The Development and Evaluation of a Novel Cat Assisted Training (CAT) Intervention for Youth With Developmental Disabilities and Their Family Cat
Phase: NA
Conditions: CAT Intervention Group, Control Group
Sponsor: Oregon State University

 
 
 
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Study Protocol and SAP: The development and evaluaƟon of a novel Cat Assisted Training 
(CAT) intervenƟon for youth with developmental disabiliƟes and their family cat. 
 
NCT05950672 
  
October 24, 2024 

 
 
 
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Study Protocol and StaƟsƟcal Plan NCT05950672 
The development and evaluaƟon of a novel Cat Assisted Training (CAT) intervenƟon for youth with 
developmental disabiliƟes and their family cat. 
IniƟal IRB (HE-2022-29) Approval: March 13, 2023 
Last IRB (HE-2022-29) Approval: October 24, 2024 
Speciﬁc Aims:  
The goal of this proposal is to develop and evaluate a novel Cat Assisted Training (CAT) intervenƟon 
creaƟng a unique acƟve partnership between early adolescents with developmental disabiliƟes (DD) 
and their family cat to promote physical acƟvity, social wellbeing, and lasƟng feelings of responsibility.  
Children with DD are 4 Ɵmes more likely to be physically inacƟve compared to peers without 
disabiliƟes, and with age their physical acƟvity further declines [1], [2]. While various intervenƟons 
have been successful at improving short-term physical acƟvity, long-term compliance and generalizing 
behavior outside of the treatment seƫng can be a challenge. Barriers to long-term compliance include 
high cost, limited access to ongoing intervenƟons and aging out of available programs. Early 
adolescence is especially challenging for children with DD, who oŌen experience diﬃculƟes with social 
skills and in developing a sense of independence and responsibility. ComparaƟvely greater supervision 
from parents/caregivers, while someƟmes necessary, has the potenƟal to impede pracƟcing and 
obtaining these skills. Although extensive research has focused on idenƟfying diﬀerences in physical 
acƟvity and social skills of children with DD, there remains a criƟcal need to develop innovaƟve 
intervenƟons that increase independent physical acƟvity and social wellbeing.  
There is increasing evidence that human-animal interacƟons (HAI) and Animal Assisted IntervenƟons 
(AAI) can promote health beneﬁts in children. Frequency and quality of HAI, including walking together, 
training and caretaking behavior, predict the strength of HAI relaƟonships and beneﬁts [3]. Companion 
animals have also been found to alleviate social anxiety and sƟmulate conversaƟon in social situaƟons 
[4], and can help improve the social- support network, integraƟon, and the overall quality of 
relaƟonships children experience [5]. In our own research, we have found that dog walking and dog 
training intervenƟons have clear beneﬁts for youth (ages 10-17) with DD and their dogs [6]. 
Importantly, in a separate line of research, we have found that cats possess many of the same qualiƟes 
that make dogs successful as acƟve AAI partners [7]. This CAT program was designed with a strong 
theoreƟcal raƟonale, uniquely integraƟng joint acƟviƟes and posiƟve interacƟons known to promote 
feelings of aƩachment and social closeness in both humans and cats. 
DomesƟc cats are one of the world’s most popular companion animals. In the U.S. alone there are over 
94 million cats compared to 90 million dogs [8]. Despite the prevalence of companion cats, relaƟvely 
liƩle research has examined human-cat interacƟons or acƟvity-based-AAIs with cat partners [9]. There 
has been even less research on cat-child interacƟons, or the impacts of AAI parƟcipaƟon on cat 
behavior or welfare. Therefore, there is a criƟcal need to conduct more research on the cat-human 
bond and on cats as AAI partners. Myths about domesƟc cats (including false beliefs that cats are 
asocial or untrainable) have likely contributed to their underrepresentaƟon in this ﬁeld [8,9]. However 

 
 
