Edited by: Mia Cobb, Working Dog Alliance Australia, Australia
Reviewed by: Geoffrey Wandesforde-Smith, University of California, Davis, USA; Hsin-YI Weng, Purdue University, USA; Mitsuaki Ohta, Tokyo University of Agriculture, Japan
Specialty section: This article was submitted to Veterinary Humanities and Social Sciences, a section of the journal Frontiers in Veterinary Science
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Dogs’ roles to support people with disabilities are increasing. Existing U.S. laws and regulations pertaining to the use of dogs for people with disabilities are only minimally enforced. Pushback legislation against some aspects of uses of assistance dogs currently is being passed or proposed in several states. Further, the U.S. Department of the Army and the Veterans’ Administration support only dogs trained by an Assistance Dogs International (ADI) or International Guide Dog Federation (IGDF) accredited facility. Lacking a mandatory national process for screening the selection, training, and placement of assistance dogs with persons who have disabilities, the U.S. offers a creative but confusing opportunity for people to train their own dogs for any disability. While no U.S. surveillance system monitors assistance dogs, other countries generally have a legislated or regulatory process for approving assistance dogs or a cultural convention for obtaining dogs from accredited facilities. We conducted an online survey investigating current demographics of assistance dogs placed in 2013 and 2014 with persons who have disabilities, by facilities worldwide that are associated with ADI or IGDF and by some non-accredited U.S. facilities. Placement data from ADI and IGDF facilities revealed that in most countries aside from the U.S., guide dogs were by far the main type of assistance dog placed. In the U.S., there were about equal numbers of mobility and guide dogs placed, including many placed by large older facilities, along with smaller numbers of other types of assistance dogs. In non-accredited U.S. facilities, psychiatric dogs accounted for most placements. Dogs for families with an autistic child were increasing in all regions around the world. Of dog breeds placed, accredited facilities usually mentioned Labrador Retrievers and Golden Retrievers, and sometimes, German Shepherd Dogs. The facilities bred their dogs in-house, or acquired them from certain breeders. Non-accredited facilities more often used dogs from shelters or assisted people in training their own dogs. Facilities in Europe and the U.S. place dogs in all roles; other parts of the world primarily focus on guide dogs. Expansion of assistance dogs in many roles is continuing, with numbers of dogs placed accelerating internationally.
The longstanding guiding role of a dog for a person with a visual impairment is obvious, and other roles of dogs have become evident. Guide dog owners report significantly increased social contacts and enhanced mental and physical well-being, as compared with visually impaired individuals without guide dogs. The close partnership is based on cooperative interactions between the person and dog in which they alternate the role of initiator for their joint actions (
Dogs to assist people with physical disabilities are referred to as mobility dogs. Canine Companions for Independence (CCI) (
The value of guide dogs and mobility dogs goes beyond their performance of specific working tasks. They also promote self-confidence, peace of mind, greater independence, a sense of safety, and enhanced social interaction. This broader range of values has opened the door to other creative uses of dogs for people with special needs. These uses range from calming or protecting individuals with autism spectrum disorder or with post-traumatic stress disorder, to alerting people with diabetes to blood hypoglycemia and alerting people to a forthcoming seizure (
While taking a guide dog or mobility dog into a public place, airplane or train to help the disabled owner has generally been accepted because of the obvious need for the dog, there can be issues with regard to taking other types of assistance dogs onto planes, trains or into restaurants. To address these issues where the owner lacks a visibly apparent disability, most developed countries now have a centralized process by which persons with a disability can address specific requirements, often registering the disability and then legally registering the officially trained assistance dog that can be taken into public places and on airplanes, e.g., in Scotland (
The U.S. lacks a centralized process by which persons with a disability can legally register an assistance dog and take the dog into public places and on airplanes. Inconsistent nomenclature is used for the dogs’ various special roles (
Assistance dog placements and roles are growing rapidly in the U.S., where the focus is on providing equal or reasonable accommodation for people with disabilities. Regulations of the various U.S. agencies assure privacy for persons with disabilities and allow them to have full public access with dogs that are presumably trained for assistance tasks for persons having any of a broadly defined range of disabilities. The open-ended U.S. regulatory process for assistance dogs has allowed for creative development of new roles for assistance by dogs.
