guide dog thesis

The End of the Partnership With a Guide Dog: Emotional Responses, Effects on Quality of Life and Relationships With Subsequent Dogs

Affiliations.

• 1 Discipline of Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
• 2 College of Health, Massey University, Palmerston North, New Zealand.
• 3 Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.
• PMID: 33969026
• PMCID: PMC8100499
• DOI: 10.3389/fvets.2021.543463

Guide dogs are mobility aids that facilitate independent travel of people who are blind or visually impaired. Additional benefits imparted to the guide dog handler include companionship, and increased: social-function, self-esteem and confidence. Some evidence shows that the end of the guide dog partnership can result in reduced mobility, and may have profound psychosocial effects on the handler due to feelings of bereavement and loss of self-esteem. However, this evidence is limited. This study examined the experiences and feelings of 36 people across New Zealand, who experienced the ending of at least one partnership with a guide dog (77 pairings), to explore issues arising at the end of the partnership and how this may impact on relationships with subsequent dogs. Results indicate that the majority of handlers experienced a reduction in their quality of life due to a decrease in independent mobility followed by the loss of a friend and companion, curtailment of social interactions, and loss of self-esteem/confidence. The end of the partnership affected people in different ways. Most handlers "accepted" the partnership had ended, but some felt guilty or angry with the guide dog school. Most applied for another dog immediately, as the need for mobility was high, while others preferred to wait and a smaller number did not reapply. Feelings at this time also affected the handlers' relationships with subsequent guide dogs, with over a quarter expressing a negative effect. Retiring a guide dog (for whatever reason) is not only difficult for the handler, but also for the handler's family, friends, co-workers, and doubtlessly, the dog. The majority of handlers expressed feelings of extreme grief when the partnership ended, whether it was successful or not. Feelings of extreme grief were more common for first than subsequent dogs. The depth of emotion was compared to losing a family member or other loved one, which has been reported in some person and pet relationships. A better understanding of issues surrounding the end of the partnership, including the human-animal bond, will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog users and the pet owning community.

Keywords: assistance dog; attachment; blind mobility aid; grief; guide dog; human—animal relationships; quality of life; vision impaired.

Copyright © 2021 Lloyd, Budge, La Grow and Stafford.

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Open Access

Peer-reviewed

Research Article

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

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Current address: Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, Colorado, United States of America

Affiliation Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States of America

Roles Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing

Affiliation Vassar College, Poughkeepsie, New York, United States of America

Roles Data curation, Investigation, Methodology, Writing – review & editing

Affiliation Purdue University Libraries, Purdue University, West Lafayette, Indiana, United States of America

Roles Conceptualization, Supervision, Writing – review & editing

Roles Conceptualization, Data curation, Project administration, Supervision, Writing – review & editing

• Kerri E. Rodriguez, 
• Jamie Greer, 
• Jane K. Yatcilla, 
• Alan M. Beck, 
• Marguerite E. O’Haire

• Published: December 2, 2020
• https://doi.org/10.1371/journal.pone.0243302
• Peer Review
• Reader Comments

9 Aug 2021: Rodriguez KE, Greer J, Yatcilla JK, Beck AM, O’Haire ME (2021) Correction: The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLOS ONE 16(8): e0256071. https://doi.org/10.1371/journal.pone.0256071 View correction

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.

Citation: Rodriguez KE, Greer J, Yatcilla JK, Beck AM, O’Haire ME (2020) The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLoS ONE 15(12): e0243302. https://doi.org/10.1371/journal.pone.0243302

Editor: Geilson Lima Santana, University of Sao Paulo Medical School, BRAZIL

Received: July 22, 2020; Accepted: November 18, 2020; Published: December 2, 2020

Copyright: © 2020 Rodriguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The roles of dogs to assist in improving human wellbeing continue to expand. Not only are companion dogs prevalent in modern society, but dogs are also often intentionally incorporated into therapeutic processes in the contexts of animal-assisted activities (AAA) and animal-assisted therapy [AAT; 1]. In other contexts, dogs can be specially trained to provide specific benefits to individuals with impairments, disabilities, or chronic conditions as trained assistance animals. Assistance dog placements and roles have grown rapidly in recent decades, especially in the United States, Canada, and Europe [ 2 ].

Assistance Dogs International (ADI) defines three types of assistance dogs, of which we use as terminology in this review: guide dogs who assist individuals with visual impairments, hearing dogs who assist individuals with hearing impairments, and service dogs who assist individuals with disabilities other than blindness or deafness [ 3 ]. Service dogs can assist individuals with physical disabilities (e.g. performing mobility-related tasks such as pulling a wheelchair or retrieving dropped items), individuals with medical conditions (e.g. alerting or responding to medical crises such hypoglycemia or seizures), and individuals with mental health disorders (e.g. psychiatric service dogs for posttraumatic stress disorder or autism spectrum disorder). Under the Americans with Disabilities Act of 1990, a United States law, an assistance dog must do work or perform tasks for the benefit of an individual with a physical, sensory, psychiatric, intellectual, or other mental disability in order to receive public access rights [ 4 ]. While there are no legal requirements specifying that an assistance dog must be certified, registered, or receive any specialized training to receive public access rights, independent organizations such as ADI, the International Association of Assistance Dog Partners (IAADP), and the International Guide Dog Federation (IGDF) define a set of minimum training and behavior standards for public access that help guide the assistance dog industry.

In parallel with an increasing amount of research quantifying the therapeutic benefits of companion dogs and therapy dogs on human health and wellbeing [ 5 , 6 ], there has been an increased focus on quantifying the physical, psychological, and social effects that assistance dogs may have on their handlers [ 7 – 9 ]. Research has indicated that beyond the physical or tangible benefits that an assistance dog is trained to provide (e.g. route finding, retrieving dropped items, alerting to a seizure), the assistance dog’s companionship, emotional and social support, and social facilitation effects in public may be particularly salient to improving the quality of life of individuals with disabilities [ 7 – 9 ]. After receiving an assistance dog, individuals retrospectively report increases to their social, emotional, and psychological health [e.g., 10 – 12 ]. Longitudinal studies have found that individuals report improvements to their emotional wellbeing, social functioning, and quality of life just 3 to 6 months after receiving an assistance dog [ 13 – 15 ]. Compared to those on the waitlist, individuals with an assistance dog report better psychosocial functioning and wellbeing [ 16 , 17 ]. Additionally, research suggests the relationship between an assistance dog and its owner may also serve as a reciprocal attachment and caregiving relationship characterized by secure and strong attachments [ 18 , 19 ].

To date, there have been several reviews summarizing the literature on the psychosocial effects of assistance dogs on their handlers. One of the first reviews published by Modlin in 2000 [ 7 ] summarized nine published quantitative and qualitative studies on the benefits of guide dogs, hearing dogs, and mobility service dogs on their handlers (omitting unpublished theses). Another early review published by Sachs-Ericsson and colleagues in 2002 [ 8 ] summarized 14 quantitative studies on both standardized and nonstandardized outcomes following mobility service dog or hearing dog placement (omitting guide dogs). Neither of these early reviews employed a formal methodological assessment of studies, but limitations were listed for each included study. While both reviews found mostly positive findings regarding mobility, guide, and hearing dogs’ effects on their handlers’ health and wellbeing, social interactions, and activity participation [ 7 , 8 ], it was concluded that “the small number of studies and methodological limitations of these studies preclude any clear conclusions” [ 8 ].

A more recent systematic review published by Winkle and colleagues in 2012 [ 9 ] summarized 12 published quantitative studies on both standardized and nonstandardized outcomes following mobility service dog placement (omitting guide dogs, hearing dogs, and unpublished theses). The scientific rigor of each study was rated according to a 5-level system while the methodological quality of each study was scored on a 7-point scale. While results described positive effects of service dogs in terms of social, psychological, and functional benefits for their handlers, it was concluded that all 12 of the studies had weak study designs with limitations including lack of comparison groups, inadequate description of the service dog intervention, and nonstandardized outcome measures. The authors concluded that although results are promising, “conclusions drawn from the results must be considered with caution” [ 9 ].

Because medical service dogs are a relatively new category of assistance dog placements [ 2 ], there has been less research on the psychosocial effects of medical alert and response service dogs on their handlers. However, a recent 2018 review summarized five published quantitative studies describing outcomes from seizure alert and seizure response service dogs. The authors found three studies reporting an association between having a seizure alert or response dog and improvements to quality of life and wellbeing, concluding a need for more research.

Research in the field of human-animal interaction (HAI) and assistance dogs is not only rapidly growing but is often disparately published across multidisciplinary journals and outlets. Conducting periodic systematic reviews of this research is crucial to both disseminate knowledge as well as to identify knowledge gaps for future studies [ 20 ]. As research on the assistance animal-handler relationship continues to increase, there is a need for an updated, comprehensive collation of the literature encompassing studies on the effects of all varieties of assistance dogs (guide dogs, hearing dogs, and both mobility and medical service dogs) including both published studies and unpublished theses and dissertations. Further, as researchers increasingly incorporate standardized outcome measures into this research, collating and pooling findings will allow researchers to compare outcomes across different populations and interventions while estimating the magnitude of effects across domains.

This research aimed to conduct a systematic assessment of the current state of knowledge regarding the potential benefits of assistance dogs on standardized outcomes of the health and wellbeing of individuals with disabilities. Specifically, this review sought to systematically identify, summarize, and evaluate studies assessing psychosocial outcomes from owning an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) with measures tested for reliability and validity among individuals with physical disabilities. The specific aims were to (1) describe the key characteristics of studies (2) evaluate the methodological rigor of studies (3) summarize outcomes.

Materials and methods

The systematic literature review was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 21 ]. A study protocol was designed a-priori to define the search strategy, inclusion and exclusion criteria, and items for data extraction.

