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 DOI: 10.1177/1049732308327088

2008 18: 1642 originally published online 27 October 2008Qual Health ResKristen E. Burrows, Cindy L. Adams and Jude Spiers

With Autistic ChildrenSentinels of Safety: Service Dogs Ensure Safety and Enhance Freedom and Well-Being for Families

  

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1642

Sentinels of Safety: Service Dogs EnsureSafety and Enhance Freedom and Well-Beingfor Families With Autistic Children

Kristen E. BurrowsUniversity of Guelph, Guelph, Ontario, Canada

Cindy L. AdamsUniversity of Calgary, Calgary, Alberta, Canada

Jude SpiersUniversity of Alberta, Edmonton, Alberta, Canada

Children with autism might display unpredictable and volatile behavior that places them in considerable physicaldanger and creates stress for the family. Families of autistic children often have limited freedom and experiencedifficulty with everyday activities. In this qualitative ethology study, we examined the effect of integrating servicedogs into ten families with an autistic child. Data included participant observation, video recordings offamily–parent–dog interaction, and semistructured interviews with the parents. The themes were (a) the dog as asentinel 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 andaffected 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, andhas implications for long-term human–animal companionship for children with special needs and their caregivers.

Keywords: autism; children; children, disability; coping and adaptation; ethology; families; safety; service dogs

Autism spectrum disorder (ASD) is the mostextreme form of pervasive developmental disor-

ders (PDD) that share core impairments in socializa-tion and communication (Bryson & Smith, 1998).The family is affected by the presence of a child witha developmental disability (particularly in terms ofdealing with the loss of the ideal child), expandedfinancial requirements, increased burden of care, lostopportunities, neglected siblings, social isolation, andconfusing systems of health and other care (Briskin &Liptak, 1995). Autism presents challenges for theparents and threatens the cohesion of the family unitbecause of the stress caused by the unpredictablebehavior displayed in autism (Bryson & Smith,1998). The behavior of children with autism is asso-ciated with fewer positive and more negative behav-ioral propensities such as impulsivity (bolting) andirritability (meltdowns), characterized by unpre-dictability and volatility (Abbeduto et al., 2004).These characteristics of autism often prevent familiesfrom traveling and make everyday activities such as

grocery shopping or visits to the doctor extremelystressful for all involved. Thus, finding coping strate-gies to deal with behavioral challenges might alleviatesome problems for parents and families (Abbedutoet al., 2004), as well as providing companionship forparents and children who are at risk of social isolationand reduced social networks (Zasloff & Kidd, 1994).

The primary function of a service dog in the con-text of autism is child safety. The dog must be able toresist a child’s attempt to bolt. The child is attached tothe dog via a leash and belt system, and the dogresponds to commands from the parent (handler) toproceed or stop. If the child tries to bolt or move dan-gerously (e.g., walking off the sidewalk), the dog willresist by using its weight to brace against the child,slowing or stopping movement, which gives theparent walking behind the child time to intervene.

Qualitative Health ResearchVolume 18 Number 12

December 2008 1642-1649© 2008 Sage Publications

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Authors’ Note: This research was generously funded by PetTrust at the Ontario Veterinary College, National Service Dogs,and the Canadian Autism Intervention Research Network.

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However, the contribution of service dogs mightextend beyond physical safety to therapeutic andcommunicative domains. Dogs provide a powerfulmultisensory stimulus that can combat the low sen-sory and affective arousal levels of autistic children(Redefer & Goodman, 1989). Animals are believed toact as transitional objects, allowing children to estab-lish a bond with them and then extend the bond topeople (Martin & Farnum, 2002). Service dogs per-form simple, repetitive, nonverbal actions that aremore easily interpreted by the autistic child than adultcommands (Redefer & Goodman, 1989). A study byMartin and Farnum (2002) indicated that childrenmight exhibit a more playful mood, focus better, andare more aware of their social environment when inthe presence of a therapy dog. Unfortunately, much ofthe research on the effectiveness of service dogs hasbeen in temporary therapy. It is not possible to inferwhether these effects are obtained when the dog isliving with the family.