Assistance Dogs International specifies three main categories of assistance dogs: guide dogs for the blind, hearing dogs for the hard of hearing, and service dogs. Service dogs include varied roles, such as wheelchair assistance for mobility, epilepsy monitoring of seizures, aid for families with autistic children, hypoglycemic detection for diabetes, and psychiatric support. Whereas the term assistance dogs in the international ADI world refers to all specially trained dogs assisting persons with disabilities, one comparable term adopted in the U.S. is service dogs (
Department of Transportation (
The names of ADI and IGDF facilities are listed online, but little information is readily available to the public on the numbers of dogs being placed for various assisting roles, or their breeds and sources. Guide Dog Users, Inc. (GDUI) (
California offers optional free registrations of assistance dogs supplanting the need for licensing dogs, and some data are available for 1999–2012 registrations. By 2005, dogs of small body size were registered at a similar frequency as those of large body sizes (
In Europe, ADI lists 56 facilities in 19 countries; the Netherlands and Belgium each list 9 facilities, and the UK lists 8, whereas 8 countries list just one facility (
In Asia, ADI lists one facility in Japan and one in Taiwan that is also accredited with IGDF (
Additionally, Japanese historical, cultural, and environmental factors may also slow the development of assistance dogs in Japan (
Assistance Dogs International offers its certification process for non-profit facilities that place assistance dogs. Facilities initially enroll for candidate status and then work toward full accreditation. During this study’s data collection in 2015, the U.S./Canada region listed 98 accredited and candidate facilities and Europe listed 56. Guide dog facilities that are accredited with IGDF and that place dogs in additional roles beyond guiding also are eligible to seek ADI accreditation.
In this paper, we describe the breeds, sources, and numbers of dogs with each role placed in 2013 and 2014 worldwide by responding facilities of ADI or IGDF, and the year of each facility’s establishment. Additionally, we similarly surveyed responding non-accredited facilities in the U.S. that placed dogs.
We first developed a brief survey with questions for each facility placing assistance dogs and uploaded it on SurveyMonkey®. Questions asked for contact and location information for the facility, the year of establishment, the total numbers of dogs placed in 2013 and 2014, and then the numbers of dogs placed each year for each category—guide dogs, hearing dogs, and service dogs for mobility, seizure alert, autism, psychiatric disorders, diabetic alert, and others. We asked whether handler-dog team training was provided, how long it lasts, and where it occurs. We asked the sources of the dogs and the breeds used. Finally, we asked the accreditation status of the facility, and for any comments. We contacted all accredited and candidate facilities worldwide that are associated with ADI and IGDF, sending them an email letter containing the survey link. Some facilities have dual accreditation; IGDF facilities placing guide dogs may apply for ADI accreditation if they place dogs in additional roles. This dual accreditation currently is held by eight North American facilities and five other international facilities. For non-responding ADI facilities in the U.S. and Europe, we accessed the facility’s year of establishment and identified a primary role of dogs that the facility placed, based on the information available on the facility’s website.
We also e-mailed a survey to all U.S. facilities that are not accredited that we could find listed online. To develop this list of 170 facilities, we searched by assistance dogs, service dogs, seizure dogs, diabetes alert dogs, autism dogs, PTSD dogs, and psychiatric dogs; we also gathered lists of facilities that were posted online. All of these facilities needed to be deleted if they also appeared on ADI or IGDF lists, or if they were duplicated.
We sent two reminder emails to all non-respondents and responded to numerous queries with follow-up replies and reminders. In addition, to gain maximal participation from ADI facilities in the U.S., we completed up to three phone calls to answer questions and remind non-responding U.S. facilities listed with ADI about the survey. Phone calls were not made to international facilities due to time zone and language differences.