Search procedure

As the field of animal-assisted intervention is multidisciplinary, a wide and extensive search was conducted encompassing medical and scientific databases. Further, as publication bias and the “file-drawer effect” is an often referenced weakness of the HAI literature [ 22 ], two dissertation and thesis databases and abstracts of two conferences were searched for unpublished studies.

A health information specialist (JY) constructed and executed comprehensive search strategies in six electronic databases: MEDLINE (PubMed platform), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost platform), ERIC (EBSCOHost), Web of Science Core Collection (Web of Science), PsycINFO (EBSCOhost), and PsycARTICLES (EBSCOhost). The electronic searches were performed on July 23, 2018, and updated on January 23, 2019. The complete MEDLINE search strategy, which was adapted for the other databases, is shown in S1 Table . Grey literature was addressed by searching ProQuest Dissertations and Theses (ProQuest) and WorldCatDissertations and hand searching the abstracts of the International Society for Anthrozoology and International Association of Human Animal Interactions Organizations conferences.

Article selection

Studies were eligible for inclusion if they met the following criteria: (1) The study population consisted of current or prospective owners/handlers of an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) with a physical disability or chronic condition in which the assistance dog is trained to do work or perform tasks directly related to the disability or condition [ 4 ]; (2) The study collected original data on the effect of the assistance dog on their handler with at least one psychosocial outcome, including those quantifying aspects of mental health, social health, and health-related quality of life; and (3) The psychosocial outcome(s) were collected via a standardized measure tested for validity and reliability. The rationale for excluding studies on emotional service dogs and psychiatric service dogs is that the primary benefits of these dogs are psychological in nature, rather than physical or medical, which complicated comparisons of their psychosocial effects. The rationale for excluding qualitative studies from inclusion was to focus on outcomes using standardized measures to facilitate quantitative comparisons across studies.

Article screening

All articles were screened by two independent reviewers (authors KR and JG) using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). In the case of disagreements, inclusion or exclusion was resolved by discussion and consultation with a third independent reviewer (author MO). After removing duplicate articles in EndNote following a validated protocol [ 23 ], articles were screened based on their title and abstract. At this stage, articles were excluded if they were (1) non-English; (2) written for a magazine or other non-peer-reviewed source; (3) book reviews, book chapters, editorials, letters, or opinion papers that did not collect original data; (4) conference abstracts or proceedings; (5) studies assessing companion, therapy, or emotional support animals that were not trained for tasks or work related to a specific disability.

After the initial title and abstract review, articles were screened based on full text. Exclusion criteria were then used to select articles based on the following (in order): (1) irrelevant to study topic; (2) assessed an excluded study population (psychiatric service dogs, therapy dogs, emotional support dogs, or companion dogs); (3) did not report quantitative outcomes from assistance dog placement (literature reviews, instrument development, not original research); (4) reported unrelated outcomes (puppy raising, service dog training, or animal-related outcomes); (5) reported only non-psychosocial outcomes (medical or physical); (6) methodological exclusions (qualitative, case studies, single-subject design); (7) no full text available.

Data extraction

Articles were extracted for information based on three aims to describe study characteristics, assess methodological rigor, and summarize outcomes. To describe study characteristics, extracted items included participant characteristics (sample size, age, gender, country of origin), assistance dog characteristics (type and provider), and details of the study (design, measurement time points, comparison conditions). To assess methodological rigor, a total of 15 extracted items were sourced from methodological assessment tools including the National Institutes of Health (NIH) Study Quality Assessment Tools [ 24 ], the Consolidated Standards of Reporting Trials (CONSORT) checklist [ 25 ], the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists [ 26 ], and the Specialist Unit for Review Evidence (SURE) Checklists [ 27 ]. Authors JG and KR independently coded 20% of the included articles to establish adequate inter-rater reliability (alpha = 0.822). Author KR then coded 100% of articles. To examine the relationship between methodological rigor score and year of publication as well as sample size, bivariate correlations were performed. To compare methodological rigor by study design, an independent t-test was used to compare mean scores across longitudinal and cross-sectional designs.

To summarize study outcomes, extracted items included statistical comparisons for any psychosocial outcomes from included studies. Because of the broad inclusion criteria, the 27 studies were widely varied in terms of human and dog participants, assessment time points, statistical analyses, and standardized outcomes. Therefore, due to observed heterogeneity, a meta-analysis was not pursued. We also planned to extract or manually calculate effect sizes to create funnel plots to investigate potential publication biases. However, due to large heterogeneity and poor reporting of effect sizes and raw data, a narrative synthesis of findings in comparison to unpublished theses and published articles was pursued instead.

A total of 1,830 records were screened via title and abstract in which 1,576 records were excluded due to irrelevancy (see Fig 1 for PRISMA diagram). A total of 254 records were screened via full text, of which 230 were excluded. Exclusions included those based on population, outcomes, and methodology. The final sample included 24 articles (12 peer-reviewed publications, 12 unpublished theses/dissertations) containing 27 individual studies. Articles were published from 1994–2018 with publication dates in the 1990s (5), 2000s (9), and 2010s (10) indicating an increasing publication rate on this topic over time.

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Study characteristics

To achieve the first aim of the review–to describe study characteristics–we extracted several features of from each study and article ( Table 1 ).

https://doi.org/10.1371/journal.pone.0243302.t001

Study designs.

Of 27 studies, 15 were cross-sectional and 12 were longitudinal. Studies compared outcomes of individuals with an assistance dog to before they received the dog (six longitudinal studies), to participants on the waitlist to receive an assistance dog (five longitudinal and seven cross-sectional studies), or to participants without an assistance dog (eight cross-sectional studies). Longitudinal assessment time points were varied. Most longitudinal studies (8/12) assessed participants at two time points: at baseline prior to receiving an assistance dog, and an average of 5.8 +/- 3.3 months after participants received an assistance dog (range of 3–12 months follow-up). The remaining four longitudinal studies assessed participants 3–5 times with final follow-up ranging from 9–24 months after receiving an assistance dog.

Study participants.

Most studies (15/27; 56%) were conducted in the United States, followed by the United Kingdom (6/27; 22%). Other countries where studies took place included Canada (3), Japan (2), New Zealand (1), and Sweden (1). A majority of studies (18/27; 67%) assessed outcomes from mobility service dogs for individuals with physical disabilities. These 18 studies recruited study populations with a range of physical impairments including para- or quadriplegia, musculoskeletal disorders, and neuromuscular disorders. Other studies assessed outcomes from hearing dogs (7/27; 26%), guide dogs (4/27; 15%), and medical alert/response service dogs (2/27; 7%). Human participants in these studies included those with hearing or visual impairments, diabetes, and seizure disorders. Most studies (24/27; 89%) assessed outcomes from a single type of assistance dog (e.g. mobility or guide), thus restricting human participants to a single category of impairments. However, three studies collapsed analyses across several types of assistance dogs and impairments. Most studies (17/27; 63%) recruited from a single assistance dog provider organization, while the remaining studies recruited from a range of providers (7/27; 26%) or did not report the source of the assistance dogs in the study (3/27; 11%). The most common provider organizations represented were Canine Companions for Independence (CCI; six mobility service dog studies), Paws with a Cause (four mobility service dog studies), and Hearing Dogs for Deaf People (HDDP; four hearing dog studies).

Samples sizes ranged from 10 to 316 participants with an average sample size across all studies of N = 83 +/- 74 participants and a median sample size of N = 53. Seven studies (26%) had sample sizes less than or equal to N = 20, all of which were longitudinal. However, more than half of all studies (16/27; 59%) had sample sizes greater than or equal to N = 50. Cross-sectional studies had the highest sample sizes with an average sample size of N = 126 +/- 73 participants (range of N = 38–316), while longitudinal studies averaged N = 29 +/- 18 participants (range of N = 10–55). Only a single study [ 16 ] assessed outcomes from child participants under the age of 18 (an additional study [ 38 ] had a minimum inclusion age of 16, but the youngest participant was 19). Average age across all studies was 42 +/- 13 years old. Samples ranged from 15% male to 85% male, with an average of 42% male participants across all studies.

Study methodologies

To achieve the second aim of the review–to evaluate the methodological rigor of studies–each study was assessed if they met a set of 15 methodological rating items using a scale of yes, no, or N/A ( Table 2 ). Fig 2 displays the total scores across each of the 15 items, separated by introduction, methods, results, and discussion sections (see S2 Table for individual study scores). Overall, studies addressed an average of 62% of methodological consideration items with a range of 23% (3/13) to 100% (15/15; denominators were variable as there were two items not applicable to all study designs). Longitudinal studies addressed an average of 59% of methodological items while cross-sectional studies averaged 65%. However, methodological rigor did not significantly differ by study design ( t (25) = -0.940, p = 0.356). Methodological rigor also did not significantly correlate with year of publication ( r = 0.327, p = 0.096) nor total sample size ( r = 0.258, p = 0.194).

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In introduction sections, all studies described an objective, but only 17/27 (63%) of studies stated a directional hypothesis. In methods sections, only 16/27 (59%) of studies indicated whether ethical approval for conducting human subjects research was sought and received. Most studies reported adequate detail on participant demographics such as age and sex or gender identity (23/27; 85%) as well as disability characteristics such as primary diagnoses or severity (22/27; 81%). However, inclusion and exclusion criteria were less commonly described (17/27; 63%). Only 5/27 studies (19%) described dogs’ breeds and sources. Finally, most studies (21/27;78%) compared outcomes to a control or comparison condition.

In results sections, 15/21 studies with a control or comparison condition (71%) demonstrated that participants in each condition were comparable on demographic variables. This occurred by either matching groups on select criteria or statistically comparing groups’ demographic characteristics before performing main analyses. When reporting statistical results, 78% of studies (21/27) provided estimates of variability for outcomes, including confidence intervals, standard deviations, or standard error of the mean. However, only 44% (12/27) of studies reported statistical values (e.g. t , F , or B values) and only 55% (15/27) of studies reported exact probability values from analyses. Only 6/27 (22%) reported any estimates of effect size in their results. Of 15 cross-sectional studies that surveyed individuals who owned assistance dogs for variable periods of time, 4/15 studies (27%) considered length of time of assistance dog ownership as a potential explanatory or moderating variable in analyses. Finally, in discussion sections, most studies (22/27; 81%) stated at least two limitations of their study.