 
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our research, and that of others, has empirically demonstrated that cats have the capacity to share 
strong secure bonds with their owners [7], can be trained (at any age) [10] and that lifeƟme 
experiences inﬂuence the quality of social interacƟon and relaƟonship shared between cats and 
humans [11].  Although cats have appeared in the AAI literature as highly eﬀecƟve passive therapeuƟc 
partners (e.g. holding sƟll for peƫng) including for children diagnosed with auƟsm [12], there are 
compelling reasons why cats should be strongly considered as partners in more acƟve AAIs, including 
cat-walking and training. Cats are smaller and weigh less than most dogs making them easier for 
parƟcipants (especially those with physical disabiliƟes) to walk on leash, pick-up, and transport safely 
without assistance. Cat walking and training, while increasing in popularity [9], [13], is sƟll viewed as 
novel and exciƟng- factors that encourage long term enthusiasm and engagement. Cats, like dogs, have 
needs for enrichment, exercise and bonding which can be addressed through high quality interacƟons 
with human caretakers. Finally, there are many people who have chosen to live with cats (over 45 
million households in the US alone [14]), some of whom may not feel comfortable walking or training 
dogs. This should not preclude them from AAIs aimed at promoƟng physical acƟvity. It is our 
responsibility to consider the possibility that our current lack of data about the domesƟc cat’s full 
potenƟal as an AAI partner could be unintenƟonally contribuƟng to AAI recruitment and parƟcipaƟon 
inequiƟes [15]. More research is needed to promote evidence-based pracƟces and accessibility.  
We propose to address a criƟcal need for more research in these areas through the following speciﬁc 
aims:  
Speciﬁc Aim 1 
To evaluate the nature and quality of bonds shared between cats and children with DD.  
Speciﬁc Aim 2 
To develop and evaluate the eﬃcacy of a novel Cat Assisted Training (CAT) intervenƟon aimed at 
increasing physical acƟvity in early adolescents with DD.  
Speciﬁc Aim 3 
To evaluate the impact of a CAT intervenƟon on social wellbeing and the child-cat bond. 
Research Strategy 
Signiﬁcance:  
This project will provide a mulƟdisciplinary One Health approach to an AAI for early adolescents (8-17 
years old) with a DD and their family cat. Limited research has focused on AAIs targeted at early 
adolescence [4]. We are not aware of any animal training intervenƟons where the AAI partner is a cat. 
There is a criƟcal need to develop intervenƟon strategies that will promote the development of healthy 
physical acƟvity behaviors, social skills and aid in developing a sense of independence and 
responsibility among adolescents with DD. AAIs have been credited with a wide range of posiƟve health 
outcomes [4], [5], [16], [17]. IntervenƟons involving an acƟve partnership between a child and a family 
pet present an important opportunity to make AAIs more sustainable, by allowing learned intervenƟon 
acƟviƟes such as animal training, care, and walking together to conƟnue in the home environment aŌer 
the on-site intervenƟon [16]. The relaƟve novelty of cat training is expected to increase retenƟon and 

 
 
 
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provide the long-term moƟvaƟon to do so. Child-pet partnerships also capitalize on both the beneﬁts of 
AAI and of pet ownership. While it has been found that child-cat bonds can beneﬁt children, including 
those diagnosed with auƟsm [12], and that stronger human-cat aƩachments lead to greater health 
beneﬁts [18], many intervenƟon strategies known to improve human-animal bonds and AAI health 
outcomes (including training and acƟvity/walking intervenƟons) have not been evaluated with cats.  
This proposal considers the health and welfare of the child and cat, as well as the quality of the shared 
relaƟonship. Our CAT intervenƟon will emphasize an acƟve partnership between the child parƟcipant 
and family cat, allowing both to develop important life-long skills over the course of six-week 
intervenƟon. Child parƟcipants will learn fear-free handling and training techniques, how to walk a cat 
on harness and leash and will be given homework to help build responsibility with respect to cat care. 
Our prior data suggests that these acƟviƟes should result in increased physical acƟvity and improved 
social wellbeing in youth with DD - a group at high risk for physical inacƟvity and fewer opportuniƟes 
for responsibility than peers without DD [19]. CAT is also expected to increase cat sociability [11], 
decrease cat stress in the presence of the child [7], and promote joint acƟvity and stronger child-cat 
bonds. Increased physical acƟvity is linked to beƩer health in cats [20].  
InnovaƟon 
Although cats outnumber dogs in the U.S., the eﬃcacy of cat AAIs aimed at increasing physical acƟvity, 
responsibility, and social wellbeing in early adolescents has not been evaluated. Dogs and horses are 
oŌen employed in AAIs [4], [17], however not all individuals have equal access to these animals. The 
absence of acƟvity based cat AAIs may represent a missed opportunity to reach a signiﬁcant porƟon of 
the populaƟon [15]. This research is innovaƟve because it focuses on the development and evaluaƟon 
of a novel physical-acƟvity-based Cat Assisted Training (CAT) intervenƟon for early adolescents (8-17) 
with DD.  
JusƟﬁcaƟon and Feasibility 
Cats are a common and accessible companion animal. There is ample scienƟﬁc evidence that cats can 
be trained using posiƟve reinforcement [7], [10]. Interest in cat walking has steadily increased, with 
24% of owners buying cat leashes in 2017, compared with 17% in 2006 [13]. This year a new world 
record was set for the number of tricks performed by a cat in one minute (26 tricks). The cat was 8 
years old; the cat owner began training her cat on her own when she was 11 years old [21]. Our team 
includes three experienced cat trainers (Drs. Udell, Vitale & Darling), who have successfully taught cat 
owners the skills included in the CAT intervenƟon (Table 1) including how to walk cats on leash. Drs. 
Udell & Vitale have run 6-week long cat training camps at Oregon State University (OSU) for over four 
years (with 50 cat parƟcipants in a 2-year period) and cat training camps for youth. We have published 
on cat social behavior and human-cat bonds. Drs. Udell, MacDonald and Jiang have successfully 
developed and evaluated dog training and walking AAIs for youth with DD (age 10-17). Dr. MacDonald’s 
specialty is physical acƟvity and social behavior in youth with disabiliƟes. Dr. Jiang is a staƟsƟcian 
experienced with AAI research. Our team has the experience, faciliƟes, interdisciplinary breadth, and 
collaboraƟve track-record to successfully recruit parƟcipants, conduct the proposed CAT AAI and 
evaluate the outcomes. Given the rapid growth of scienƟﬁc knowledge in the areas of AAI, HAI, and cat 
behavior in recent years, the development and empirical evaluaƟon of new AAI programs targeted to 
meet the needs of early adolescents from diverse populaƟons is especially criƟcal.  The methods of this 