We summarized the numerical information in several tables. ADI and IGDF present their members’ information by continent, and we followed that pattern for the introductory Table
Type of dog | # Dogs 2013/2014 | % of Total dogs | # Facilities 2013/2014 | Mdn dogs/year/facil (range of total dogs placed by all facilities/year) | |
---|---|---|---|---|---|
International Assistance Dogs International and International Guide Dog Federation facilities ( |
Guide | 249/261 | 45 | 18/17 | 8.3 (1–77.5) |
Mobility | 99/106 | 18 | 16/19 | 5.5 (1–14) | |
Autism | 53/67 | 10 | 9/11 | 4.3 (1.5–18) | |
Hearing | 118/141 | 23 | 3/5 | 9 (1–110) | |
Psychiatric | 3/20 | 2 | 2/6 | 1.5 (1–6.5) | |
Diabetes | 0/10 | 1 | 0/5 | 1 (0.5–2) | |
Seizure | 6/10 | 1 | 2/3 | 3.8 (1–5.5) | |
Total | 528/615 = 1,143 | 100 | 34 | Mdn = 10 (1–110) | |
North American ADI and IGDF facilities ( |
Guide | 442/476 | 39 | 9/11 | 20 (2–199) |
Mobility | 471/472 | 40 | 41/40 | 3.5 (1–177) | |
Autism | 95/110 | 9 | 18/19 | 3 (1–26.5) | |
Hearing | 59/50 | 5 | 8/7 | 4 (1–30) | |
Psychiatric | 52/67 | 5 | 14/16 | 2.3 (1–11) | |
Diabetes | 37/32 | 3 | 7/8 | 3 (1–10.5) | |
Seizure | 7/4 | 0 | 6/3 | 1 (1–2) | |
Total | 1,163/1,211 = 2,374 | 100 | 55 | Mdn = 10 (1–233.5) | |
U.S. non-accredited facilities ( |
Guide | 2/1 | 0 | 1/1 | 1.5 (1.5–1.5) |
Mobility | 59/52 | 14 | 15/12 | 2.5 (1–13) | |
Autism | 38/34 | 9 | 8/8 | 1.4 (1–14.5) | |
Hearing | 10/7 | 2 | 5/4 | 1.8 (1–3) | |
Psychiatric | 232/294 | 66 | 11/11 | 5 (1–136.5) | |
Diabetes | 17/23 | 5 | 6/4 | 3.5 (1–9.5) | |
Seizure | 15/13 | 4 | 6/5 | 2 (1–5) | |
Total | 373/424 = 797 | 100 | 22 | Mdn = 8 (1–136.5) |
Regions | Total dogs 2013/2014 | Total dogs | # Facilities 2013/2014 | Median dogs/facility in 2013/2014 | % Increase 2013–2014 |
---|---|---|---|---|---|
Europe | 397/485 | 882 | 22/24 | 10/11 | 23 |
Australia/NZ | 46/50 | 96 | 5/5 | 8/9 | 9 |
Asia | 87/91 | 178 | 5/5 | 10/12 | 5 |
Canada | 43/50 | 93 | 5/5 | 7/12 | 16 |
U.S. | 1,120/1,153 | 2,273 | 49/48 | 5/6.5 | 3 |
Western | 350/370 | 720 | 14/13 | 6/8 | 6 |
Central | 315/310 | 625 | 11/11 | 5/6 | −2 |
Southern | 196/218 | 414 | 16/16 | 5/7 | 12 |
Eastern | 259/255 | 514 | 8/8 | 22/17.5 | −2 |
No personal information was obtained from any individual; only facilities were contacted and asked to provide information about the facility. Thus, IRB approval was not sought.
To assess the historical opening of facilities and the specific roles they primarily addressed in 2013 and 2014, the year of 1915 was taken as the recent, starting point year for the formal training of assisting dogs. Each facility was categorized by primary role of dogs it places and the years lapsed since 1915 until the facility was established; for Europe and the U.S., responding and non-responding ADI/IGDF facilities were combined, as they did not significantly differ. Kruskal–Wallis tests were employed to test for differences between Europe, the U.S./Canada, and other international facilities in establishment dates of facilities for each of the primary roles of dogs for which there were sufficient numbers (e.g., guide, mobility, and autism). None of these tests showed significant differences, so the specifics are not included in the results.