The use of service dogs for children with autism hasspecific effects because of the physical proximity, timespent together, and the triadic relationship betweendog, child and parent/handler. Service dogs forchildren with autism differ from traditional guide-dogservices because the dog is handled by the parent, butis connected to the child. The dog must take its com-mands from the parent or handler, but must also followand bond with the autistic child. It is necessary toassess the effect of service dogs in the family, ratherthan in relation to the child with a disability (Davis,Nattrass, O’Brien, Patronek, & MacCollin, 2004).Unfortunately, little research has investigated themechanisms that mediate service dogs’ effects, or thebenefits to the individual or family (Lane, McNicholas,& Collis, 1998; Modlin, 2000).

Methods

Qualitative ethology is the systematic, detailed studyof behavior within the context in which it occurs(Morse & Bottorff, 1990). The goal was (a) to identifyand describe important patterns of behavior in the rela-tionship between service dog, child with autism, andfamily members, and (b) to draw conclusions about theorganization of this behavior and its functional signifi-cance (Bottorff & Varcoe, 1995). Ethology was themethod of choice for this study because most of the par-ticipants (service dogs and children) could not be inter-viewed, so detailed reporting of observations wasnecessary (Morse & Pooler, 2002; Sanders, 2004).

Ethological methods allow for a combination ofobservation and other data-collection strategies toincrease the knowledge of a poorly understood phe-nomenon (Morgan & Drury, 2003; Snyder, 2004) fromboth the participants’ perspective and an etic perspec-tive (Camp, 2001). Institutional review approval wasgranted by the University Research Ethics Board andthe Animal Care Committee, in accordance with theCanadian Council for Animal Care.

Sample

The data set consisted of observational and experi-ential data from ten families recruited from south-western Ontario (Canada). Service dogs for theparticipating families were placed by NationalService Dogs in November 2003 and May 2004. The7 boys and 3 girls with autism ranged in age from 4.5to 14 years at the time of service-dog placement. Thechildren’s motor skills varied, as did their communi-cation abilities and temperament. Two of the familieshad a second child who was also autistic, but the dogwas selected for one child rather than both siblings.The parents were the primary sources of interviewdata because of the children’s inability to communi-cate. The parent interviewed in each family was alsothe primary dog handler. Nine mothers and one fatherparticipated in the interviews.

Data Collection

Following participant observation of the familiesduring the week when the dogs and families weretrained together, five home visits (every 3 months)and semistructured interviews were conducted over12 months for the first group of four families. Threevisits were conducted with the second group of sixfamilies over a period of 6 months. At the beginningof the study period, National Service Dogs wereplacing service dogs every 6 months, which meantthat to fit within the time constraints of thisresearch, the second group could be followed for only 6 months after placement, instead of a 12-month period as in the first group. The 3-monthtime period between interviews/home visits wasselected as most feasible in relation to family avail-ability and commitment requirements. Anecdotalevidence suggested that the integration of a servicedog into the home is a relatively slow process, sothis was another factor in the decision. Thirty-sixinterviews were conducted, ranging from 35 minutesto 2 hours.

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In addition to the interviews, the first author (KB)spent time with each family to observe their interac-tions with the dogs. Participant observation occurredin a number of settings, including at home, during carrides, at the local mall, walking/recreational activi-ties, and in the school classroom. Some of theseactivities were videotaped with a handheld digitalcamera and used for detailed analysis of caninebehavior related to the dogs’ welfare, a secondarycomponent of this research. Detailed field notes wereaudiotaped or written for each observational period.