 
 
 
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program are based on a strong foundaƟon of theoreƟcal knowledge related to the social beneﬁts of 
joint synchronous acƟvity (cat walking)[22], behavior analysis (beneﬁts of incremental posiƟve 
reinforcement-based shaping and training)[23] and aƩachment theory (cat-human bonding)[7], and our 
teams prior research on cat training and acƟvity based AAIs with dogs. 
Preliminary Data:  
Cat training classes are likely to 
promote engagement and 
retenƟon (Fig. 1): Preliminary data 
support the conclusion that there 
is strong community interest in 
parƟcipaƟng in cat training classes. 
For example, Drs. Udell & Vitale 
oﬀered ﬁve formal (6-week long) 
cat training classes to the public at 
Oregon State University over a two-year period. 100 kiƩen-owner pairs enrolled in the program during 
this Ɵme, with 50 assigned to the training class (experimental group); 86% of owners completed the 6-
week program. Owners that completed the course aƩended 91% of the class sessions and 84% of them 
parƟcipated in research tesƟng at baseline and follow-up. Cats also readily learned behaviors through 
use of posiƟve reinforcement training. Successfully learned behaviors included “go to mat and stay”, 
“sit”, “stand”, “target”, “walk on harness with leash” and more advanced behaviors such as “stay” while 
in a kayak. Drs. Udell & Vitale have also oﬀered mulƟple highly successful summer cat training camps 
where local youth were taught to train shelter/foster cats.  
Cats share many traits that have predicted AAI success in other 
species: Prior research suggests that the quality of aƩachment 
between human and animal AAI parƟcipants is an important 
predictor of health outcomes and AAI success [6], [18]. 
Members of our research team have evaluated cat-owner 
aƩachment bonds by exploring if cats can be categorized into 
the same secure and insecure aƩachment styles in a strange 
situaƟon as seen in humans [24] and domesƟc dogs [25]. Drs. 
Vitale and Udell have found that like human infants and pet 
dogs, kiƩens (n = 70) and adult cats (n = 38) can display either 
secure or insecure aƩachment styles toward their adult owner, 
with the majority (64 - 69%) displaying a secure aƩachment 
(similar to the dog and human literature). What we have found 
in our work looking at dog-child aƩachment, is that oŌen stable 
caregiver aƩachment relaƟonships have not yet been 
established between children and their dogs prior to 
intervenƟon, and that intervenƟon parƟcipaƟon signiﬁcantly 
increases secure aƩachment formaƟon between children and 
their animal partners [25]. We plan to evaluate this in cats. 
 

 
 
 
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Research by Drs. Vitale and Udell has also indicated that while individual cat behavior can vary, most 
pet cats acƟvely seek out social interacƟons with human caretakers and are highly sensiƟve to human 
social cues. For example, adult pet cats parƟcipaƟng in a sociability test spent on average 60 - 70% of a 
2-min session seeking the proximity of an aƩenƟve owner [11]. In another study, 50% of cats chose to 
engage in social interacƟon with a human, over access to a preferred food item, toy and scent object (p 
< .01) [26], 37% choose their favorite food over social interacƟon (for many of these cats social 
interacƟon was their second choice). Interest in owners and interest in food are both useful starƟng 
points for training. 
Human-cat interacƟons, including parƟcipaƟon in training classes, can also have a posiƟve impact on 
cat behavior and cogniƟon. For example, we found that aŌer parƟcipaƟon in six-weeks of cat training 
classes with their owner, cats were signiﬁcantly more responsive to their owner’s aƩenƟonal cues and 
spent signiﬁcantly more Ɵme in proximity to their owner when the owner was aƩenƟve to the cat (Fig. 
2). Cats in the control group (no training experience) did not display this level of sensiƟvity to their 
owner’s aƩenƟonal state. 
The proposed study will address gaps in the current literature by providing more informaƟon about 
cat-child aƩachment bonds, the eﬃcacy of a novel acƟve CAT intervenƟon and evaluaƟon of the 
potenƟal behavioral and social health and wellbeing outcomes of AAI parƟcipaƟon for both human and 
cat parƟcipants.  
Our team has experience developing and evaluaƟng 
successful training & physical acƟvity AAIs:  
Drs. Udell, MacDonald and Jiang have previously 
developed, evaluated and published data on 
successful dog walking and training-based AAIs 
aimed at promoƟng physical acƟvity and social 
wellbeing in children with DD. Drs. Vitale and Darling 
have both parƟcipated in the implementaƟon of 
those intervenƟons and are therefore familiar with 
the intervenƟon approach. This prior dog AAI work 
was conducted with the support of the NIH 
[R21HD091895], and successful recruitment of 
children and adolescents with DD (N=30). We 
successfully met all study aims, resulƟng in published 
outcomes and measurable impact (e.g., 
presentaƟons, media features, and growth to an R01 
award [R01HD101098] that has allowed for regional 
expansion of our program to sites across the Paciﬁc 
Northwest). The current proposal beneﬁts from our experienƟal knowledge of what is feasible and 
achievable within the proposed Ɵmeline given our unique populaƟon, methods, and aims. 
In our prior work, we found that adolescents reported greater feelings of responsibility towards their 
dog, including increased rates of walking and training aŌer parƟcipaƟon in a dog training-based AAI 
(Fig. 3). The relaƟonship between dogs and children improved, with signiﬁcantly more secure 