To assess the historical development of each of these dogs’ roles in various parts of the world (e.g., Europe, other international, and U.S./Canada), for each region, we listed all facilities placing a specific type of dog in 2013 in order of the facilities’ year of establishment. Then for each role, we determined the number of dogs placed by each facility during 2013 and computed the weighted median year of facility establishment, weighted by the median numbers of dogs placed. This measure was determined in each region—Europe, other international, and U.S./Canada—for the seven roles of dogs. It was calculated for responding ADI and IGDF facilities and then also for non-accredited U.S. facilities. Finally, a canonical correspondence analysis (CCA) was used to depict the relationships among data, especially the characteristics of accredited, candidate, and non-accredited facilities with respect to types of dogs they placed and sources of the dogs.
Among the 229 invitations sent to ADI or IGDF facilities, only one was returned due to an inactive email address with no forwarding suggestion. In contrast, among the 170 invitations sent to non-accredited facilities, 37 (22%) bounced back, suggesting a high rate of turnover. Response rates from ADI facilities were 35% internationally and 57% in North America; response rates from facilities only in IGDF were 16% and 25%, respectively. Considering only the invited non-accredited U.S. facilities whose invitations were not bounced back, the response rate was 17%.
Accredited facilities in North America had a similar median number of dogs placed overall to those internationally, 10 per year (Table
When considering only facilities outside North America, ADI and IGDF each list similar numbers of facilities, 68 (belonging to ADI and some also to IGDF) and 62 (belonging to IGDF only). Among the 34 responding facilities, close to 45% of the dogs placed in 2013 and 2014 were guide dogs (Table
As shown in Table
As shown in Table
As shown in Table
The number of responding ADI or IGDF facilities in the U.S. was more than double the number from Europe. Yet, overall, the U.S. had only a 3% increase in total number of dogs placed in 2014 as compared with 2013. In fact, the Central and Eastern states each reported a decline of 2% in their numbers of dogs placed. Facilities in the Eastern states differed from other regions in placing a large number of dogs per facility, reflecting their large guide dog facilities (medians 22 and 17.5 for 2013 and 2014). Southern states had the greatest increase in total number of dogs placed in 2014 compared with 2013, 12%, and the Western states were intermediate, 6%.
Examining changes over time, we considered facilities that were established: prior to 1980, when primarily only guide dogs and hearing dogs were placed; 1981–2000, a period when the new service roles were developed; and 2001–2014, when the new service roles continued growing.
Except for the U.S., the pioneering facilities that were established early generally continue to focus primarily on placing traditional guide dogs (Figure
In the U.S., three responding accredited facilities, already established by 1948, continued placing primarily guide dogs, though one also diversified and placed mobility, psychiatric and hearing dogs (Figure
Of the three international responding facilities in this category and outside Canada and Europe, two currently placed only guide dogs and one placed only hearing dogs (Figure
Twenty-three U.S. ADI facilities responded, including three guide dog facilities, two of which place a large number of dogs (Figure
Eight responding non-accredited U.S. facilities were established in this time frame (Figure
Of the four responding facilities in this category and outside the U.S./Canada and Europe, two primarily placed guide dogs (Figure
Of 21 responding U.S. ADI facilities, 18 placed some mobility dogs; other roles addressed by facilities were autism (8), psychiatric (7), diabetes (6), seizure (4), guide (3), and hearing (2) (Figure
From 14 responding non-accredited U.S. facilities, mobility (9), autism (6), and psychiatric (5) dogs, and seizure, hearing, and diabetes dogs also were represented (Figure
Breeds that were almost invariably mentioned by accredited facilities include Golden Retrievers and Labrador Retrievers, sometimes with crosses, and often German Shepherd Dogs. Although a few facilities favored another specific breed CCAs addressing breeds by role or geography were unremarkable for other breeds.
As revealed in CCAs, fully accredited facilities very often bred their own dogs (Figure
These facilities often placed diabetes, seizure, and autism dogs (Figure
Facilities that are non-accredited often acquired dogs from shelters or worked with persons who trained their own companion dogs (Figure
The years of establishment for all facilities currently placing dogs in the various roles do not significantly differ for Europe and the U.S. However, the picture changes when considering the numbers of all dogs placed in the various roles and the years the relevant facilities were established. Figure
In the U.S., guide dogs often are trained and placed by large facilities (median per facility = 20 dogs/year) and the weighted median year of facility establishment for the median dog placed in 2013 was 1946. Internationally, facilities are smaller, placing a median number per facility of eight dogs per year, with the weighted median year of facility establishment placing the median dog being 1999. Even guide dogs are relatively new in some parts of the world, and several countries focus almost entirely on placement of only guide dogs. Responding non-accredited U.S. facilities placed only three guide dogs; although placing so few dogs, the weighted median facility year of establishment for the median dog placed was 1984.