Data Analysis

Content analysis, an inductive qualitative strategy,was used to explicate the behaviors and dimensions ofinterest. The analysis of the first interview and fieldnotes from each family formed the basis of an evolvingcoding system and provided direction for explorationin future interviews. This recursive and cyclical codingallowed for concurrent data collection and analysis.Analysis was carried out within each family data set, aswell as across family data sets. This process allowedfor the comparison and contrast of individual familysimilarities and differences. An ethogram consisting ofdetailed textual descriptions and documentation of thebehavioral patterns was created. Persistent behaviorsand themes, in addition to data anomalies (i.e., specificincidents that appeared to be very different), wereidentified (Carney, Joiner, & Tragou, 1997). Dataanalysis ended once new themes or patterns of datafailed to emerge and we concluded that we had reachedanalytic saturation. Although the sample size was rela-tively small (ten families), we are confident that satu-ration of themes was achieved, given the specificcharacteristics of the participating families.

Results

Sentinel of Safety

The most important expected function of the servicedog was to improve the safety and security for the autis-tic child at home and in public, with the parent, andwhen separated from the family. For example, the doginhibits the child from bolting by physically anchoringthe child. This delay gives the parent time to react to thesituation and catch up with the child.

The biggest change is that walking to school fourtimes a day is getting . . . almost relaxing . . . I get toschool and I’m not all frazzled, and I’m able to just

talk to the EAs [education assistants] about otherstuff . . . that one hour out of my day was a big deal,a big fear and a big stress . . . now it’s just like okay,time for school and away we go.

At home, the service dogs were acknowledged asan extra caregiver because they provided a second setof eyes, even when the dogs were not “in harness.”Before the dog’s arrival, many parents had resorted toextreme measures to ensure home safety. Some lockedthe child into the bedroom at night to prevent wander-ing (falling down stairs, leaving the house). Othersinstalled video cameras to track movement, and addednumerous locks and alarms on doors and windows.The integration of the service dogs into these homesprovided an additional sense of security for theparents, especially at night. Most families chose totrain their service dog to sleep on the child’s bed or atleast in the child’s room.

The dog now lies up beside her and leans against herbecause she loves the pressure so she’s asleep withinminutes of crawling into bed now.

The close proximity of the dog to the child at nightfacilitated the relationship between child and dog andallowed the parents to feel secure, knowing that thedog would wake them if anything was wrong, such asthe child being upset or injured.

Definitely [the dog]’s there as the bed buddy, youknow, and to alert us of issues though the night ratherthan us lie there with one eye open, both ears . . . andI can get a sounder sleep and that’s helped outimmeasurably. I remember the first time we broughtthe dog home, it was the first time in nine years ourson slept through the night.

Parents reported that they were up less often dur-ing the night with their child, and slept more com-fortably knowing that the dog would alert them if thechild left his/her bedroom, thus improving the qualityand quantity of the parents’ sleep.

The service dogs assisted the parents with dailytasks such as keeping the child calm while bathing,and keeping the child seated at the dinner table.

I get the dog’s jacket on, and I hook my child up andthen I know he can’t go anywhere, and then we getthe socks on and the shoes and that’s another stressreliever because before I was chasing him all over,up into our bedroom, really all over, so its just a niceway to contain him and know that he’s not leavingthere.

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Although additional time was required to put thedog in harness and load up the car, everyday taskssuch as appointments, transportation to and fromschool, grocery shopping, and recreational activitieswere eased by the presence of the dog. The presenceof the dog improved the safety of everyone in the carby monitoring and distracting the restless child.Before receiving the service dog, some familiesavoided car rides because of this unpredictable,volatile irritability. Despite some respite offered bytechnology, such as portable DVD players, the servicedogs played a vital role in monitoring the behavior ofthe child. The service dogs would often become rest-less, alerting the parent if the child unbuckled the seat-belt or wriggled out from the car seat.