Study outcomes

To achieve the third aim of the review–to summarize outcomes–psychosocial outcomes within each study were extracted. Studies made an average of 5.4 statistical comparisons on psychosocial outcomes, ranging from 1–15 comparisons. In total, 147 comparisons were made across the 27 studies that examined the effect of having an assistance dog on a standardized scale or sub-scale on a psychosocial outcome: 58 (39%) psychological outcomes, 43 (29%) social outcomes, 34 (23%) quality of life outcomes, and 12 (8%) energy/vitality outcomes. Of 147 comparisons, 44 (30%) were positive (improved or better functioning in comparison to pre- or control conditions), 100 (68%) were null (no observed difference), and 3 (2%) were negative (decreased or worse functioning in comparison to pre- or control conditions). Of the 44 positive comparisons, 36 (82%) were from published papers and 8 (18%) were from unpublished theses. Of the 100 null comparisons, 43 (43%) were from published papers and 57 (57%) were from unpublished theses.

Psychological outcomes.

Table 3 summarizes psychological outcomes across studies in terms of general psychological health, emotional health, mental health, and self-evaluation. Of 27 studies, 20 (74%) assessed a psychological outcome with a total of 24 different standardized measures. Of 58 total psychological outcomes, 21 (37%) were positive (improved or better psychological health in comparison to pre- or control conditions), 37 (63%) were null (no difference), and zero (0%) were negative (decreased or worse functioning in comparison to pre- or control conditions).

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For general psychological health, 5/11 (45%) outcomes were significant across group or condition. Six studies used standardized measures to assess general health and health symptoms, three of which [ 17 , 28 , 35 ] reported null findings on the general health domain of the RAND 36-Item Short Form Health Survey [SF-36; 47 ]. However, Lundqvist et al. [ 35 ] found increased SF-36 health transition scores after 3-months of having a mobility, hearing, or medical service dog, while Guest [ 13 ] found an increase in general health 3-months after receiving a hearing dog using the 30-item General Health Questionnaire [GHQ-30; 48 ]. Three studies found positive findings on measures of overall psychological wellbeing or psychosocial health, including increased psychological wellbeing 3-months after receiving a mobility, hearing, or medical service dog [ 35 ], 6-months after receiving a mobility service dog [ 14 ], and better overall psychosocial health in those with a mobility or medical service dog compared to a control group [ 16 ]. On the other hand, Spence [ 34 ] found no improvement to a composite score of psychological health 12-months after receiving a mobility service dog.

Regarding emotional health, 7/15 (46%) outcomes were significant across group or condition. Yarmolkevich [ 46 ] found a significant effect of having a guide dog on positive affect using the Scale of Positive and Negative Experience [SPANE; 49 ] compared to a control group, while others studies found no effect of having a hearing dog [ 29 ] or mobility service dog [ 39 ] on affect via the Positive and Negative Affect Scale [PANAS; 50 ]. Guest [ 13 ] used the Profile of Mood States Scale [POMS; 51 ], finding less overall mood disturbance, less tension, and less confusion 3-months after hearing dog placement. In terms of emotional functioning, two studies found positive results using the SF-36 role emotional domain; Lundqvist et al. [ 35 ] found increased functioning 3-months after receiving a mobility, hearing, or medical service dog, while Shintani et al. [ 17 ] found better functioning among those with a mobility service dog compared to a control group. On the other hand, Donovan [ 28 ] found no change in emotional functioning 4-months after receiving mobility service dog. Using a different measure of emotional functioning, Rodriguez et al. [ 16 ] found higher emotional functioning in those with a mobility or medical service dog compared to a control group.

A total of 13 mental health outcomes were assessed in which 4 (31%) were significant across group or condition. Of 5 studies that used the mental health domain of the SF-36 or the shorter 12-Item Short Form Health Survey (SF-12), only Shintani et al. [ 17 ] found an effect of having an assistance dog on mental health. The other four studies reported no changes in participants’ mental health 3-months after receiving a mobility, hearing, or medical service dog [ 35 ], 4-months after receiving a mobility service dog [ 28 ], and 7-months after receiving a hearing or mobility service dog [ 32 ]. Six comparisons were made to measure the effect of having an assistance dog on clinical measures of depression or anxiety. However, none of the four studies using the Center for Epidemiologic Studies Depression Scale [CES-D; 52 ] found significant differences in self-reported depression among those with a mobility service dog compared to a control group [ 39 – 41 ] or after 4-months with a mobility service dog [ 28 ]. However, Guest et al. found significantly lower depression and anxiety using the POMS and GHQ-30, respectively, 6-months after receiving a hearing dog [ 13 ].

In the self-evaluation subcategory, 5/19 (26%) outcomes found a significant effect of having an assistance dog on standardized measures of self-esteem, self-concept, and other measures of self-evaluation. Nine studies assessed self-esteem as a primary outcome, with four studies [ 14 , 32 , 36 , 46 ] finding a significant effect of having a guide, hearing, mobility, or medical service dog on self-esteem as measured by the Rosenberg Self Esteem Scale [RSES; 53 ]. However, other studies reported no relationship between having a mobility service dog and self-esteem via the RSES [ 39 , 41 ] or other standardized measures of self-esteem [ 15 , 28 , 36 ]. Using the Psychosocial Impact of Assistive Devices Scale [PIADS; 54 ], Vincent et al. [ 15 ] found no difference in self-esteem, adequacy, or competency over 12-months following receiving a mobility service dog. Other self-evaluation outcomes assessed with null findings included no differences in self-concept between control groups and those with mobility service dogs [ 37 ] or guide dogs [ 46 ], no differences in attitude towards a disability 4-months after receiving a mobility service dog [ 28 ] or among guide dog users compared to a control group [ 38 ], and no differences in flourishing among guide dog users compared to a control group [ 46 ]. The only other positive outcome was from Allen et al. [ 14 ] which found significantly higher internal locus of control 6-months after receiving a mobility service dog.

Social outcomes.

Table 4 summarizes the social outcomes across studies within the sub-categories of general social functioning, loneliness, and social participation. Of 27 studies, 18 (67%) reported outcomes a standardized measure of social health with a total of 18 different standardized measures. Of 43 total social outcome comparisons, 7 (16%) were positive (improved or better social health in comparison to pre- or control conditions), 36 (84%) were null (no difference) and zero (0%) were negative (decreased or worse social health in comparison to pre- or control conditions).

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In terms of general social functioning, 2/10 comparisons made were significant. Three studies using SF-36 failed to find significant effects on the social domain; Lundqvist et al. [ 35 ] found no improvement 3-months after receiving a mobility, hearing, or medical service dog, Donovan [ 28 ] found no improvement 4-months after receiving a mobility service dog, and Shintani et al. [ 17 ] found no difference among mobility service dog users compared to controls. However, on different measures of social functioning Rodriguez et al. found better social functioning in those with a mobility or medical service dog compared to a control group [ 16 ] while Guest found improved social functioning 3- and 12-months after receiving a hearing dog [ 13 ]. In addition, null findings were reported on standardized measures of family role 3-, 6-, and 12-months after receiving a mobility service dog [ 15 ], discrimination and social inclusion 12-months after receiving a mobility service dog [ 34 ], and family and social self-concept among mobility dog users compared to a control group [ 37 ].

The sub-category of loneliness had 19 comparisons in which only 1/19 (5%) was significant. Of five studies using a version of the UCLA Loneliness Scale [ 55 ] only Yarmolkevich [ 46 ] found significantly lower self-reported loneliness in those with a guide dog compared to a control group. Four studies found no effect of having a hearing dog [ 29 ] or mobility service dog [ 39 , 41 ] on the UCLA Loneliness Scale. Two studies from the a single thesis [ 29 ] made the remaining 14 comparisons on measures of loneliness distress and complementary loneliness, finding no significant changes to loneliness six months after receiving a hearing dog and no significant group differences in loneliness compared to those without a hearing dog.

Regarding social participation, 14 comparisons were made in which 4/14 were significant (29%). Two studies found increased social participation 3-, 6-, and 12-months [ 15 ] as well as 7-months [ 33 ] after receiving a mobility service dog, while Donovan [ 28 ] found no change in social participation 4-months receiving a mobility service dog. Other studies found increased social connectedness 3-months after receiving a mobility or hearing dog [ 31 ] and increased community integration 6, 12, 18, and 24 months after receiving a mobility service dog [ 14 ]. Using the CHART, both Milan [ 41 ] and Davis [ 44 ] found no group differences in social integration among those with a mobility service dog control groups. Other null findings included no effect of having a guide dog on social conflict stress and interactions with others [ 42 ], no improvement in social relationships 12-months after receiving a mobility service dog, and null findings regarding self-reported friendship and companionship with a mobility or medical service dog [ 16 ] or 4-months after receiving a mobility service dog [ 28 ].

Quality of life outcomes.

Table 5 displays all quality of life outcomes across studies within the sub-categories of overall quality of life, life satisfaction, and independence. Of 27 studies, 19 (70%) reported outcomes a quality of life measure with a total of 13 different standardized measures used. Of 34 total quality of life outcomes, 9 (26%) were positive (improved or better quality of life in comparison to pre- or control conditions), 22 (65%) were null (no difference) and 3 (9%) were negative (decreased or worse quality of life in comparison to pre- or control conditions).

https://doi.org/10.1371/journal.pone.0243302.t005

In the overall quality of life sub-category, 2/8 (25%) comparisons were significant. Lundqvist et al. [ 35 ] found higher health-related quality of life 3-months after receiving a mobility, hearing, or medical service dog on one of three measures used [EuroQol Visual Analog Scale; 56 ]. Hall et al. [ 45 ] found higher health-related quality of life among those with a mobility service dog compared to a control group, but not among those with a hearing dog. Other studies found no effect of having a mobility service dog on quality of life including more specific measures such as physical and environmental quality of life [ 33 , 34 ].

