Service Dogs as Interventions: State of the Science

Assistance, Service, Emotional Support, and Therapy Dogs

This article focuses on the areas where harnessing the canine's trainability, mobility, and sociability enables their use for aiding and augmenting humans. This area, which is rapidly expanding, has provided life-changing solutions for persons affected by various impairments and disabilities (eg, visual, hearing, physical, mental).

The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review

Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. However, this research is not only widely disparate but, despite its growth, has not been reviewed since 2012. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted across seven electronic databases. Records were independently screened by two authors. Studies were eligible for inclusion if they assessed outcomes from guide, hearing, medical, or mobility service dogs, if they collected original data on handlers' psychosocial functioning, and if the outcome was measured quantitatively with a validated, standardized measure. Studies on psychiatric service dogs, emotional support dogs, and pet dogs were excluded. Of 1,830 records screened, 24 articles were identified (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality. However, it is of note that several methodological weaknesses of the studies make it difficult to draw any definitive conclusions, including inadequate reporting and a failure to account for moderating or confounding variables. Future research will benefit from stronger methodological rigor and reporting to account for heterogeneity in both humans and assistance dogs as well as continued high-quality replication.

The impact of service dogs on children, youth and their families: A systematic review

BACKGROUND

Having a service dog can help to increase independence and well-being among people with a disability or a chronic health condition. Although there has been an increasing use of service dogs among children and youth their impact has not yet been synthesized.

OBJECTIVE

The purpose of this article was to conduct a systematic review assessing the impact of service dogs on children, youth and their families.

METHODS

Systematic searches of seven international databases from 1985 to 2020 led to 29 studies meeting our inclusion criteria. Using a narrative synthesis review approach we analyzed these studies regarding their sample characteristics, methods, results and quality of evidence.

RESULTS

There were 29 studies in our review that included 1121 children and youth (or parents representing them) that spanned across six countries over a 32-year period. Although the outcomes of the impact of service dogs varied across the studies, 23/29 of them reported an improvement in at least one of the following: physical health (i.e., diabetes management, seizure management, mobility), psychological health (i.e., quality of life, safety, behavior, stress, anxiety, self-confidence and independence), social well-being (i.e., social interactions, school and work) and dog-owner-bond. Children, youth and their parents also described several challenges in owning a service dog.

CONCLUSIONS

Our findings highlight that service dogs have potential to provide many benefits for children, youth and their families. Further research, including more rigorously designed studies, is needed to fully understand their impact.

Effects of a mobility assistance dog on the performance of functional mobility tests among ambulatory individuals with physical impairments and functional disabilities

This study aims to verify whether individuals with physical impairments and ambulatory disabilities perform functional mobility tests faster using an assistance dog for mobility (AD(Mob)). Thirty-four individuals with various physical impairments and functional disabilities performed at least one of the four functional mobility tests within their natural environment during an in-home assessment. Participants randomly performed the 10-meter walk test, the timed up-and-go (TUG) test, and the stair ascent and descent tests with and without an AD(Mob) during an in-home assessment. The main outcome measure was the time needed to complete all tests with and without an AD(Mob). When using an AD(Mob), many participants (> or = 70.4%) were faster when performing the 10-meter walk test (15.7 +/- 8.5s vs. 19.1 +/- 11.2s), TUG test (23.6 +/- 14.2s vs. 27.3 +/- 16.5s), and stair ascent test (18.6 +/- 13.5s vs. 22.4 +/- 17.5s) compared to doing the tests without an AD(Mob). As for the stair descent test, the use of the AD(Mob) had no significant effect on performance (20.7 +/- 15.9s vs. 24.0 +/- 17.1s). When using an AD(Mob), the majority of individuals with physical impairments and functional disabilities significantly improved their performance (i.e., reduced their time) during the 10-meter walk test, the TUG test and the stair ascent test.

Natural activity: an explorative study of the interplay between cage-birds and older people in a Swedish hospital setting

Aim.  The aim of this study was to describe the interaction between cage-birds and older people as it arises in spontaneous situations in a Swedish hospital ward setting. Background.  Older people are at risk of being affected by mental fatigue because of various age-related reductions and disease. Mental fatigue manifests itself through a reduced ability to concentrate. The method of alleviating mental fatigue with the use of stimulating natural settings or animal-assisted activities is so far unexplored in Sweden and subsequently it is important to study the method in a Swedish context to implement it as a recognized nursing intervention in the care of older people. Design.  The study had an explorative observational design, and was conducted at a geriatric ward with a consecutive selection of participants. Method.  The observations were analysed using a constant comparative method influenced by Grounded Theory. 'Attention restorative theory' was used as the theoretical framework to guide the study. Result.  Our findings indicate that animal-assisted therapy has a positive effect on involuntary attention and mental restoration, as well as on enhanced social behaviour among older people. Relevance to clinical practice.  The result strengthens the assumption that animal companionship should be considered a beneficial nursing intervention for older people to prevent mental fatigue.

Service dogs and people with physical disabilities partnerships: a systematic review

Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened.

Sentinels of safety: service dogs ensure safety and enhance freedom and well-being for families with autistic children

Children with autism might display unpredictable and volatile behavior that places them in considerable physical danger and creates stress for the family. Families of autistic children often have limited freedom and experience difficulty with everyday activities. In this qualitative ethology study, we examined the effect of integrating service dogs into ten families with an autistic child. Data included participant observation, video recordings of family-parent-dog interaction, and semistructured interviews with the parents. The themes were (a) the dog as a sentinel of safety, (b) gaining freedom through enhanced safety, facilitating public outings and family activities, and (c) improving social recognition and status, in which the presence of the dog promoted awareness of autism and affected social interaction. The triadic relationship between parent, autistic child, and service dog constantly evolves. This research provides valuable information for parents interested in having a service dog for their autistic child, and has implications for long-term human-animal companionship for children with special needs and their caregivers.

From puppy to service dog: raising service dogs for the rehabilitation team

Service dogs, also known as assistance dogs, are seen increasingly in public places, including healthcare settings. Whereas an earlier article reviewed literature relevant to the human-animal bond in general, this article recounts my personal and professional experiences as a volunteer for Canine Companions for Independence (CCI). Rehabilitation professionals are advocates for their clients, and this article provides important information about the issues, benefits, and challenges in obtaining, training, and living with a service dog. For additional information, sources available through the Internet and a bibliography are provided.