Child Companionship andLearning New Skills

Walking beside the dog allowed the child to regu-late his/her pace, making the walking process moreefficient and relaxing for the entire group. In additionto helping some of the children regulate their move-ments while walking, the dog helped the children todevelop motor control. Parents reported a wide vari-ety of physical tasks that were facilitated by the dog’sparticipation. One child learned how to take the lidoff a dog food container, pour the food into the dog’sbowl, place the bowl on the floor, and look at theparent to give the dog a command to eat the food. Anumber of children learned how to pick up and throwa ball for their dog. Motor function improvementswere gained by the parents sitting with the child andhelping him/her learn how to pet the dog. Many of thechildren struggled to control their movements to petthe dog, and by using the dog as a therapeutic tool theparents were able to teach the children to pet or caressthe dogs gently. Children learned to throw a ball andmanipulated grooming tools.

Despite wide variation in the children’s behav-iors, the parents reported decreased anxiety,increased calmness, reduction in the number ofmeltdowns or tantrums, dissipated/defused anger,and more manageable bedtime routines. In manycases, they reported that their child “just seemedhappier.” Many parents were successful in trainingthe service dog to break their child’s trance behav-ior, directing the child’s attention back to the dog toredirect his/her attention from what had initiallystartled him/her.

Shifting the Focus from Autistic Child toService-Dog Companion

Integrating the service dogs into these homes shiftedthe respective families’ attention from children withspecial needs to family pets that provided a crucialservice to the families—especially the parents.

This is the first time that something’s been for me. Thedog is for the child, but the benefits benefit me, not thechild . . . the pressure that’s off me because of the dogoutweighs far more than anything else out there.

The service dog increased the child’s compliancewith the parents’ directives, thus reducing some of the strain the parents felt in trying to control disruptivebehavior. The dog helped parents encourage the child’sappropriate affection and interaction. The presence ofthe service dog allowed some parents to spend timewith their child and share an activity, such as groomingor petting the dog.

Individual Respite, Relaxation,and Family Recreation

For many of the parents, seeing the bond formbetween child and dog was fundamental to acceptingthe dog into their household and normalizing theirday-to-day lives. Although the parents worked con-tinually to establish a bond between the child and thedog, there was a significant bond between the pri-mary handler and the service dog. The parents drew asense of companionship and personal time from thisrelationship.

When days were tough for me in the beginning withhim, he was like my dog. . . . So, I still say I wouldbe sliding into depression seriously. He came intoour house eight weeks after my mom died and I thinklife [in this house] would have been a lot harder if hehadn’t come into it.

The companionship between dog and parentallowed the parents to find personal time and spacewhile doing dog-care activities. The parents had tomaintain the dogs’ training, and the dogs had to beexercised.

For me he relieves a lot of stress. . . . Because I haveto walk him, and that time is, you know, exercise is agood down time, right? So that’s really been worthits while.

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All of these moderating effects achieved by thesentinel guarding, monitoring, and moderating func-tions accumulated to reduce parental stress, increas-ing the possibility of activity and independence, andproviding time for respite and relaxation.

For some families, the change was as minor asbeing able to endure short car rides. For otherfamilies, travel or vacation became a possibility. Onefamily visited Disney World because the presence ofthe dog meant their daughter could cope with the longcar ride to Florida, and was able to take in the newenvironment without being overwhelmed. Otherfamilies reported that ferryboat rides, airplane flights,weekends spent at a cottage (cabin), and hotel stayswere all more manageable with the assistance of theservice dog. For many of these parents, sending theirchild to day camps or overnight camps with the dogwas the first step in giving themselves some respitefrom the constant demands of care for their child.

Enhancing the Family’s Social Status

The service dog was a source of pride for otherchildren in the family. The service dog gave otherchildren in the family an opportunity to talk abouttheir brother or sister without having to talk aboutautism. This change was especially noted in familieswith older siblings who had spent the majority oftheir lives with an autistic sibling. The presence of theservice dogs, especially in public, enabled the sib-lings of the autistic children to feel prouder and lessembarrassed. The attention the family received wasmuch more positive than the attention they hadreceived before the dog was placed with them.