 
 
 
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aƩachments between dogs and children aŌer the AAI [6]. Given strong parallels in the theoreƟcal 
framework and given the current state of scienƟﬁc knowledge about cat-human relaƟonships and cat 
social behavior, we predict similar outcomes for our cat-based intervenƟon. 
Experimental Approach: 
ParƟcipants  
50 early adolescents with a DD, between the ages of 8-17 years whose family includes at least one cat 
at the Ɵme of enrollment (see Sample Size JusƟﬁcaƟon & Data Analysis) will be recruited from Corvallis 
OR and the surrounding communiƟes through schools, community-based programs serving children 
with developmental disabiliƟes (DDs) and through social media). A DD will be conﬁrmed through 
parent report (e.g., iniƟal recruitment conversaƟons, and documented through demographic 
quesƟonnaire). Although developmentally appropriate and adapted pedagogical techniques will be 
implemented within all intervenƟon protocols, inclusion criteria for child and cat safety require all 
parƟcipants to follow basic instrucƟons. To assess this, parƟcipants will complete the Head-Toes-Knees-
Shoulders task (HTKS) [27]. This task requires parƟcipants to follow basic and more complicated 
instrucƟons, including rule changes. To parƟcipate a minimum score of 1 (range 0-2) on 90% of the test 
items will be required of parƟcipants. For safety cats showing signs of aggression towards humans will 
not be eligible to parƟcipate. Cats will be carefully monitored to ensure their welfare during all 
acƟviƟes. Because restricƟng the age of cats could limit human parƟcipant eligibility, and because there 
is evidence that a cat’s age is not a reliable predictor of training success [10], for the proposed study we 
will allow any cat over 8 weeks to parƟcipate as long as they meet the above criteria, and will collect 
data on age as a variable. In recent years, we have successfully taken this approach with our dog 
training AAIs. Dyads meeƟng eligibility requirements will be randomly assigned (Randomized Control 
Trial) to either the CAT intervenƟon (n=25) or Control (n=25) group aŌer compleƟng the consent/assent 
process. Dyads assigned to the control group will have the opportunity to parƟcipate in training classes 
aŌer study parƟcipaƟon is complete to ensure equal access to a potenƟally beneﬁcial AAI. Each class 
will last 45-min for 6 sessions (see Table 1). 
Study Groups: There will be 3 assessments per parƟcipaƟng dyad over the course of 1 year; aŌer iniƟal 
enrollment (baseline), aŌer six weeks (post-intervenƟon or Ɵme matched control) and 1-year aŌer 
enrollment. All parƟcipants (experimental & control groups) will complete each of these assessments.  
CAT intervenƟon Group 
The experimental group will take part in the CAT intervenƟon (Table 1) aŌer baseline assessments. 
All cat-training methods will be posiƟve reinforcement based, using owner-approved food, toys and 
social reinforcers (e.g. peƫng). Children will learn about cat body language, behavior and proper 
cat handling techniques. 
Control Group 
Control parƟcipants will complete the same three assessments as the CAT intervenƟon groups but 
will not parƟcipate in the CAT intervenƟon. AŌer the compleƟon of the third assessment (end of 
proposal-related data collecƟon), control parƟcipants will be oﬀered the opportunity to parƟcipate 

 
 
