Therapy and service dogs: Friends and healers

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Like other volunteers at The Hospital for Sick Children (SickKids), Gus has a special vest and an ID badge. The difference is that his vest says "Therapeutic Paws of Canada" and his badge is attached to his dog collar. Gus is just one of the many animals who help children and adults in a wide variety of ways as a service and therapy animal.

Most people are familiar with guide dogs for the blind. Other dogs help people with hearing loss, mobility problems, seizures, and even autism. Dogs, cats, rodents, horses, and even dolphins are used as partners in some forms of physical, occupational, speech, and psychological therapy.

Animal therapy in one form or another goes back thousands of years. Dogs in the temples of Asklepios or Aesculapius, the Greek and Roman god of healing, were thought to be able to diagnose and cure disease by licking the patient's body. Various written patient endorsements suggest that it even worked, at least once in a while. Dogs' saliva has mild antibacterial properties, which may have helped with wound healing.

More recently, the presence of an animal in stressful situations has been found to lower blood pressure, increase relaxation, and reduce perceived pain. In fact, the calming effect of animals is such that they are also used to help children learn to read and as visitors in hospital wards.

Therapy animals: The dog-tor is in

A physical or psychological therapist may use an animal as a "therapeutic partner," either to improve physical fitness or in social or emotional therapy. This is called Animal Assisted Therapy (AAT). A more casual approach is through Animal Assisted Activities (AAA), which include hospital visiting programs and reading programs. A growing body of evidence suggests that animals can have a positive effect in many such situations.

Pets At Work

SickKids' Pets At Work (PAWS) program brings in specially trained dogs to visit children who are in hospital. It's not quite the same thing for children as seeing their own pet, but it's an important change in the hospital routine - a chance for kids to relax and be kids instead of patients.

Gus, a mellow nine-year-old Golden Retriever, visits SickKids for one hour twice a week with his owner, Susan Bresler. Some children are old friends; others are just meeting Gus for the first time. Gus sits on beds and next to wheelchairs and strollers, welcomes dog biscuits and cuddles, and poses for portraits. Five other dogs, large and small, do the same on other wards.

Pets can play a big part in helping children through their hospital stay, says Alexis Shinewald, a Child Life specialist at SickKids. "They give children a pleasant and comforting experience. A lot of kids have pets at home, and a big sadness about being in hospital is that they miss their pets."

A study on the impact of the PAWS program found that visits from friendly dogs helped children and, to a lesser extent, their parents with the experience of hospitalization. Many said that it made the hospital feel less medical and more like home. Nearly three-quarters of the children and half of the parents felt that the visit was a pleasant distraction that calmed them and relieved stress.

As Gus makes his rounds, the truth of that is obvious. One little girl, recovering from a tough physiotherapy session, cracks a smile as Gus sits next to her wheelchair. Another sets aside lunch to give Gus more space on her bed. Faces light up all the way down the corridor.

One boy is dubious: "Dogs bite."

"Gus has been coming here for five years," Bresler assures him, "and in all that time he's never bitten anyone."

Reassured, the boy gives Gus a tentative pat and, eventually, a smile.

"It's a true break in their day," Shinewald says. "You don't look at pets as being part of the hospital experience, so it's something special. It gives the children something to look forward to."

Learning to read with some furry or feathery help

Reading Education Assistance Dogs (R.E.A.D.) pairs kids with specially trained dogs, cats, and even a parrot to help them learn to read. Children who are nervous or self-conscious about their reading skills sit with a pet and read aloud to it. With the help of the pet's calming, non-judgemental presence, children can focus on the story without having to worry about making mistakes or being laughed at. The program's anecdotal results are striking, with children gaining reading skill and confidence at the same time. Since 1999, the program has spread from its Utah roots to over 750 teams in 45 states. Organizers are hoping to evaluate the program more formally.

Potential drawbacks of therapy animals

Some authors have raised concerns about the possible risks therapy animals pose to patients, including infection, bites, and allergies. While these risks cannot be discounted, they are certainly no greater than with any family pet, and should be addressed in the same way: by keeping animals healthy, vaccinated, and well groomed, by training animals carefully, and by supervising children's interactions with the animals.