In the next sub-category, six studies assessed life satisfaction outcomes using Satisfaction with Life Scale [SWLS; 57 ]. However, only 1/6 (17%) found a significant effect, in which Yarmolkevich found higher life satisfaction among those with a guide dog compared to a control group. The other five studies found no effect of having a mobility service dog [ 32 ], hearing dog [ 29 , 32 ], or guide dog [ 38 ] on life satisfaction using SWLS.

In the sub-category of independence, a total of 20 comparisons were made in which 9 (45%) were significant, but 3 (15%) were in the negative direction. The most commonly used measure was the Craig Handicap Assessment and Reporting Technique [CHART; 58 ] which assesses how people with disabilities function as active members of their communities. Using the occupation domain of the CHART, Rintala et al. [ 32 ] found no difference in occupational functioning 7-months after receiving a mobility service dog and Milan [ 41 ] found no group difference in those with and without a mobility service dog. However, 2 studies found worse occupational functioning in terms of employment, schooling, or homemaking. Rintala et al. [ 32 ] found that participants reported worse occupational functioning 7-months after receiving a hearing dog while Davis [ 44 ] found that individuals with a mobility service dog reported worse occupational functioning compared to a control group.

In the economic domain of the CHART, which assesses socio-economic independence, Davis [ 44 ] again found that those with a mobility service dog reported worse economic functioning than controls while two mobility dog studies reported null findings [ 30 , 41 ]. In the mobility domain, only Milan [ 41 ] found a significant effect of having a mobility service dog on the CHART mobility domain (which includes hours per day out of bed and days per week out of the house) while Davis [ 44 ] and Rintala et al. [ 32 ] reported no relationship between the mobility domain and having a service dog or hearing dog. Using other standardized measures of independence, Matsunaka & Koda [ 42 ] found that those with guide dogs reported and lower stress while being mobile. Similarly, Crudden et al. [ 43 ] found that individuals who had guide dogs reported less stress while walking, but not while using public transportation. Using the Reintegration to Normal Living Index [RNLI; 59 ], Hubert found improvements in the ability to return to ‘normal life’ after 7-months with a mobility service dog while Vincent et al. [ 15 ] found improvements to daily work activities 3- and 12-months after receiving mobility service dog (but not in self-care or dealing with life events). Finally, Rodriguez et al. [ 16 ] found that those with a mobility or medical service dog reported significantly higher work/school functioning than a control group.

Vitality outcomes.

Table 6 summarizes vitality outcomes across studies within the sub-categories of general energy/vitality and sleep. Of 27 studies, 7 (26%) reported outcomes from at least one standardized measure of vitality with a total of five different standardized measures. Of 12 total vitality comparisons, 6 (50%) were positive (improved or better vitality in comparison to pre- or control conditions), 6 (50%) were null (no difference) and zero (0%) were negative (decreased or worse vitality in comparison to pre- or control conditions).

https://doi.org/10.1371/journal.pone.0243302.t006

In terms of general vitality and energy, four studies used the SF-36 to measure the effect of having an assistance dog on the vitality domain. Only Vincent et al. [ 15 ] found a significant increase in pep, energy, and feeling less worn out 3- and 6-months after receiving a mobility service dog while three studies found no relationship between the vitality domain and having a mobility service dog [ 17 , 28 ] or a mobility, hearing, or medical service dog [ 35 ]. Using the Profile of Mood States Scale [POMS; 51 ], Guest found increased self-reported vigor 3- and 12-months after receiving a hearing dog and less fatigue 3-months after receiving a hearing dog. Using another measure of energy and fatigue, Craft [ 40 ] found no difference in those with or without a mobility service dog. Regarding sleep, Guest found better self-reported sleep quality 3- and 12-months after receiving a hearing dog while Rodriguez et al. [ 16 ] found no difference in sleep disturbance between individuals with mobility or medical service dog and a control group.

This systematic review summarized the current state of knowledge regarding the effects of owning an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) on standardized outcomes of psychosocial health and wellbeing of individuals with disabilities. Our search procedure identified 24 articles containing 27 studies assessing psychosocial outcomes from a wide variety of human and assistance dog populations. These studies were reviewed to complete three specific aims: to describe the key characteristics of studies, to evaluate the methodological rigor of studies, and to summarize outcomes. The discussion section aims to review the findings from each aim and to provide targeted suggestions for future research.

Our first aim was to describe study characteristics of the literature. We found that most studies were conducted in either the United States or the United Kingdom, but there was international representation of the research in Canada, Sweden, New Zealand, and Japan. Most articles were published in the 2010s, indicating an increasing publication interest in this topic over time. In fact, nine new articles were identified (three theses, six publications) that had been published since the last review on this topic in 2012 [ 9 ]. Increased research on this topic is likely in parallel with the increased roles and demands for different types of assistance dogs worldwide [ 2 ] as well as increased interest in the benefits of animal interaction for human health and wellbeing [ 60 ]. The most commonly studied type of assistance dog was mobility service dogs, followed by hearing dogs. Guide dogs were only assessed in four studies (all of which were cross-sectional, and one of which was an unpublished thesis [ 46 ]). The lack of guide dog-specific research is especially surprising given that guide dogs not only have the longest history of any type of assistance dog [ 61 ] but are also the most commonly placed assistance dog placed by professional facilities worldwide [ 2 ]. Future longitudinal research in this population is necessary to understand the complex psychosocial and physical roles that guide dogs play in the lives of their handlers. Medical service dogs for diabetes and seizure alert/response were rarely studied [ 16 , 35 ], and were assessed in conjunction with mobility service dogs rather than on their own. However, these are relatively new categories of assistance dogs [ 2 ], many of which may also be self-trained [ 62 ], and it appears that emerging research on this population has centered on medical benefits [ 63 ] rather than psychosocial. Future research should focus on assessing outcomes from these medical alert and response assistance dogs and how their roles may be similar or different than mobility, guide, or hearing dogs.

Study designs included both cross-sectional and longitudinal studies, with only one randomized longitudinal study identified [ 14 ]. However, it should be noted that this study by Allen & Blascovich has received considerable critique due to incredibly large effect sizes, unrealistic retention and response rates, and severe methodological omissions including a lack of reporting on recruitment, funding, or where assistance dogs were sourced and trained [despite repeated requests for clarification; 64 , 65 ]. The remaining studies were quasi-experimental in that they did not use randomized assignment to treatment or control groups. Therefore, the current literature is limited to correlational, rather than causal conclusions regarding the benefits of assistance dogs on the psychosocial health of their owners. Overall, sample sizes were higher than what is usually observed in targeted animal-assisted intervention studies with dogs (e.g. [ 66 , 67 ]) but smaller than that of pet dog research [ 68 ]. Interestingly, only one included study [ 16 ] assessed outcomes from participants under the age of 18. Although outcomes from assistance dog placement for children and adolescents have been quantified with qualitative [e.g., 69 – 71 ] and observational [e.g., 72 ] study designs, effects on standardized measures of psychosocial wellbeing including social functioning have not been explored. Therefore, future studies are warranted that specifically assess health and wellbeing using validated parent-proxy or self-report measures to fully understand the potential effects that assistance dogs can have on children and adolescents with disabilities.

Methodological rigor

Our second aim was to evaluate the methodological rigor of studies. We found that similar to the range of study characteristics observed, there was considerable variation in the methodological rigor of included studies. The most notable weaknesses included a lack of adequate reporting in the methodological sections, which not only limits interpretation of findings but prevents reproducibility. First, only 59% of studies stated whether ethical approval for human subjects was sought and received. Future research should specify not only ethical protocols for human subjects research, but also for animal subjects, which is often underutilized and/or underreported in AAI research [ 73 ]. Second, only 63% of studies described inclusion and/or exclusion criteria of recruited participants, and some studies did not report all demographic or disability characteristics of participants. Future studies should provide detailed researcher-specified criteria for participation as well as organizational-specified criteria for placing/receiving an assistance dog, if applicable. For example, organizations that place assistance dogs may have housing, familial, physical, or even financial requirements for potential recipients that should be subsequently reported in the manuscript to fully define the population. It is unreasonable to assume that the changes to an individual’s life following receipt of an assistance dog is identical for all ages, gender identities, backgrounds, and disabilities. Therefore, detailed descriptions of study populations is critical for helping the field understand for whom assistance dogs are beneficial regarding social, emotional, or psychological health and under what contexts or conditions [ 74 ].

Finally, one of the most notable examples of poor methodological reporting across studies was the omission of information regarding assistance dogs’ sources (e.g. purpose-bred from a provider, self-trained) and breeds (e.g., Labrador Retriever, Golden Retriever, Mixes). As the assistance dog itself is the key component of the intervention, details regarding the dog’s breeding, rearing, selection, and training, as well as the assistance dog-handler matching process are critical to disentangling potential mechanisms [ 75 ]. In addition, reporting detailed information on assistance dogs allows for the consideration of the dogs as individual agents in the therapeutic process rather than as uniform tools [ 1 , 74 ].

In addition to poor methodological reporting, many studies were restrained by statistical weaknesses. Many studies did not confirm that participants across groups were statistically equivalent on key demographic variables such as age and sex/gender before conducting statistical analyses. This poses a severe threat to the validity of findings as group differences in outcomes could be caused by underlying differences in certain demographics or characteristics and cannot be confidently attributed to the presence of the assistance dog. Secondly, many studies did not report sufficient detail in results in terms of estimates of variability and effect size. Thorough reporting in terms of the magnitude and variability of effects observed will allow researchers to make informed comparisons across populations and interventions and conduct critically needed meta-analyses in the field.