 
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in the cat training classes. This will ensure equal access to any beneﬁts that might occur as an 
outcome of the intervenƟon.    
Cat Assisted Training IntervenƟon 
We predict that parƟcipaƟon in the CAT intervenƟon, which will teach children with DD how to use 
basic behavioral principles and posiƟve reinforcement skills with their cats will facilitate increased 
opportunity and moƟvaƟon to engage in joint physical acƟvity (walking, training), responsibility-
taking and will improve social wellbeing including quality of interacƟons between child and cat. The 
CAT intervenƟon will be a six-session cat training and socializaƟon camp, with each session lasƟng 
approximately 45 minutes. Over the course of the 6 session camp children will learn about cat body 
language and proper cat handling. They may also train their cat to walk in harness/leash, sit on 
command, and train trick behaviors as a ﬁnal project. Trained assistants (one assistant per child) will 
help children train their cat using posiƟve reinforcement training techniques. Breaks will be taken as 
needed or at least for 5 minutes, every 15 minutes. Focus will be on providing children with a beƩer 
understanding of cat body language and how to train basic behaviors in order to facilitate enjoyable 
independent cat-human interacƟons at home. All training methods used with cats in the CAT 
intervenƟon will be posiƟve reinforcement based, using owner-approved food treats, toys or social 
engagement as reinforcers and/or lures where appropriate. An outline of acƟviƟes and homework 
for the 6 session CAT intervenƟon can be found below: 
Table 1. Outline of acƟviƟes and homework for the 6-session CAT intervenƟon 
Approach and Assessments:  
Speciﬁc survey and behavioral assessments for each speciﬁc aim are outlined below. During 
assessments children and a parent/adult household member will complete several short, validated 
quesƟonnaires. There are adaptable procedures, allowing for ﬂexibility in administraƟon. ParƟcipants 
can ﬁll out the quesƟonnaire on their own or an assessor can read aloud and allow the parƟcipant to 
respond. Scoring will conform to standard methods speciﬁed for each assessment. Cat-speciﬁc 
quesƟonnaires have been adapted from previously validated animal quesƟonnaires. All child and cat 
assessments will occur at each of the three assessment Ɵme points (Baseline, six weeks and 1 year). In 
total, assessments will include 4 pages of survey quesƟons to be completed by the child, one 11-page 

 
 
 
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survey about the cat’s behavior to be completed by a parent/adult in the household, and 8 minutes of 
behavioral tesƟng by the cat and child during each assessment.  Cat’s will also parƟcipate in one 
addiƟonal behavioral aƩachment test with the primary adult caretaker during the iniƟal assessment for 
iniƟal paired comparison with child-cat bonds. 
Aim 1: To evaluate the nature and quality of bonds shared between cats and children 
with DD.  
Our hypothesis is that cats and children will show evidence of bonds prior to intervenƟon. However, 
the quality and type of relaƟonships shared between cats and children are predicted to be variable and 
less secure than cat-adult bonds iniƟally. *Note: The successful compleƟon of Aims 2 & 3 is not 
dependent on the presence of secure aƩachment bonds between children and cats prior to AAI 
parƟcipaƟon. We expect CAT parƟcipaƟon to improve aƩachment scores by week 6 (Aim 3), similar to 
what we have observed in our dog AAI research [6].  
Aim 1 Assessments:  
1. Behavioral AƩachment Test: A cat sociability [11] and Secure Base aƩachment test [25] will be 
conducted to evaluate the cat-child bond (and the cat-adult bond at baseline). The cat’s contact, 
proximity seeking, gaze, exploraƟon, play and avoidance behavior will be evaluated over a series of 2-
minute sessions (8 minutes total) where the child (or parent) is either present and passive, present and 
aƩenƟve, absent or reuniƟng with the cat. Behaviors will be double coded from video (to assess inter-
rater reliability), coders will be blind to group assignment. AƩachment style classiﬁcaƟons will be made 
in line with previously validated methods [7]. 
2. Child-Cat RelaƟonship Surveys: Children will complete a 1-page Children’s Treatment of Animals 
QuesƟonnaire (CTAQ) [28], 1-page Pet Care Responsibility Inventory [29], and a 1-page Lexington 
AƩachment to Pets Scale (LAPS) [30]. These will characterize iniƟal child-cat aƩachment (Aim 1) and to 
evaluate AAI outcomes related to predicted strengthening of the child-cat bond at 6-week and 1-year 
assessments (Aim 3). 
Aim 2: To develop & evaluate the eﬃcacy of a novel Cat Assisted Training (CAT) 
intervenƟon aimed at increasing physical acƟvity in early adolescents with 
developmental disabiliƟes.  
Our hypothesis is that parƟcipaƟon in this novel CAT intervenƟon will result in high parƟcipant 
retenƟon and signiﬁcant improvement in study related physical acƟvity goals when compared with 
baseline measures, and when compared with a randomized control group. 
Aim 2 Assessments:  
1. EvaluaƟon of CAT intervenƟon retenƟon: Our retenƟon goal for this program is 68% (overall) - 76% 
(experimental group), as this is what we achieved in our prior dog walking/training AAI [NIH 
R21HD091895].  Lower retenƟon would not rule out future CAT intervenƟons but would signal that 
improvements may be needed to increase eﬀecƟveness. If aƩriƟon occurs, we will evaluate retenƟon 

 
 