The weighted median year of facility establishment for placing the median hearing dog in 2013 in North America was 1975; the corresponding figure internationally is 1982. International respondents placed many more hearing dogs than those in North America (Table
In North America, the weighted median year of facility establishment for placing the median mobility dog in 2013 was 1979, whereas, internationally, it was 1997. Among the 15 non-accredited U.S. facilities placing mobility dogs in 2013, the weighted median facility year placing the median dog was 2008.
The weighted median facility establishment year for placing the median autism dog in North America was 1995; internationally, it was 2013. Of eight non-accredited U.S. facilities placing autism dogs, the weighted median year was 2001.
Similar to autism dogs, the weighted median facility establishment year for placing the median psychiatric dog in North America in 2013 was 1995; internationally, the corresponding year was 2013. Among 11 non-accredited U.S. facilities placing psychiatric dogs, the weighted median year for placing the median dog in 2013 was 2010.
Among six responding facilities placing seizure dogs in 2013, the weighted median establishment year for placing the median dog in North America was 2001; the corresponding year internationally for the two facilities in 2013 was 1993. Six non-accredited U.S. facilities placed seizure dogs in 2013, and the weighted median facility year for placing the median dog was 2005.
Among seven responding facilities placing diabetes alert dogs in 2013, the weighted median year of facility establishment in North America placing the median dog was 2000. Internationally in 2013, no reporting facilities placed diabetes dogs, but by 2014 (figures used only in this case for comparable data), among five facilities placing a few dogs, the facility’s establishment weighted median year for placing the median dog was 2008. Among six non-accredited U.S. facilities placing diabetes dogs, the weighted median year was 2009.
In general, many of North America’s accredited facilities that today place high numbers of assistance dogs were established prior to 2000. Although facilities for various dogs’ roles were also established in Europe prior to 2000, much of their growth in the numbers of dogs placed has come from the recent creation of facilities. In North American and non-accredited U.S. facilities, dogs for autism are being placed by long-established facilities, just following guide, hearing, and mobility dogs, but dogs for autism placements began later at international facilities. Relative to other roles of dogs, North American facilities were somewhat delayed in placing dogs for seizure detection. Dogs for diabetes primarily have arisen since 2000. In countries beyond North America and Europe, placement of dogs has proceeded more slowly with a primary emphasis continuing on the role of dogs as guides.
The past decade or two in the U.S., Canada, and Europe have seen major increases in uses of assistance dogs for improving the function, health, and well-being of their human companions. Data-based studies document benefits not just for the people with visual impairments and those using wheel chairs but for seizure alerting, hypoglycemia detection, and comforting children with autism or adults with post-traumatic stress disorder (
Some European countries and the U.S. are increasingly welcoming to dogs in public areas. Asia is less accepting of dogs in public, which may affect the regional differences in the development of assistance dogs. Equal accommodation for people with disabilities developed in the U.S. alongside their growing expectations for individually trained dogs; the public access that was previously allowed pet dogs was insufficient for people who had assistance dogs supporting them. Therefore, DOJ (
The organizational strength of accredited facilities accounts for some of their stability, accomplishments, and growth. Not only are they proficient in their ability and infrastructure for training dogs but also they maintain the financial power and human resources that are required to be accredited by ADI and IGDF, always preparing required documents and inviting inspectors from ADI or IGDF. This helps explain why the accredited facilities are placing many more dogs of most types than the non-accredited U.S. facilities. Although there are numerous non-accredited facilities, they inevitably suffer high turnover with financial and staffing struggles as reflected in the high level of bounced back email messages, and a few of these facilities place unqualified dogs. Non-accredited facilities have no obligation to be non-profits, so occasional unscrupulous persons can exploit unwary people seeking assistance dogs. Members of the public who are seeking dogs do not necessarily know about accreditation and may pay a large fee for a dog that proves not to be useful in assisting with a specific disability.