The third aim of the review was to summarize psychosocial outcomes of studies. We found that studies reported mostly psychological outcomes (74%), followed by social outcomes (67%), quality of life outcomes (70%), and vitality (26%) outcomes. Overall, most (68%) of comparisons made across studies were null in which no statistical difference was found in the outcome compared to before getting an assistance dog or compared to a control group. Importantly, only a few comparisons were made in the negative direction (2%) indicating that there is limited reason to believe that acquiring an assistance dog is associated with worse functioning. A total of 30% of comparisons made were positive in which having an assistance dog was associated with improved psychosocial functioning among individuals with disabilities. In fact, positive findings were identified in all domains and sub-domains of psychosocial health and wellbeing. Promising areas include psychological wellbeing, emotional wellbeing, and social participation in which several positive outcomes were identified. However, almost all positive findings were accompanied by a null finding using the same or similar standardized measure in a different study. The below discussion considers various potential explanations for the inconsistencies in findings across studies.

Variability in assessment times.

One of the main considerations in understanding the potential variability across findings is the aspect of time since assistance dog placement. In longitudinal studies, the first follow-up time point varied from 3- to 12-months after receiving an assistance dog. Within cross-sectional studies, number of years since first partnering with an assistance dog ranged from 6-months to 45 years with means ranging from 2–9 years. This variation in assessment times makes it difficult to draw definitive conclusions on conflicting findings. Further, the number of years spent with the assistance dog at the time of surveying was unknown for half of the cross-sectional studies [ 29 , 37 , 40 , 42 – 45 ]. Therefore, in the cases where positive outcomes were reported in these studies, it is unknown what amount of time with an assistance dog the finding was associated with (and therefore difficult to compare to findings from other studies).

Variability in interventions.

Another potential explanation for inconsistent findings across studies lies in the inherent variability of the assistance dog intervention itself. Assistance dog categories (guide, hearing, mobility, and medical) were collapsed for the purposes of this review, but undoubtedly contribute to the lives of individuals with disabilities in diverse ways. However, even within a single category, there are differences in assistance dog breeds, temperaments, and training that may significantly contribute to observed variance across studies. Second, there is inherent variation in both the quality and quantity of interactions from one assistance dog-owner pair to the next. In addition to the different human and dog phenotypes that contribute to this heterogeneity, there are likely differences in the strength of the human-animal bond and attachment relationships formed between assistance dogs and handlers [ 19 , 76 ]. Moderator analyses will be useful in determining the potential explanatory effects that handler-service dog relationships have on psychosocial outcomes.

Variability in standardized measures.

Another potential reason for the inconsistencies in findings from studies assessing the same construct is disparities across standardized measures. Measures of the same outcome not only can have different wording and items, but also can measure functioning over different time periods or contexts. In one example, four studies included in this review failed to find significant results in comparisons of depression using the CES-D [ 28 , 39 – 41 ]. However, positive findings were found in depression using the POMS by a different study [ 13 ]. The CES-D asks participants to rate how often they had experienced 20 depressive symptoms in the prior week using statements such as “I thought my life had been a failure,” while the POMS asks participants to rate from not at all to extremely how they feel right now using single words such as “sad” and “unhappy.” It is also possible that some standardized measures do not capture the intended effects from having an assistance dog. One author argued that an “important methodological issue is the absence of appropriate measures” in measuring the effect of an assistance dog on recipients’ lives [ 32 ]. Future research is necessary to determine if in fact some measures are inappropriate to measure change following an assistance dog, which may be addressed using interviewing and focus group techniques among assistance dog handlers. The replicated measures identified in this review can serve as a basis for future researchers to collate the existing literature when making assessment choices.

Variability in study rigor.

A final potential reason for outcome discrepancies is variation in methodological rigor across studies. In particular, not only did studies vary largely in terms of sample size, but they also varied in the manner in which statistical analyses were conducted. As mentioned above, a surprisingly high number of studies did not ensure that assistance dog and control groups were statistically equal across demographic and disability characteristics prior to outcome analyses. In these studies, positive findings (i.e., better social functioning in those with an assistance dog compared to a control group) may be partially attributed to an unmeasured variable driving the group difference [ 77 ]. In addition, many studies did not account for confounding variables such as having a pet dog, the progressiveness or type of disability, or relationship status.

Other considerations.

An important finding from this review was that most positive findings were reported in published studies, while unpublished theses were more likely to report null findings. This pattern suggests a potential publication bias present in which disproportionately more positive findings are in the published studies than the unpublished theses [ 78 ]. Importantly, unpublished theses had a similar average sample size as published studies, with similar power to detect effects compared to published studies. Thus, this pattern may be better explained by the “file drawer effect” in which there is a bias towards publishing positive findings over null findings [ 79 ]. Although this tendency occurs in many fields, the file-drawer bias may especially be prevalent in human-animal interaction research due to the preconceived notion that animals are beneficial for humans [ 80 ]. In fact, positive, null, and negative findings are equally instrumental in understanding the complexities of the role that assistance dogs play in the lives of individuals with physical disabilities. As Serpell and colleagues point out, individuals that don’t benefit from animal-assisted interventions may be just as informative from a scientific perspective as the ones that do, and “the entire field potentially suffers when these sorts of contrary or ambiguous findings get buried or ignored” [ 74 ]. Therefore, future efforts should be made to publish null findings in peer-reviewed journals and to encourage scientific transparency [ 80 ].

As a final consideration, it is possible that assistance dogs may not confer significant psychosocial benefits as quantified by some of the standardized measures used. First, there may be ceiling effects present whereby individuals are functioning at initially healthy levels of the measured construct (e.g., depression, self-esteem) prior to receiving an assistance dog and thus may not significantly improve on these measures. This effect may be compounded by the possibility that those who apply for an assistance dog may inherently have certain positive characteristics (e.g., stable housing, stable finances, has a familial support system) that contribute to overall psychosocial health. Further, in contrast to a psychiatric service dog or an emotional support dog, the assistance dogs in this review are not explicitly trained for mental health-related support and their effects on the psychosocial health of their handlers may be variable rather than population-wide. For example, the benefits of an assistance dog for a socially isolated individual who experiences periodic anxiety and depression may be significantly different than an individual without these characteristics. An important question for the field moving forward will be to determine for whom an assistance dog may confer the most significant psychosocial health benefits for, and under what contexts or conditions.

Conclusions

This systematic review identified 24 articles containing 27 studies that assessed a psychosocial outcome of having an assistance dog (guide dog, hearing dog, mobility service dog, or medical service dog). Included studies assessed psychosocial outcomes via standardized measures from assistance dogs that were trained for functional tasks related to a physical disability or medical condition (omitting psychiatric service dogs or emotional support dogs). Despite the purpose of these assistance dogs specifically for physical tasks, positive outcomes were noted in psychological, social, quality of life, and vitality domains. However, results suggested that for most outcomes, having an assistance dog had no effect on psychosocial health and wellbeing. Methodological weaknesses including poor reporting of assistance dog interventions and statistical limitations prevent any clear conclusions made regarding the psychosocial effects of assistance dogs on individuals with disabilities. Inconsistencies in findings were discussed in terms of wide variability in assessment times, interventions, measures, and rigor, and recommendations were made to contribute to the knowledge of this growing application of the human-animal bond. Continued efforts are required to improve methodological rigor, conduct replicable research, and account for heterogeneity in both humans and animals to advance the state of knowledge in this field.

Supporting information

S1 checklist. prisma 2009 checklist..

https://doi.org/10.1371/journal.pone.0243302.s001

S1 Table. MEDLINE search terms and search strategy.

The search strategy was adapted to the other databases, including mapping terms to each database’s thesaurus or prescribed vocabulary, as appropriate.

https://doi.org/10.1371/journal.pone.0243302.s002

S2 Table. Summary of methodological rating scores by each of the N = 27 individual studies.

Studies are organized by design (longitudinal or cross-sectional).

https://doi.org/10.1371/journal.pone.0243302.s003

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Original research article, an investigation of the complexities of successful and unsuccessful guide dog matching and partnerships.

• 1 Discipline of Veterinary Sciences, James Cook University, Townsville, QLD, Australia
• 2 College of Health, Massey University, Palmerston North, New Zealand
• 3 Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand

Matching a person who is blind or visually impaired with a guide dog is a process of finding the most suitable guide dog available for that individual. Not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may result in reduced mobility and quality of life for the handler (owner), and are costly in time and resources for guide dog training establishments. This study examined 50 peoples’ partnerships with one or more dogs (118 pairings) to ascertain the outcome of the relationship. Forty-three of the 118 dogs were returned to the guide dog training establishment before reaching retirement age, with the majority ( n = 40) being categorized as having dog-related issues. Most ( n = 26) of these dogs’ issues were classified as being behavioral in character, including work-related and non-work-related behavior, and 14 were due to physical causes (mainly poor health). Three dogs were returned due to matters relating to the handlers’ behavior. More second dogs were returned than the handlers’ first or third dogs, and dogs that had been previously used as a guide could be rematched successfully. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches, suggesting that some handlers were retaining what they considered to be a poorly matched dog. Almost all the handlers who regarded a dog as being mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor working behavior may have shown good home and/or other social behaviors. The same principle was true for successful matches, where few handlers claimed to have had a perfect dog. It is hoped that these results may help the guide dog industry identify important aspects of the matching process, and/or be used to identify areas where a matching problem exists.

Introduction

The guide dog, like the long cane, is a primary mobility aid intended to enhance the lifestyle of people with a visual disability (blind or visually impaired) by facilitating independent travel ( 1 – 5 ). Additional benefits imparted to a guide dog handler (the person who uses a guide dog) include friendship, companionship, increased social function, and improved self-esteem and confidence ( 3 , 4 , 6 – 14 ).