 
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across the course of the six-week CAT intervenƟon using a survival curve to help idenƟfy any elements 
that could have contributed.  
2. EvaluaƟon of CAT intervenƟon for increasing joint physical acƟvity: As in our prior research 
evaluaƟng dog training AAIs, survey items about pet walking, training and joint acƟvity found on the 
validated Pet Care Responsibility Inventory [29] will be used to determine if intervenƟon parƟcipaƟon 
predicts a subsequent increase in joint physical acƟvity (including walking and training behaviors) in 
CAT parƟcipants aŌer the intervenƟon, when compared with baseline measures and the control group. 
At each training session parƟcipants will also be asked if they completed their training and walking 
homework in the prior week, providing informaƟon about engagement that can be used to guide future 
development of the CAT program. This informaƟon will guide the development of our ﬁnal program for 
our R01 proposal, where we will conduct a larger scale study of the CAT program, collecƟng addiƟonal 
physical acƟvity data using accelerometers.  
3. EvaluaƟon of cat training success: We will evaluate the training success of cats across the behaviors 
presented in Table 1, primarily to help inform (and modify, if needed) future training strategies and 
goals. We have found in past studies that the number of behaviors an animal learns during the 
intervenƟon itself is less important to AAI health-related outcomes than the process of engaging in the 
intervenƟon [6], nonetheless we aim to make the AAI training goals and methods as successful and 
data driven as possible. We will also evaluate behavior changes across assessment Ɵme points using 
the validated 11 page Feline Behavioral Assessment & Research QuesƟonnaire (Fe-BARQ) [31] 
completed by a parent/adult in the household. 
Aim 3: To evaluate the impact of a CAT intervenƟon on social wellbeing & the child-cat 
bond.  
Our hypothesis is that parƟcipaƟon in a novel CAT intervenƟon will result in increased feelings of social 
wellbeing, increased aƩachment towards the family cat and will promote greater independent 
responsibility for the family cat by adolescent parƟcipants with DD when compared to baseline 
measures, and controls. We also predict that we will ﬁnd behavioral evidence of increased sociability 
and higher rates of secure aƩachment among cat-child dyads following intervenƟon when compared to 
baseline. 
Aim 3 Assessments:  
1. AƩachment Measures: The aƩachment test [25] and the Child-Cat RelaƟonship Survey outlined 
under Aim 1 Assessments will be used to compare the quality and strength of the child-cat bond before 
and aŌer CAT intervenƟon parƟcipaƟon and to compare child-cat bonds between intervenƟon 
parƟcipants and controls at 6 weeks and 1 year. Importantly these measures provide informaƟon on 
aƩachment from the perspecƟve of both the human (survey) and the cat (behavioral assessment).   
2. Social Wellbeing Measures: Human parƟcipants will complete a 1-page EmoƟonal Support survey 
validated for children ages 8-17 [32], and cats will complete the sociability test described in Aim 1 
before and aŌer intervenƟon parƟcipaƟon. This will allow us to compare indicators of social comfort 
and wellbeing as a funcƟon of intervenƟon parƟcipaƟon from both the child and cat’s perspecƟve. 

 
 
 
Page 11 of 17 
 
3. Independent Responsibility Measure: We will use the 1-page Pet Care Responsibility Inventory [29] 
to evaluate changes in reported caretaking and responsibility for the family cat before and aŌer 
intervenƟon. We will also compare Pet Care Responsibility Inventory scores between the experimental 
and control group. 
Sample Size JusƟﬁcaƟon and StaƟsƟcal Analysis Plan:  
To determine the opƟmal sample size, we based our power analysis on eﬀect size and noise level 
esƟmated using our preliminary data from our successful prior R21 dog training AAI study 
[R21HD091895]. To achieve at least 92% power for detecƟng an increase in the overall care and 
responsibility acƟviƟes, the minimum sample size would be 10 per group, power increased to 99% with 
a sample size of 15. A sample size of 10 would also enable a power of 79% for detecƟng an increase in 
animal walking (physical acƟvity measure), a sample size of 15 increased this to 93% power. However, 
we anƟcipate a higher level of aƩriƟon than in previous studies due to behavioral diﬀerences between 
cats and dogs. Therefore, for the proposed project, we will recruit 25 parƟcipants per group, which will 
provide the necessary power to detect staƟsƟcal diﬀerences where they exist, even if aƩriƟon occurs. 
This sample size will also allow us to model the eﬀects of covariates, such as age of parƟcipants, that 
could potenƟally inﬂuence the eﬃcacy of the CAT intervenƟon. Behavior will always be coded from 
video by two independent coders (blind to group assignment) to assess inter-rater reliability. 
Characterizing the cat-child bond will consist of holisƟc aƩachment style analysis from which 
proporƟons of dyads falling into diﬀerent aƩachment classiﬁcaƟons can be determined and included in 
eﬃcacy analyses (Aim 1).  
*Minor updates to staƟsƟcal analysis plan post data collecƟon  
To assess eﬃcacy of the CAT intervenƟon we planned to conduct a survival analysis for program 
retenƟon and for the populaƟon of cats reaching each milestone in the training program (Aim 2). 
However, our retenƟon rate was high at 97% so no survival analysis was necessary. Cat milestones were 
analyzed as part of our ﬁdelity analysis using non-parametric correlaƟon tests appropriate for non-
normal and/or non-conƟnuous data (e.g., Spearman’s Rank CorrelaƟon). To assess the eﬀecƟveness of 
CAT (Aims 2 & 3), we will perform paired t-tests, independent t-tests, linear regression and analysis of 
variance as appropriate to evaluate any changes in physical acƟvity/joint walking, sociability (cat) and 
social wellbeing (child) scores, and HAI measures, for CAT parƟcipants across three assessment Ɵme 
points. We will also compare any improvement in the training group to changes within the control 
group. This study design allows us to evaluate the diﬀerence between the CAT intervenƟon group and 
control group aŌer accounƟng for baseline variability among child-cat pairs (see below). The 
incorporaƟon of baseline data will reduce the noise level in our model and therefore enhance the 
staƟsƟcal eﬃciency. For any data not conforming to the requirements of parametric tests (e.g., 
normality), we will use non-parametric tests such as McNemar’s Test, Fisher’s Exact test, etc.).A fully 
randomized control trial approach will be uƟlized. Block randomizaƟon will be conducted to ensure a 
balance in the sample size between groups 