Siblings experienced different interactions atschool, and were acknowledged for something otherthan having an autistic sibling. For many families, theservice dog played a central role in easing the family’sexternal relationships by shifting the focus to some-thing other than a child with disabilities.

Facilitating Awareness andEducation About Autism

By facilitating social interaction, the service dogimproved people’s awareness, understanding, and tol-erance of autism. When the dog and child were in har-ness, strangers quickly realized that there were specialcircumstances regarding the child. Specifically, publicconfrontations were avoided when the child dis-played inappropriate behavior or a tantrum, whereasstrangers had previously attributed the behavior to a

lack of parenting skills. For the first time, being outin public became a positive experience. Instead of thechild being avoided or being the object of curiosity,the service dog attracted questions and introductionsfrom the public. Parents were able to use these oppor-tunities to explain autism.

The biggest benefit has been that when you’re out inpublic, the dog generates empathy and support. Inever expected that. It’s sort of like standing, youstand up and say, “Yes, yes, I have special needs,”and so you’re really making yourself stand out muchmore than almost anything else that you could doexternally. But, because it’s a dog, people react pos-itively . . . people are drawn to animals, and to seethat an animal could help somebody who could ben-efit from it, it really draws on the heartstrings. And,therefore, the people are much more open to mydaughter. They are much more different. They willstand aside and let us move past. It’s quite rare thatsomebody is annoyed because we are in their way . . .people are more comfortable, more accepting.

Although this altered social acknowledgement cre-ated its own set of challenges, such as unwantedpublic attention and extra time needed to socialize,the parents all reported that walking with their childand service dog had a positive effect on autism edu-cation and awareness.

Discussion

The results of this study are fourfold. First, wehave developed a description of the interactional rela-tionships and roles of service dogs in families with anautistic child. The relationship between parent (han-dler), the child with autism, and the service dog isunlike traditional applications of service dogs such asguide dogs and seizure-alert dogs. Most important tothese new areas of pediatric service-dog applicationsis the need to evaluate the effect of these dogs in thecontext of the family (Davis et al., 2004). The pattern-ing of relationships had not previously been describedin long-term relationships beyond the “protectionfrom bolting” function. In fact, the service dogs pro-vided a sense of security, well-being, and improvedquality of life for their families. The reported advan-tages extended beyond the dog’s training to stop thechild from bolting. The risk of bolting was immedi-ately alleviated once the dog was placed in the home,and the child was comfortable being attached to theservice dog; however, the dogs continued to assist the

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parents far beyond their initial training. The dogsslept with the children, followed them if they got outof bed at night, and acted as an extra set of eyes andhands (paws) around the home.

In the home, the presence of the service dogimproved the quality and quantity of sleep for both theautistic child and the parents. The parents suggestedthat the dog allowed their child to settle into bed fasterbecause of the weight and heat of the dog’s body onthe bed. Many children in this study enjoyed deeppressure or being squeezed as a calming mechanism,which is common for persons with autism—especiallythose with high levels of arousal or anxiety (Edelson,Goldberg Edelson, Kerr, & Grandin, 1999). Instead ofparents crawling into bed with the children, the ser-vice dogs curled up against or on top of the restlesschildren. The dogs quickly alleviated the need for theparents to stay up at night watching the child, thusimproving the bedtime routines for the parent, child,and other members of the family.

The dogs helped keep the children calm and dis-tracted during medical visits. Methods such as usingcompanion animals have been found useful to reducephysiological arousal and behavioral distress forchildren who frequently endure physical examinations(Hansen, Messinger, Baun, & Megel, 1999; Nagengast,Baun, Megel, & Leibowitx, 1997). Service dogs helpthe child cope with his/her surroundings and makemedical visits less distressful, thus alleviating parentalstress. In this study, the reduction in distress extended to other environments, such as schools, churches, andgrocery stores.