The process of producing guide dogs involves the selection and breeding of suitable dogs, raising and socialization of the pups, and their subsequent training as mobility aids ( 15 – 19 ). The making of a handler-guide dog pairing involves the matching of a trained dog to its handler, the training of the handler and dog as a team, and ongoing follow-up. Matching a person who has a visual disability with a guide dog is a process of finding the most suitable guide dog available for that individual, and a successful match is one of ongoing satisfaction with the partnership ( 20 ). However, not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may be severe in terms of the reduction in mobility and quality of life for the handler, and time and resources for guide dog training establishments ( 3 , 4 , 21 , 22 ).

Guide dog schools worldwide pay a great deal of attention to the process of matching a dog to its new handler, but little evaluation has been carried out regarding the matching process or its subsequent outcome. Although a guide dog is principally an aid to mobility, the success of a team is not solely dependent on the dog’s ability to lead an individual safely and efficiently through the environment ( 23 , 24 ). Factors other than orientation and mobility (O&M) such as those relating to social situations and home environment are considered when making matches ( 25 ). Lane et al. ( 26 ) suggested that the dog’s effects on enhancing the handler’s social interactions may be at least as important as increased mobility and independence. This suggestion was supported in a study of first time guide dog handlers ( 24 ) who found that the dog’s effects on the handler’s social interactions appeared to be a significant predictor of matching success. Matching is an art as much as a science, and there may be no such thing as a perfect match. Hence, the purpose of this research was to explore handler and guide dog relationships, from the handlers’ perspective, to identify characteristics of handler and dog that influence the success or failure of the match.

Materials and Methods

This study examined 50 peoples’ (26 females and 24 males) partnerships with one or more dogs (118 pairings). All the dogs in the study were trained by guide dog schools that are members of the International Guide Dog Federation (IGDF), and as such are accredited to the highest international standards. The method of participant recruitment is described in Lloyd et al. ( 3 ) (p. 21). Descriptive and inferential statistical techniques were used to analyze the data.

The study was carried out in accordance with the recommendations of Massey University Human Ethics Committee with written informed consent from all subjects.

Sample Description

To differentiate between the human and canine elements in the study, the term “handler” or “dog” will be used when referring to the 118 handler-dog teams (pairings), and the term “participant” will be used when referring in general to the 50 individuals involved in the study.

At the time the study was conducted, 39 of the 50 participants were currently using a dog; 14 were currently using their first dogs, 13 their second, 7 their third, 2 their fourth, 1 person a sixth, and 2 people were using their eighth dog. At this time, the age of the participants ranged from 21 to 86 years, with a mean of 50.3 years (SD = 15.61). Participants were on average 37.6 years old (SD = 15.46) when they received their first guide dog, with an age range from 17 to 75 years. More than a fifth of participants ( n = 11) were not currently using a dog. Eight participants had decided not to use a dog in the future due to: having a limited workload ( n = 3); family pressure/unsuitable living environment ( n = 3); and two people whose relationship with the guide dog school had foundered. The remaining three participants were on the waiting list for a replacement dog. Information on how the end of the relationship affects people’s desire to apply for a replacement can be found in Lloyd et al. ( 21 ).

Of the 118 dogs in the sample, 66.9% ( n = 79) had been retired or withdrawn before the study commenced and 33.1% ( n = 39) were currently in work (Table 1 ). There were nearly twice as many bitches as male dogs in the sample, and both sexes were neutered except for one male. 1 The Labrador Retriever was the most commonly used breed (57.6%), 11% were German Shepherd dogs, 11% were Labrador/Golden Retrievers (first crosses), and 4.3% were Golden Retrievers. Other breeds, including mix-breeds and “exotics” like Standard Poodles, Boxers, Giant Schnauzers, and Flat and Curly Coated Retrievers comprised 16.1% of the sample. Coat color was predominately yellow (39%) or black (36.5%) (Table 1 ).

Table 1. Canine ( N = 118) demographic data .

Independence of Errors

Most of the participants ( n = 32) had used more than one dog and were serially represented in the database. Hence, an “intra-class correlation coefficient” (ICC) was calculated to test for any “non-independent” observations (caused by potential clustering) on the outcome of matching success 2 using the values shown in Table 2 and the following formula provided by Snedechor and Cochran ( 27 ) (pp. 242–244):

where n -bar = average group size = 118/50 = 2.36, MSB = mean square between subjects = 0.169, and MSW = mean square within subjects = 0.214.

Table 2. Tests of between-subjects-effects generated to calculate the intra-class correlation coefficient for the outcome (dependent) variable of matching success .

The resulting value (ICC = −0.086) was very small and negative, which according to Snedechor and Cochran ( 27 ) argues strongly against there being any meaningful positive correlation between measurements within the same handler. This value, along with the average number of dogs used in the sample being only 2.4 (118 dogs/50 people), supported the decision not to make any adjustments and to treat each handler-dog pairing as an independent observation.

Data Collection

Data was collected via a structured self-report questionnaire (Data Sheet S1 in Supplementary Material) that was delivered via telephone to 39 participants and face-to-face for 11. The method of data collection was either chosen by the participant or was by way of necessity due to the logistics of travel. There did not appear to be any discernible difference in the quality of the data obtained by the two methods of data collection.

Demographic data (e.g., age, gender) was collected on each participant. Participants were asked to comment on the “good” and “bad” behavioral and physical characteristics of each dog they had used and to rate the importance of these traits. Participants were also asked about the outcome of the handler-dog partnership regarding whether the dog was currently working, retired, 3 accidentally deceased, or had been returned 4 to the guide dog school. Further questions concerned: why dogs ceased working; mismatched dogs versus returned dogs; and reasons for successful and unsuccessful matches. As over a third ( n = 17) of participants had used or were using dogs that had been matched with at least one other handler, participants were also asked to comment on the use of “rematched” dogs.

Characteristics of “Good” and “Bad” Dogs

The handlers’ comments on what was good and bad, behaviorally and physically, about their dogs (118 pairings) are shown in decreasing order of frequency in Table 3 . Handlers also rated the three most important traits within each of the four categories, denoted in Table 3 with one, two, or three asterisks in decreasing order of importance.

Table 3. Good and bad canine ( N = 118) behavioral and physical characteristics .

The most commonly mentioned good behavior was related to “social behavior” (83.3%) including the dog being personable and well behaved at home and in other social settings, followed by “work rate” (capacity/ability to work) (75.7%) and “specific guiding tasks” (70.6%). These three characteristics were also considered to be the most important. The bad behavior most commonly reported concerned “specific guiding tasks” (29.8%) closely followed by “distractions (mainly to other dogs) while working” (28.1%) and “work rate” (27.2%). The three traits most often cited as being of first, second, and third equal importance regarding undesirable behavior are “distractions (mainly to other dogs) while working,” “scavenging,” and poor “coping skills” or “running away,” respectively (Table 3 ).

Concerning physical characteristics, the “size” of the dog matters. Over half of the handlers (55.3% of 118 pairings) mentioned that they liked the size of their dogs, with most handlers preferring a compact dog as opposed to a large one—mainly for ease of fitting into confined spaces such as under a desk at work or in a transport vehicle. Tall handlers said that they required a dog to be big enough for them to use the harness handle effectively, but not to be taller or longer than necessary. Smaller dog were deemed easier to lift, bathe, and be less strong and hence not be able to pull as hard as a more powerfully built dog. “Breed” was the next frequently mentioned desirable physical trait (48.5%) followed by “attractiveness” (40.8%). One handler, who returned her dog said “I thought that everything would be alright if only my next dog was a Poodle,” but then described the Standard Poodle as being “dizzy” and “unfocussed” when it was received. Reasons given for wanting a dog to be attractive included “I feel like I live my life in a fish bowl, with everyone watching—so why shouldn’t my dog look nice?” and “I miss my old dog’s soft, soft ears. I don’t like [the new dog’s] ears. I don’t suppose [the instructor] would find that important as it’s not a mobility thing.” “Size,” “breed,” and “attractiveness” were also consecutively considered to be the three most important characteristics concerning physical traits (Table 3 ).

Over a third of handlers (36.6% of 118 pairings) stated that their dogs had no bad physical characteristics, 27.2% experienced dogs with health problems (including skin issues), and 22.1% expressed troublesome issues regarding the dogs’ coat such as shedding and amount of care required (grooming/bathing). “Health” was rated as being of most importance in this category, followed by “coat,” and the dog being too large in “size.”

Rating Canine Qualities

To gain a more specific understanding of what qualities were found attractive and unattractive in guide dogs, the 32 participants who had worked with more than one dog were asked to state the main characteristic that they liked best about their favorite dog ( n = 32), and the main characteristic they liked least about their least favorite dog ( n = 32). The 18 participants who used only one dog were asked to state the best and worst qualities of that particular dog ( n = 18). Participants were asked to categorize these responses into either work (W) or non-work (NW) scenarios, and state if this was behavioral (B), physical (P), or emotional 5 (E) in nature.

The results of these classifications (Figure 1 ) show that most of the favorite and least favorite traits were behavioral in nature. Specifically, half of the “favorite” responses were classified as non-working behavior (NW/B), followed by working behavior (W/B) (36.0%) and non-working emotional (NW/E) (14.0%). To illustrate with examples from this sample, the NW/B category is demonstrated by a dog that “was wonderful company at home”; W/B is shown by a dog that “was excellent at finding destinations”; and NW/E via a dog that “was a soulmate for almost 12 years.” Likewise, the majority of the “least favorite” responses were categorized as NW/B (42.0%). This was followed by W/B (30.0%), non-working physical (NW/P) (16.0%), NW/E (6.0%), working physical (W/P) (4.0%), and working emotional (W/E) (2.0%). Illustrations of NW/B included a dog that “solicited too much attention at social functions” and another that “growled at visitors at home.” A dog that “failed to stop consistently at the end of the pavement” (down kerb) exemplifies W/B, and a dog that “shed hair excessively” represents NW/P. The statement “I don’t know why I did not like that dog… it was quite a good worker and well behaved at home, but we just did not gel” was coded as NW/E. A dog that was categorized W/P was considered “too sick to work,” and a dog classified as W/E pertained to the inexperience of the handler who professed that he “did not know how to work with my first dog.”