Page 12 of 17 
 
ModiﬁcaƟon Requested: 
“AŌer consultaƟon and approval from our funder (NIH program oﬃcer), we propose to expand the parƟcipant 
age range in our study from 10-12 years to 8-17 years. This adjustment aligns with our original intenƟon to 
explore the intervenƟon eﬃcacy in children with disabiliƟes more broadly. We have successfully run AAI 
programs with 8–17-year-old children previously. The revision maintains our current procedures and 
assessments, ensuring no addiƟonal risk to our parƟcipants.” 
HE-2022-29 - ModiﬁcaƟon 
Date: September 13, 2023 
PI: Megan MacDonald 
Department: ASC - Animal & Rangeland Sciences, HHS - Public Health/Human Sci Admin 
Re: Modification - HE-2022-29 
 
The development and evaluation of a novel Cat Assisted Training (CAT) intervention for youth with 
developmental disabilities and their family cat. 
 
The Oregon State University Institutional Review Board has rendered the decision below for The 
development and evaluation of a novel Cat Assisted Training (CAT) intervention for youth with 
developmental disabilities and their family cat.. 
 
Decision: Approved 
 
Category: 6. Collection of data from voice, video, digital, or image recordings made for research 
purposes. 
7. Research on individual or group characteristics or behavior (including, but not limited to, research on 
perception, cognition, motivation, identity, language, communication, cultural beliefs or practices, and 
social behavior) or research employing survey, interview, oral history, focus group, program evaluation, 
human factors evaluation, or quality assurance methodologies. (NOTE: Some research in this category 
may be exempt from the HHS regulations for the protection of human subjects. 45 CFR 46.101(b)(2) and 
(b)(3). This listing refers only to research that is not exempt.) 
 
Any modifications to the approved study must be submitted for review through Cayuse HE. All approval 
letters and study documents are located within the Study Details in Cayuse HE. 
The above referenced study was approved by the OSU Institutional Review Board (IRB). The IRB has 
determined that the protocol meets the minimum criteria for approval under the applicable 
regulations pertaining to human research protections. The Principal Investigator is responsible for 
ensuring compliance with any additional applicable laws, University or site-specific policies, and sponsor 
requirements. Study design and scientific merit have been evaluated to the extent required to determine 
that the regulatory criteria for approval have been met [45CFR46.111(a)(1)(i), 45CFR46.111(a)(2)]. 

 
 
 
Page 13 of 17 
 
Cayuse Index Number: 22-0709 
 
All previous determination and waivers still apply to this study. If any additional determinations were 
made as part of the review of this submission, they are listed below. 
 
Risk Level determination: The IRB determined the research procedures described in this application 
constitute no more than minimal risks to subjects. 
Consent: Consent is obtained in accordance with 45 CFR 46.116. Written consent is not required for eligibility 
screening procedures. 
Child Risk Level and Category: The IRB determined that this research can be conducted under 45 CFR 
46.404 as it involves no greater than minimal risk to child subjects. 
Child Capacity to Assent: The IRB determined that the child subjects are capable of assent according to 
45 CFR 46.408(a). 
Assent: Assent is obtained in according to 45 CFR 46.408(a) 
Parent permission: Parent permission is obtained in according to 45 CFR 46.408(b). Documentation 
of Parent Permission: Written parent permission will be obtained from all subjects’ parents and for all 
procedures in accordance with 45 CFR 46.117. 
Clinical Trial - This study meets the NIH definition of a clinical trial. The investigator must register this study 
on ClinicalTrials.gov no later than 21 days after enrolling the first subject. If you do not already have an 
account with ClinicalTrials.gov, one will be created for you. Once you have registered the study, you 
must update the record in ClinicalTrials.gov at least annually. If you amend the protocol in a way that 
impacts the information that you have entered into the ClinicalTrials.gov record, you are required to 
update that record within 30 calendar days after the amendment is approved by the IRB. 
Notes to Researcher: Modifications to participant ages and recruitment flyer. 
 