In the home, the dog is a companion to both theautistic child and the parents. Owning a dog is anexperience that is familiar to families with or withoutan autistic child. Service dogs might provide com-mon ground, bridging the differences that causesocial isolation and facilitating a sense of connectionwith others (Camp, 2001). Pets might enhance socialinteraction between people, increasing or strengthen-ing social networks and social provisions, and thuselevating psychological well-being (McNicholas &Collis, 2000). The social interactions are furtherenforced by a “pet” that provides a crucial service tothe family in addition to accompanying them every-where in public. The improved safety and facilitatedactivities of daily living allowed the families to par-ticipate in different activities and to navigate throughpublic places they would ordinarily have avoided.Most importantly, no parent reported a decline intheir child’s behavior or in family activities over the

course of the service-dog placement. Indeed, improv-ing the child’s safety, increasing the frequency andsuccess of public outings, and increasing the numberof positive social acknowledgements of child andfamily all had a beneficial effect on the family unit.

The second contribution of this study is its descriptionof the social acknowledgement generated by the pres-ence of the service dogs, which was particularly strongand valued by the participants in this study. It is consis-tent with previous research exploring the role of servicedogs, guide dogs, and other assistance dogs in the contextof social interaction (Allen & Blascovich, 1996; Camp,2001; Davis et al., 2004; Eddy, Hart, & Boltz, 1988; Hall& Malpus, 2000; Lane et al., 1998; McNicholas & Collis,2000). Dogs might act as powerful social catalysts evenwhen trained to ignore other people in public, indicatingthat the effect is not simply a consequence of initiations bythe dogs or handlers (McNicholas & Collis, 2000).

The family becomes publicly identifiable by theirassociation with the service dog. The dog becomesthe focus of attention, alleviating some of the embar-rassment and stress felt by other family members.Before receiving the dogs, parents reported feelingexcluded, embarrassed, and avoided when in publicwith their autistic children. Parents were concernedabout their other children feeling the same way. Thedogs act as catalysts for person-to-person interaction,which helps the families integrate into the school sys-tem, church, and community.

Previous research with guide-dog recipients indi-cates it is possible for people to feel as though the doghas a stigmatizing affect in public because of amerged social identity. People with visual, physical,mobility, or psychological impairments are publiclyidentifiable by the presence of an assistance dog(Sanders, 2004). This effect did not occur in thisstudy, perhaps because the parents and autisticchildren tended not to be particularly anonymous inpublic because of the children’s erratic behaviors.Although the dogs made them more visible, theresponse from the public was more gracious and pos-itive than it was without the dogs. Parents were thank-ful to have the dog as a focal point in public, ratherthan having people trying to figure out what waswrong with their child. In the case of the autism ser-vice dogs, the parents noticed the extra attention theyreceived because of the dog, but for the first time theydid not feel stigmatized because of their child’sbehavior. Fundamentally, it appears that increasedsocial acknowledgement has different meanings forrecipients of different types of assistance dogs.

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Third, this study describes how service dogstrained to assist children with autism spectrum disor-der have a marked effect on the parents. It is possiblethat the human–animal bond, or the role of the ser-vice dog, is of even greater importance to familieswho face daily problems because of their autisticchild’s disability. For example, families experiencingcrisis or chronic illness might use pet involvement tohelp with critical developmental tasks or to cope withdepression or loss (Cox, 1993). Even though theseparents had not physically lost their respectivechildren, there was a sense of loss in the absence ofexpected interaction and affection. The dog’s role inmanaging behavioral challenges (child safety, bolt-ing, tantrums) alleviated some of the negative out-comes for parents (Abbeduto et al., 2004). The dogacts as a form of respite and provides the parents withsocial support that buffers some of the stress associ-ated with the safety and social issues they face.Researchers exploring coping in families with autis-tic children emphasize the importance of helpingparents develop coping strategies that reduce thestrain on the family and enable them to meet boththeir own needs and those of their children (Sivberg,2002). The service dog provides a family-orientedservice that allows the parent to regain some control.The presence of the dog encourages normal patterns ofliving in both the home and community, and is a sourceof support for the parents. The support maximizes thefamily’s independence and functioning, two importantcomponents of intervention needed to help familiescope with autism (Briskin & Liptak, 1995).