Although guide dog facilities are established in Asia, few people acquire guide dogs. Studies of obstacles to acquiring dogs in Japan show that people with visual disabilities feel that information resources pertaining to guide dogs are limited (
Working success of dogs is a challenge: half of the IGDF facilities surveyed to assess the working success of German Shepherd Dogs, Labrador Retrievers, Golden Retrievers, and Labrador × Golden Retriever crosses found diminished working success for the Labrador × Golden crosses (
A limitation of this study was the low response rate from the non-accredited facilities in the U.S. We experienced the high turnover rate and frequent difficulty in reaching these facilities: presumably, the facilities that responded represented those with greater efficacy, stability, and resources.
Lacking professional centralized guidance for assistance dogs in the U.S., the widespread lack of knowledge people have about assistance dogs creates problems for everyone involved. Businesses and landlords often are unaware of the requirements to create access for handlers with their dogs, or which questions can be asked of someone with an assistance dog. People considering acquiring an assistance dog may simply get one to self-train without realizing that the dog will not provide meaningful assistance for their particular needs. A further burden faced by the growing number of persons training their own dogs and unaccredited U.S. facilities acquiring dogs from shelters to train is the poor predictive value of screening tests to select dogs. One small study found no correlation between a dog’s performance on the selection test and its ability to successfully complete a retrieval task for someone using a wheelchair (
Numerous historic accredited facilities continue to place large numbers of guide or service dogs, and also often account for the increasing number of placements of dogs for families with an autistic child. Arguably this is a new role for dogs that is now in the mainstream for accredited facilities, going beyond the uses of dogs for diabetes, seizure, or psychiatric needs. As studies documented in Canada and Ireland, the dogs for autism ensure the safety of the child, while also enhancing the freedom and well-being of the family (
The placement of psychiatric dogs by accredited facilities has proceeded slowly while expanding more rapidly in the U.S. non-accredited facilities, where a majority of dogs placed assumed roles for psychiatric assistance. The distinction in the U.S. between psychiatric service dogs, emotional support dogs, and well-trained companion dogs for persons with mental illness can be confusing. Even ownership of pet dogs contributes toward the recovery from serious mental illness (
A newer use of dogs is for medical alert, such as responding to low glycemia levels for persons with diabetes and under glucose control medication. Among 212 pet dog owners, 32% reported more than 10 incidents where the pet dog’s behavior changed in relation to hypoglycemia (
Guide dogs continue as the primary assisting role of dogs around the world. Assisting with mobility is a well-established role for dogs in North America that is increasing in Europe. Hearing dogs continue to be important in Europe but are somewhat eclipsed in the U.S. by new roles for dogs. Uses of dogs for families with an autistic child are steadily increasing throughout the world, and the placements often are by large accredited facilities.
Currently, with minimal U.S. enforcement of guidelines regarding the training and placement of assistance dogs and their access to public areas, restaurants, and airplanes, assistance dog facilities have already had a period of rapid growth. Studies show that assistance dogs play an essential role in human health and welfare. Further worldwide exploration of acceptable ways to integrate such dogs and other animals into the human health realm is still another angle on the “One Health” approach to medicine.
The study included only census information on the numbers of dogs placed by assistance dog facilities. The study involved no direct involvement with the dogs or handlers, and thus no ethical review was required. We simply contacted the assistance dog facilities to acquire information on the dogs they have recently placed.
LH conceived the idea, oversaw data collection, and drafted manuscript. SW conducted all electronic communications with survey participants and prepared some final figures. AT prepared some final figures and edited all drafts. NW provided statistical guidance. MY participated in initial concept and survey design, assisted in initial manuscript draft, and reviewed all drafts. AG provided repeated contacts to facilities to remind them to participate and summarized data by regions.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer GW-S declared a shared affiliation, with several of the authors and a past collaboration with one of the authors (LH) to the handling Editor, who ensured that the process nevertheless met the standards of a fair and objective review.
The authors appreciate the willing assistance throughout this project provided by Martha Bryant (recently deceased). They also acknowledge useful feedback offered by Benjamin Hart. Partial financial support for this project was provided by the UC Davis Center for Companion Animal Health and by a gift from Pfizer/Zoetis.