Figure 1. The participants’ ( N = 50) most favourite and least favourite characteristics of their dogs ( n = 82) concerning behavior, physical, and emotional categories, and whether this relates to work or non-work .

Thirty of the 32 participants who had handled multiple dogs rated their dogs ( n = 93) in order of favoritism. Sixteen of the 30 dogs considered to be the favorite had been the participants’ first guide dog, seven were subsequent dogs previously employed as a guide, and seven were dogs in current use.

The Outcome of the Partnership

The outcome of all the handler-dog partnerships (118 pairings) in terms of whether a dog was currently working, retired, accidentally deceased, or returned to the guide dog school is illustrated in Figure 2 . One-third (33.1%) of dogs in the sample were currently working. Of the two-thirds (66.9%) that were not, 36.4% were returned to the guide dog school before the dog reached retirement age, 27.1% were retired due to disorders related to old age (poor health, failing eyesight, slowing down, etc.) and 3.4% died from accidental causes prior to retiring. An itemization of the dogs that were currently working and the main general and specific explanation for why dogs either were returned or were under consideration for return are shown in Table 4 .

Figure 2. The outcome of the dogs’ ( N = 118) working lives . The white bars show the broad outcomes and the black bars categorize the main reason why dogs were returned to the guide dog school.

Table 4. The outcome of the dogs’ ( N = 118) working lives, and the general and specific categories for why dogs were returned or were being considered for return .

Reasons Dogs Cease Working

Although the majority of dogs in the sample (66.9%) had ceased working, most (63.6%) had not been returned. The primary reasons for dogs not currently working or for being considered for return have been categorized as either dog (D) related or handler 6 (H) related, grouped into work (W) versus NW scenarios, and considered behavioral (B) or physical (P) in nature. Results fell into four of the eight possible combinations, which are displayed in Figure 2 .

Forty of the 43 dogs that were returned were returned for dog-related problems. Of these 40 dogs, most ( n = 26) were returned for dog behavioral problems, with almost two-thirds ( n = 17) related to working behavior and nine dogs for behaviors unrelated to work (i.e., poor social and/or home behaviors) (Table 4 ). Problems relating to working behavior included dogs being distracted by and/or aggressive to other dogs, coping skills, and specific-guiding tasks. The few handlers who returned their dogs for incompatible walking speed said it was “frightening and uncomfortable to be dragged around” by a dog going too fast, “frustrating to be held back” by a slow dog and “confusing” if speed was inconsistent as the handler may not know why the dog slowed. Fourteen dogs were returned due to physical causes, that is, health issues that were unrelated to work including musculoskeletal disorders and cancer. The remaining three dogs were returned for NW-related handlers’ behavior. One of these dogs had been matched on a temporary basis while the handler awaited a more permanent dog, one handler said he/she was pressurized not to have a dog in the workplace, and one handler’s partner did not want a dog living in the house.

Of the 39 dogs (33.1%) working at the time, the study was conducted, five were being considered for return because of various dog-related health and behavior problems. In general, more second dogs were returned than first or third dogs, respectively, and around twice the number of second and third dogs that were currently working were being considered for return compared with first.

Most of the handlers who regarded their dogs as mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor work may have shown good home and/or other social behaviors. The same principle held true for successful matches, where few handlers claimed to have had a perfect dog. However, it is noteworthy that the majority of dogs ( n = 24 of 26) returned primarily for D/B reasons exhibited more than one undesirable behavior. Eight of the nine dogs that were returned for D/NW/B (primarily for poor home and social behavior) also had behavioral problems related to work. These included low coping skills, poor work rate, easily distracted, overly sensitive, working speed too fast, and toileting on walks. Sixteen of the 17 dogs returned mainly for their W/B also displayed a range of NW-related problems including poor social behavior ( n = 8) and three dogs were criticized for physical issues such as excessive hair shedding and for being a specific breed.

Classification of Outcome

The majority (73.7%, n = 87) of dogs in the sample were considered to have been successfully matched and 63.6% ( n = 75) of all dogs were retained (Table 5 ). However, not all dogs that were returned before reaching retirement age were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches. Thus, the dogs were classified as:

Combination 1: successfully matched and retained (56.8%, n = 67)

Combination 2: mismatched, but retained (6.8%, n = 8)

Combination 3: successfully matched, but returned (17.0%, n = 20)

Combination 4: mismatched and returned (19.5%, n = 23).

Table 5. Whether handlers deemed their dogs ( N = 118) to be successfully matched or not and how this relates to the dogs being returned or retained .

Combination 1: Successfully Matched and Retained

Most of the dogs (56.8%, n = 67) in the sample were considered to be well matched and were kept by their handlers. Three dogs whose handlers believed them to be poor mobility aids were included in this group. This was due to the handlers feeling that they had enough useful residual vision to compensate for the dogs’ lack of abilities and/or because the dogs were considered good companions.

Combination 2: Mismatched but Retained

The 6.8% ( n = 8) of dogs that were considered mismatched, but not returned, were retained for several reasons. These included three participants who had used more than one dog becoming emotionally attached to their first dogs and being highly motivated to make the partnership work, and another who claimed not to have known any better as it was his first dog and he had nothing to compare it to. The other four dogs that were retained despite being unsuccessfully matched were four of the five dogs in current use that were being considered for return (Table 4 ) for reasons of: being distracted by and aggressive to other dogs when working; being aggressive to other pets; being overly sensitive and not coping with the demands of guiding; and scavenging on and off the job.

Combination 3: Successfully Matched but Returned

Twenty dogs in the sample (17.0%) were returned before the dogs reached retirement age despite being successfully matched. Of these dogs, 12 were returned due to the dogs’ unexpected ill-health, one dog was returned for slowing down through the normal aging process as it neared retirement age, one dog was withdrawn by the guide dog school because of protective aggressive tendencies, one dog was returned as it had been matched on a temporary basis until the handler’s preference for a younger dog could be fulfilled, one dog was swapped with a close associate of the handler with the approval of the guide dog school, and one dog was withdrawn by the guide dog school for reasons unknown. The remaining three dogs that were returned, although successfully matched, were ultimately returned by handlers who had made informed choices to accept these dogs when the guide dog school discussed potential problems at the time of matching, and these problems were the reason for return. Two of these dogs were returned for dog distraction/aggression and one for an ongoing health problem.

Overall, handlers claimed to be very emotionally attached to 18 of the 20 dogs in this group. Regarding the other two dogs, one handler was moderately attached (temporary match), and the other, who returned her dog because of its poor health, felt guilty for not bonding more with a dog she had not realized at the time was too sick to work effectively.

Combination 4: Mismatched and Returned

Twenty-three dogs (19.5%) were returned for being considered to be poorly matched by the handler. Reasons provided for this included the dog having poor social/home behaviors, limited capacity to work (work rate), problems with specific-guiding tasks (including speed), and having poor coping skills. However, as shown above, more dogs were thought to be mismatched (26.3%, n = 31) than were actually returned for this reason. None of the three handlers who returned their dogs because of, or related to, their own behavior considered these dogs to be mismatched.

Relationships between the Combinations

Frequencies for the four combinations to which the handlers assigned their dogs are illustrated in Figure 3 . A chi-square test for independence was conducted to examine these relationships. A significant result was obtained using Yates’ Correction for Continuity [χ 2 (1, N = 118) = 23.71, p < 0.0005] suggesting that the proportion of dogs that was returned for being mismatched (74.2% of all mismatched dogs) was significantly different from the proportion of dogs that was returned although successfully matched (23% of all successfully matched dogs). A calculation of the odds ratio indicated that dogs were 9.6 times more likely to be returned if deemed mismatched.

Figure 3. Association between matching success and dogs that are returned or retained .

Duration of the Partnership

Seventy-nine (66.9%) of the 118 dogs in the sample had reached the end of the working partnership (retired or returned) with a particular handler (Table 1 ). The duration of the partnership is calculated only on these 79 dogs, as the sample as a whole does not reflect the full working life of all partnerships. The 79 dogs previously employed as a guide worked from as little as 1 month to as long as 156 months 7 (13 years) with an average working life of 4.7 years (M = 55.9 months, SD = 46.0). Handler defined successful partnerships ( n = 53), lasted from one month to 13 years, with an average service duration of 6 years (M = 72.3 months, SD = 42.8), and the largest number of dogs (mode) were retired at about 10 years of age (norm). Unsuccessful partnerships ( n = 26) (inclusive of three dogs that were not returned) lasted from 1 month to 11.5 years (138 months), but dogs were returned on average at less than 2 years (M = 22.2 months, SD = 32.2), with the largest number (mode) being returned after 3 months. Dogs that were returned for being unsuccessfully matched ( n = 23) worked from 1 month to 6 years (72 months) and were returned on average at just over 1 year (M = 12.6 months, SD = 14.7). All dogs that were returned for being unsuccessfully matched were returned within 2 years, with the exception of one dog that worked for 6 years. Excluding this dog, dogs that were returned for being unsuccessfully matched worked on average for just under 10 months, and the largest number were returned after 3 months.

Trends between Dogs

Concerning the relationships handlers had with their dogs, a recurring trend of “first dog best—second dog worst,” with little apparent difference between the first and third dogs, was found. As this pattern may be of interest to the guide dog industry, this “second dog syndrome” was further investigated. The focus is on the trends between the first three dogs only, as these dogs comprise the majority of dogs (82.2%) in the sample.