Finally, this study provides a realistic view of thecontribution a service dog might make to a family. Despitenumerous benefits to these families, there are some disad-vantages to service-dog ownership (Burrows, 2005). Forparents who were already highly stressed, the servicedog could add to their workload as another body in thefamily that requires feeding, grooming, exercising, andtoileting. However, most parents quickly learned howto integrate the dog into their daily schedule. Parentswith unreasonable expectations as to what the dogcould do were less likely to realize the benefits the dogcould provide. It is important for any parent interestedin pursuing a service dog for their child to realize thatthe training of these dogs is ongoing, and failure tomaintain the dog’s training both in and out of harnesscan affect the success of the placement (Burrows,Adams & Millman, 2008).

This study has provided an in-depth description ofthe typical daily life and interaction of families with

a service dog trained to assist a child with autism.Although it would have been preferable to interviewthe autistic children as well, research is limited by thelack of communication ability of this particular pop-ulation; most of the autistic children in this studywere nonverbal. Perhaps the advantages of the servicedogs were more important to the parents than to thechildren. In this study, interviews with the parentsrevealed personal experiences that, combined withobservations, allowed for a detailed understanding ofdaily life with a particular focus on the quality of lifeand functional independence (Modlin, 2000). In otherhuman-animal interaction studies, the participant’spoint of view is clearly missing.

Because of the small number of service dogstrained and placed in families with autistic children,the sample size was small. The development of ahuman–animal bond can be a slow process, and thestudy was limited to a 1-year follow-up period, to fitwithin the constraints of a graduate research project.Because of placement timing from National ServiceDogs, it was only possible to follow one group for 1year and the second group for 6 months. Although thegoal of this research was to describe the dynamicrelationship between service dog, child, and parent,perhaps the first year is not fully representative of therelationship. Future research should follow thefamilies for longer periods, especially to understandthe impact on the family and child when the servicedog has to be retired, becomes ill, or dies. Failure tounderstand the end stage of these assistance-dog rela-tionships is a gap in understanding the human–animalbond as it pertains to service-dog and assistant-dogapplications. Within this study, to the greatest extentpossible, the parents were allowed to describe in theirown words the role of the service dog for their childwith autism, their other children, and for themselves.

Conclusion

Service dogs trained to assist children with autismcan provide numerous benefits for the child they havebeen matched to, as well as the family that has inte-grated the dog into their home. Benefits for theparents and family include an increase in family out-ings, a sense of security both in the home and inpublic, and a dramatic increase in positive socialacknowledgment. For many of the parents in thisstudy, the addition of a service dog was an effectiveway to alleviate some of the stress they experienced inraising a child with a developmental disorder. Daily

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activities such as transportation to school, groceryshopping, doctor’s appointments, and recreationalactivities were all facilitated by the use of the servicedog, because the presence of the dog calmed the child,prevented or interrupted tantrums, and stopped bolting.In a human–animal interaction context, the servicedogs benefited the children and families though com-panionship, facilitating social acknowledgement, andaiding with the development of the children’s finemotor skills. The constant presence of the service dogin the home and in the community improved the qual-ity of life of both children and families.

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Kristen E. Burrows, BSc, MSc, is an epidemiology consultantand was a graduate student at the Ontario Veterinary College,Department of Population Medicine, in Guelph, Ontario, Canadaat the time of this study.

Cindy L. Adams, MSW, PhD, is an associate professor of vet-erinary medicine, Department of Veterinary Clinical andDiagnostic Sciences, University of Calgary, Calgary, Alberta, Canada.

Jude Spiers, RN, PhD, is an assistant professor in the Faculty ofNursing at the University of Alberta, Edmonton, Alberta,Canada.

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