Principal InvesƟgator responsibilities: 
• Keep study team members informed of the status of the research and ensure all team members 
follow the approved protocol. 
• Obtain IRB approval for project revisions prior to implementing changes. 
• Report all unanticipated problems involving risks to participants or others within three calendar 
days. 
• Use only approved consent document(s). 
Sincerely, 
 
Oregon State University Institutional Review Board 

Page 14 of 17 
 
ModiﬁcaƟon requested: 
“We request to increase the target enrollment from 60 to 100 parƟcipants. Our iniƟal target enrollment was 
based on anƟcipated aƩriƟon levels derived from a similar study with children and dogs. However, we now 
anƟcipate aƩriƟon levels may be higher in this current group, due to behavioral diﬀerences between cats and 
dogs. 
We have adjusted the language describing the intervenƟon by changing "six week" program into "six session" 
program. This will provide scheduling ﬂexibility/increased retenƟon based on parƟcipant schedules. Total 
duraƟon and all parƟcipant experiences remain the same.” 
HE-2022-29 - ModiﬁcaƟon: ModiﬁcaƟon 
Date: September 13, 2023 
PI: Megan MacDonald 
Department: ASC - Animal & Rangeland Sciences, HHS - Public Health/Human Sci Admin 
Re: ModiﬁcaƟon - HE-2022-29 
The development and evaluaƟon of a novel Cat Assisted Training (CAT) intervenƟon for youth with 
developmental disabiliƟes and their family cat. 
The Oregon State University InsƟtuƟonal Review Board has rendered the decision below for The development 
and evaluaƟon of a novel Cat Assisted Training (CAT) intervenƟon for youth with developmental disabiliƟes and 
their family cat.. 
Decision: Approved 
 
Category: 6. CollecƟon of data from voice, video, digital, or image recordings made for research purposes. 
7. Research on individual or group characterisƟcs or behavior (including, but not limited to, research on 
percepƟon, cogniƟon, moƟvaƟon, idenƟty, language, communicaƟon, cultural beliefs or pracƟces, and social 
behavior) or research employing survey, interview, oral history, focus group, program evaluaƟon, human 
factors evaluaƟon, or quality assurance methodologies. (NOTE: Some research in this category may be exempt 
from the HHS regulations for the protection of human subjects. 45 CFR 46.101(b)(2) and (b)(3). This listing 
refers only to research that is not exempt.)Any modiﬁcaƟons to the approved study must be submiƩed for 
review through Cayuse HE. All approval leƩers and study documents are located within the Study Details in 
Cayuse HE. 
The above referenced study was approved by the OSU InsƟtuƟonal Review Board (IRB). The IRB has 
determined that the protocol meets the minimum criteria for approval under the applicable regulaƟons 
pertaining to human research protecƟons. The Principal InvesƟgator is responsible for ensuring compliance 
with any addiƟonal applicable laws, University or site-speciﬁc policies, and sponsor requirements. Study design 
and scienƟﬁc merit have been evaluated to the extent required to determine that the regulatory criteria for 
approval have been met [45CFR46.111(a)(1)(i), 45CFR46.111(a)(2)]. 
Cayuse Index Number: 22-0709 
All previous determinaƟon and waivers sƟll apply to this study. If any addiƟonal determinaƟons were made as 
part of the review of this submission, they are listed below. 

 
 
 
Page 15 of 17 
 
Risk Level determinaƟon: The IRB determined the research procedures described in this applicaƟon consƟtute 
no more than minimal risks to subjects. 
Consent: Consent is obtained in accordance with 45 CFR 46.116. WriƩen consent is not required for eligibility 
screening procedures. 
Child Risk Level and Category: The IRB determined that this research can be conducted under 45 CFR 46.404 
as it involves no greater than minimal risk to child subjects. 
Child Capacity to Assent: The IRB determined that the child subjects are capable of assent according to 45 CFR 
46.408(a). 
Assent: Assent is obtained in according to 45 CFR 46.408(a) 
Parent permission: Parent permission is obtained in according to 45 CFR 46.408(b). DocumentaƟon of Parent 
Permission: WriƩen parent permission will be obtained from all subjects’ parents and for all procedures in 
accordance with 45 CFR 46.117. 
Clinical Trial - This study meets the NIH deﬁniƟon of a clinical trial. The invesƟgator must register this study on 
ClinicalTrials.gov no later than 21 days aŌer enrolling the ﬁrst subject. If you do not already have an account 
with ClinicalTrials.gov, one will be created for you. Once you have registered the study, you must update the 
record in ClinicalTrials.gov at least annually. If you amend the protocol in a way that impacts the informaƟon 
that you have entered into the ClinicalTrials.gov record, you are required to update that record within 30 
calendar days aŌer the amendment is approved by the IRB. 
Notes to Researcher: ModiﬁcaƟons to parƟcipant ages and recruitment ﬂyer. 
Principal InvesƟgator responsibiliƟes: 
• Keep study team members informed of the status of the research and ensure all team members follow 
the approved protocol. 
• Obtain IRB approval for project revisions prior to implemenƟng changes. 
• Report all unanƟcipated problems involving risks to parƟcipants or others within three calendar days. 
• Use only approved consent document(s). 
Sincerely, 
Oregon State University InsƟtuƟonal Review Board 
 

 
Page 16 of 17 
 
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