Service dogs: Everyday assistance

Dogs have guided blind people as long ago as the first century AD, but the modern, systematic training of guide dogs goes back to World War I. In 1916, Dr. Gerhard Stalling opened a guide dog school in Germany to help the many veterans who had been blinded in the war. The idea was both successful and popular; guide dogs have since given thousands of people mobility and independence.

The success of these guide dogs sparked other ideas: if dogs could help blind people, why not those with other disabilities? Specially trained dogs now alert deaf people to ringing telephones, doorbells, and alarms; help people with mobility problems open doors, retrieve objects, and move from wheelchair to bed; warn people who are about to have a seizure; and more.

Service dogs help children with autism

National Service Dogs, a charity based in New Hamburg, Ontario, pairs dogs and children with autism. While the dogs' main function is to prevent children from running into traffic or other unsafe situations, they also help improve the child's communication, skills, and behaviour.

The dog, usually a Golden or Labrador Retriever, is fitted with a special harness and leash. The leash has a handle for the child to hold, and also wraps around the child's waist. If the child suddenly runs off, a parent can order the dog to stay. This stops the child from getting too far.

Kristen Burrows studied the dogs' impact on children with autism and their families for her Master's thesis at the University of Guelph under the supervision of Dr. Cindy Adams. She interviewed parents and families who had received service dogs and followed them for a year, starting from when they first brought the dog home. Burrows found that children and families benefited from the dogs in a number of ways:

  • By helping keep the child safe while exploring the environment, the dog relieved pressure from the parents. Parents no longer needed to hold their child's hand, so both children and parents gained freedom when walking outside.
  • Parents found that the child was usually calmer with the dog around, with less social anxiety, fewer "meltdowns," and reduced anger. In many cases, parents reported that the child "just seems happier."
  • Finally, Burrows says, "another benefit that was reported over and over again was the dog's influence on the behaviour of strangers in public. The presence of the dog signals to the public that the child has some challenges. This in turn minimizes the number of people that make comments to the parents regarding the child. Instead of being avoided or stared at, the service dog attracts questions and introductions from people, thus providing an avenue for autism awareness."

The challenges of owning a service dog

Burrows stresses that owning a service dog can also be challenging, and it's important that parents understand everything that is involved.

"People are so taken with the idea that a dog can help these families that they overlook some of the negative aspects of ownership," she says. "One of the reported benefits was that people now had a reason to approach the family in public, because they could ask about the dog. Although this is great for a population that has been rather ostracized due to a child with autism, it gets very tiring. Parents loved how much easier it became to keep their child calm in public, but were not always prepared for the amount of attention they received. Sometimes they just wanted to run into the grocery store for a bag of milk, and spent half an hour with someone who kept asking questions about the dog."

As many people with a service or guide dog discover, access to public places or stores can sometimes be a problem. "After all the families go through to get one of these dogs, it is very discouraging when they are fighting store managers for their right to be in the store," Burrows says. She notes, though, that with the growing popularity of service dogs and guide dogs, things are improving.

"And of course, a dog is a dog," Burrows adds. "It's an extra mouth to feed, something else in the family that requires affection, grooming, time and energy, walks, bathroom breaks, et cetera." Once they receive a dog, families must pay for all its care, starting with food and veterinary care. Families should expect to spend at least $700 per year on the dog, and probably more.

Service dogs aren't for every child

Some organizations, such as Canadian Guide Dogs for the Blind, have a minimum age requirement: a person must be at least 16 years old in order to apply for a guide dog. Even if there's no age requirement, before a child is matched with a service dog, it's important to consider several factors:

  • What are the child's needs? Will the child benefit from a service dog?
  • Are the child and/or the family able to put in the time and effort required to learn to work with the dog?
  • Is the family willing and do they have the time and money to meet the dog's needs - food, grooming, veterinary care, exercise, and a fenced yard?
  • Are adults in the family committed to the dog's training and supervision?
  • Is the child or another family member afraid of dogs? If so, a service dog may not be the best option.
  • Is the child or another family member allergic to dogs?
  • Is there another dog in the home? The presence of an untrained dog can make training the service dog more challenging.

Of course, not every dog is cut out for the job either. Becoming an assistance dog takes a specific temperament and, most of all, time, starting with months of socialization in puppyhood and moving on to six to ten months of intensive training. Dogs who fail the training find homes as pets.

But for the successful partnerships, the effort is worth it.

Robin Marwick
Medical Writer, AboutKidsHealth



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