and improves contact with the environment [6,7]. DAT enables children to improve gross motor skills, own-body perception as well as fine motor skills. It favourably affects cognitive skills, such as concentration, perceptivity, ability to take decisions, as well as ability to adequately perceive and respond to a given situation. Games and fun activities taking place during DAT facilitate learning and consolidation of such notions as colours, sizes, numbers, differences, and similarities. A review of the related literature shows that DAT also contributes to better psychomotor efficiency [8–10]. Studies by Jorge et al. showed positive effects of DAT in children's motor development, particularly balance, motor planning, and spatial orientation [11]. It appears that DAT is particularly successful as a way to help individuals with intellectual disabilities and improve their psychomotor efficiency. Interaction with an animal leads to enhancement of neurotransmission in the human, which initiates decrease in blood pressure and induces relaxation. This association may be beneficial in reducing arousal as well as psychological symptoms of chronic diseases, including physical and mental disabilities [12,13]. A study by Scorzato et al., assessing effects of DAT in individuals with intellectual disability, showed significant improvement related to a number of cognitive factors, including focus on movement, visuomotor coordination, exploratory games, and imitation of motion. The effects of the therapy did not depend on the subjects' age and degree of intellectual disability [14]. Gocheva et al. also reported statistically significant findings related to attention and concentration in patients with brain injury participating in DAT [15]. Kongable et al. observed positive effects of DAT in tactile and visual perception as well as verbalisation [13]. Systematic participation in appropriately structured activities involving a dog makes it possible for children using this type of therapy to improve their physical and mental condition. DAT promotes overall physical activity and motor capacities. Children with intellectual disability participating in exercise frequently have problems with motor activity, they are sluggish and unwilling to move. A dog motivates them to take action; they approach the animal to say hello, and they focus their attention on the dog. DAT improves precision of movements, as a result of which the child gains greater motor control [16]. This is also an excellent form of rehabilitation for a child. Presence of a dog helps in performance of self-care activities and reduces emotional tension. "Depending on the child's needs, during dog-assisted therapy session the child may perform a number of exercises focusing on gross motor skills, manual efficiency and visual perception" [17]. Contact therapy involving a dog facilitates own-body schema orientation, allowing the child to understand the structure of both animal and human body, and to improve their motor efficiency, as a result of exercise performed together with the dog and through stimulation of the senses of vision, hearing, and touch as well as practice of attention and concentration. Numerous studies demonstrated effectiveness and usefulness of animals in therapy [12–19]. An animal does not only help to calm down and to develop one's social behaviours but also constitutes a source of motivation [20]. Owing to their inherent qualities, animals may induce child's interest and may stimulate a variety of sensory functions through sounds, movement, smell, and touch. Their activity is simple, repeatable, and non-verbal; as a result, it is more accessible even to individuals with language dysfunctions [21]. Animals are a source of and the purpose for attention [22]. Efforts to systematically categorise the ways humans are affected by animals made it possible to distinguish a few mechanisms:


Therapy intended for a child with intellectual disability should be intensive and multidimensional; it should boost the development of and strengthen the child's intellectual functioning, as a result potentially increasing his/her independence. Because of this, therapy should be designed to stimulate perception-related functions of the brain, concentration, and attention, to improve motor functions, to promote development of speech and communication skills [20]. The methods facilitating rehabilitation of children with intellectual disability include DAG, which is intended to stimulate development in all the domains and promote improvement in motor capacities. The above review of literature suggests that DAT favourably a ffects concentration and attention [9], motor planning [15], spatial orientation [15] as well as sense of touch [21]. DAT is a widely used form of supplementary treatment. However, few reports so far have specifically focused on the e ffects of this type of intervention in children with intellectual disability [24,25]. Therefore, the present study aimed to investigate whether or not long-term/delayed e ffects of DAT would impact children's performance during a period when they did not participate in education and rehabilitation programs.

In view of the above, the study was designed to assess psychomotor e fficiency, reflected by the factors of attention and concentration, motor planning, spatial orientation, and sense of touch in children with mild intellectual disability participating in DAT and in controls receiving no such therapy, immediately after the period of education and rehabilitation and following a period during which the children did not receive DAT and did not participate in education and rehabilitation.

Hypotheses:

**Hypothesis 1**. *Children with intellectual disability, participating in an educational program supplemented with DAT, achieve improvement in attention and concentration, motor planning, spatial orientation, and sense of touch, in assessments carried out at the end of the educational program and at a two-month follow up*.

**Hypothesis 2**. *Improvement in the DAT study group is significantly greater than in the non-DAT control group*.

**Hypothesis 3**. *E*ff*ects of education supplemented with DAT are long-lasting. Children additionally receiving DAT after a two-month break in the education program present greater improvement compared to the non-DAT control group*.

### **2. Materials and Methods**
