Author
WINKLE Melissa; CROWE Terry K.; HENDRIX Ingrid;
Title
Service dogs and people with physical disabilities partnerships: a systematic review.
Journal citation/publication details
Occupational Therapy International, 19(1), 2012, pp.54-66.
Summary
Some promising social, functional and psychological benefits were identified as possibly being associated with service dog ownership. However the evidence from the twelve studies included in this review was limited by poor study quality. Areas for further investigation are outlined, and the potential for occupational therapists to become involved in assisting clients before during and after service dog placement is discussed.
Context
Assistance dogs have been used to support people living with a range of disabilities and conditions including visual impairment, deafness, diabetes, and physical disabilities. Service dogs are trained to work specifically with people with physical disabilities, helping them to prevent injury, assist with some activities of daily living, and summon help. This study was prompted by the increase in interest in the use of service dogs from individuals with disabilities, and the need for evidence of effectiveness to aid occupational therapists when recommending service dogs as an assistive technology option.
Methods
What sources were searched?
The electronic databases 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 were searched during a two-year period from 2008 to 2010. The lead author’s personal citation database was also searched.
What search terms/strategies were used?
Searches were carried out using a combination of keywords, and subject headings appropriate to individual databases. The keywords ‘included dogs and disabled persons, assistance dog* or service dog*, and (dog* and (handicap* or disab*))’. Searches were limited to articles in English; no date limits were set.
What criteria were used to decide on which studies to include?
Studies focusing on the effect of service dogs with people suffering from ambulatory difficulties that were either neurological, congenital or acquired, were eligible for inclusion. Outcomes had to include psychosocial and/or functional measures. Papers targeting those with visual or hearing impairment, mental health conditions, or autism, were excluded as were qualitative studies, reviews and dissertations.
Who decided on their relevance and quality?
Two authors screened titles and abstracts after the removal of duplicate records. Full-text papers were then examined in full against the selection criteria. The level of evidence of each study was rated using the American Academy of Cerebral Palsy and Developmental Medicine, AACPDM, five-point scale (where the highest level is indicated by a I); study quality was measured using the seven-point scale, where the greater the score the higher the quality. The quality ratings are described in Table 1.
How many studies were included and where were they from?
The search strategy produced 432 records from electronic databases and 119 from the personal database; 371 unique records remained after the removal of duplicates. Twenty-three papers were examined in full, twelve of which met the selection criteria and are included in the systematic review. Study settings are not systematically reported but it is evident that there at least four reports from the USA, and one each from the United Kingdom and Japan.
How were the study findings combined?
Specific details on data collection are not included but study characteristics are summarised in a table and the results are presented under the headings ‘functional effects of service dogs’, psychological effects’, and ‘issues of service dog ownership’. The review is narrative in nature.
Findings of the review
Seven of the 12 studies used a comparison group, and five were single group descriptive studies. The majority of the comparative studies had no more than 20 participants in each group. Study quality was weak, overall; all but two scored 2 or under. The level of evidence was three or below in all but one study.
Service dogs produced many beneficial effects related to socialisation and community participation. People with disabilities reported more approaches from members of the community when they were in public since owning a service dog. Other benefits included a decrease in loneliness, more social interaction, making new friends, and feeling emotionally supported and secure. There were also reports of the negative effects of owning a service dog such as the shift of attention away from the disabled person, and petting the dog, which may interfere with the dog’s concentration and training.
Service dogs most commonly assisted with retrieving objects, opening doors, getting around the community or the home, shopping, and alerting others in an emergency. Two studies found that the use of service dogs reduced paid human assistance. Benefits to caregivers were also reported; the four themes that emerged from qualitative interviews were: decreased burden on caregivers, greater peace of mind, freeing up caregiver time, and, enjoying the dog as a member of the family.
Four studies identified psychological benefits related to service-dog ownership such as increases in self-esteem, internal locus of control, well being, and positive affect.
Authors' conclusions
‘Although the findings of this systematic literature review are promising, they are inconclusive and limited. This suggests the need for more rigorous studies to demonstrate the effectiveness of service dog/person partnerships.’
Implications for policy or practice
None are discussed.