When accounting for the proportion of dogs at the time the study was conducted, the number that were (a) returned, (b) mismatched, and (c) mismatched and returned were all highest for second dogs and lowest for third (Figure 4 ). Odds ratios indicated that the likelihood of a dog being (a) returned and (b) mismatched was nearly twice (1.8) as high for second dogs as first dogs, and second dogs were three times more likely to be (c) mismatched and returned than first dogs. Third dogs were around three times less likely than second dogs to be (a) returned (2.7) or (b) mismatched (3.0), and nearly five times less likely to be (c) returned for being mismatched. Only half of the mismatched first and third dogs were returned, but mismatched second dogs were returned four times as often. None of these trends reached statistical significance on chi-square analyses. However, second dogs were significantly (four times) more likely to be returned if mismatched than retained (Fisher’s Exact Probability test p < 0.004).

Figure 4. Comparisons of the relationships between the first, second, and third dogs concerning the percent of dogs returned, mismatched, and those returned for being mismatched . **Denotes the significant relationship between the second dogs that are returned for being mismatched and those that are retained ( p < 0.004).

In light of this, it is not unexpected that the working life of dogs that had been retired or withdrawn before the study commenced ( n = 79) is shortest in second dogs (Table 1 ). Independent samples t -tests revealed that second dogs (M = 44.1, SD = 47.3) were used for significantly less time than first dogs [M = 69.7, SD = 41.2, t (53) = 2.09, p = 0.042, η 2 = 0.08]. No significant difference was seen between second and third dogs (M = 65.8, SD = 46.5, η 2 = 0.05). However, this was likely due to the small number of third dogs that were not in current use in the sample ( n = 8).

Defining Matching Success

Based on the study findings, defining matching success is not clear-cut. The results indicate that a substantial number of handlers return dogs (17.0%, n = 20) for reasons that do not pertain to being mismatched, mainly for the dogs’ poor health. The results also suggest that more dogs were considered mismatched (26.3%, n = 31) than were returned for problems arising from these mismatches (19.5%, n = 23). As a goal of this research was to identify what factors were important in creating a successful match, it seemed sensible to focus on whether a dog was considered mismatched per se as opposed to whether it was returned for being mismatched.

A discriminant function analysis was conducted using the data relating to the four matching success/outcome categories to check that the above classification decision was viable. Although a significant Box’s M value indicted that assumptions of equality of covariance matrices were not met, the results (Figure 5 ) suggest that there were three significantly distinct groups (χ 2 = 170.57, df = 36, p < 0.0005): Combination 2, Combination 4, and Combinations 1 and 3 combined. In effect, the dogs deemed to be mismatched (Combinations 2 and 4) were considerably different from those that were not (Combinations 1 and 3). There were no meaningful differences between dogs that were considered successfully matched that were retained (Combination 1) and those that were returned (Combination 3). Dogs that were considered mismatched but retained (Combination 2) appeared to differ somewhat from those that were considered mismatched and returned (Combination 4). However, the number of dogs in Combination 2 ( n = 8) was very small, and the decision to combine these dogs with the other mismatched dogs in Combination 4 was justified based on the qualitative data described in “Classification of Outcome.” Hence, it was decided that a reasonable definition of matching success was whether dogs were considered to be mismatched or not by their handlers.

Figure 5. A discriminant function analysis plot showing estimation of the group centroids and the corresponding confidence circles for matching success for Combinations 1–4 . Note: the confidence circles were calculated as per Maxwell ( 29 ).

Rematched Dogs

Just over a third ( n = 17) of the participants had used or were using dogs that had been matched with at least one other previous person. This scenario is common as dogs are returned to guide dog schools for a variety of reasons that do not preclude them from being rematched to others. These reasons include ill-health (of the person), emigration, or changes in individual mobility needs and/or family dynamics.

The majority (84%) of participants said that they were or would be content to be matched with a dog that had been previously used as a guide by another person, although caveats included “it is OK, as long as you know the dog’s history” and “people need to know that it may take longer to bond [with the dog].” Some participants preferred dogs that had been used previously as a guide, as these dogs tended to be more mature and, therefore, less rambunctious than dogs fresh out of training, or “had been round the block and knew a thing or two about guiding.” Eight participants (16%) stated they would not be happy if offered a dog that had been previously used as a guide because they were concerned that it may be more likely to have behavioral problems or take longer to adjust to a new home/working environment.

Twenty (17.2%) of the 118 dogs in the sample had been returned to the guide dog school by their previous handlers, and ultimately, 15 of these 20 rematches were successful. However, according to the participants in this study, four of these 15 dogs did not have a successful partnership with the first person they were rematched to, but did on a subsequent match, and three of these 15 dogs had the opposite experience. Of the five dogs that were not rematched successfully, three were eventually withdrawn; one for extreme excitability, one for marked aggression to other dogs, and one for a musculoskeletal problem. The other two dogs that were not rematched successfully, although currently working, were being considered for return, as one exhibited the same problem that its previous handler returned it for (scavenging) and the other developed an unrelated health issue (skin problem).

The purpose of this study was to investigate the relationship between handlers and their guide dogs to understand, from the handlers’ perspective, why some partnerships worked while others did not, to improve the outcome of the matching process. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches. The latter finding suggests that some handlers were retaining what they considered to be a poorly matched dog, which could have detrimental effects on both the handlers’ and the dogs’ quality of life.

This study measured the success of the match based on whether handlers thought the dog was mismatched or not. Ratings of good and bad behaviors and physical characteristics described what qualities handlers found attractive and unattractive in guide dogs in general, and how they related to work (mobility-related) versus NW (home/social) situations, and were primary used to describe the data in a meaningful way. While there are theoretical grounds to believe that a handler is more similar to themselves than another handler in how they perceive a dog, each human–animal relationship is unique and the decision to treat each handler-dog pairing as independent observations was supported by statistics (i.e., insignificant ICC value and average number of dogs used close to only two). However, although not detectable in the present study, it is possible that some handlers might be more likely to return dogs than others. For example, a person who may have had a specific problem with one dog might pay more attention to the same issue in a subsequent dog, and this should be taken into account during the matching process.

Although several studies have described peoples’ attitudes toward guide dogs ( 1 , 23 , 30 , 31 ), there appears to be little data available on the reasons why some matches fail. This may be because some guide dog schools compete with others for clients. However, it would benefit those involved with guide dogs if this information was more freely available.

Most dogs in this study were successfully matched. Partnerships ended for one of the three reasons: (1) the dog retired, (2) it was returned (whether mismatched or not), or (3) it died. Over a third of dogs were returned in total, primarily for problems concerning the dogs’ behavior, followed by canine health problems. In addition, three handlers returned their dogs for personal or social reasons. More dogs were returned for behavior problems relating to work than for NW. However, the largest single behavior problem that dogs were returned for was poor home/social behavior. It would be advantageous for guide dog schools to pay equal attention to working and non-working behaviors when training dogs and making matches, as in addition to this finding, Lloyd et al. ( 24 ) and Lloyd ( 32 ) found that factors relating to both the working and the non-working relationship appeared to be significant predictors of matching success.

Just over a quarter of dogs were considered to be mismatched, but only a one-fifth of dogs were returned for this reason. Reasons for dogs being returned or considered to be mismatched related more to the dog than the handler, and problems were behavioral more than physical. More dogs were considered mismatched for reasons that pertained to work than for NW. This discrepancy was due to a number of dogs being returned, despite being considered successfully matched, for health reasons. The probability of a mismatched dog being returned was several fold higher than for successfully matched dogs, and as may be expected, the reasons that dogs are returned (whether mismatched or not) correspond with what handlers said they liked the least about their dogs. It should be appreciated that matching is not absolute; some unsuccessful matches had good points, and few successfully matched handlers claimed to have a perfect dog. However, some handlers kept dogs that they thought were mismatched because they were emotionally attached to the dog, had enough vision to compensate or were inexperienced. This was more likely to happen for first-time dogs than second ones, which is discussed below.

Successful partnerships lasted for an average of 6 years, with the largest number (mode) of dogs being returned after 10 years of service. This is lower than the average of 7 years reported by Nicholson et al. ( 22 ). However, the present study included dogs that had previously worked with other handlers and had been rematched, and it is possible that Nicholson et al. ( 22 ) were referring to successfully matched dogs that had worked with only one handler. A recent paper by Caron-Lormier et al. ( 33 ) who investigated aging in guide dogs also recorded the length of the dogs’ working life. The researchers found that 84% of working guide dogs were able to function as guide dogs until they had worked for 8.5 years, when they retired. However, this sample excluded dogs that were withdrawn for behavioral reasons and so methodological issues make it difficult to compare this study with the present study.

In the present study, excluding one dog that worked for 6 years before being returned for behavioral problems, mismatched dogs worked for 10 months on average, but the largest number (mode) were returned after just 3 months—presumably before an emotional bond had fully developed. Therefore, a handler who is frustrated with a new partnership should be informed that the working and the non-working relationship might take longer than this to improve, possibly from 6 months up to a year ( 34 ). These findings are similar to those of Fuller ( 35 ) who reported that most unsuccessfully matched dogs were returned within the first year, and that several dogs were returned for behavioral problems after 5 years of use. Although not stated by Fuller ( 35 ), it is possible that these late returns were due to replacement dogs becoming more readily available at that time. Fuller ( 35 ) indicated that returns were due to handler-related reasons one-third of the time, and the remainder for dog-related reasons, with physical incapacity or death being the major factor in both categories. Both Fuller ( 35 ) and the present study suggests that the number of returns because the handler has personal or social problems is small, but results differ in that Fuller ( 35 ) reported more dogs stopped working for health (59.4%) than for behavioral problems (7.4%). Adjusting for the inclusion of the human’s physical incapacity or demise as reasons for partnerships to end, the number of dogs returned for behavioral problems in the present study (22.0%) was double that of Fuller ( 35 ) figures (10.2%). This finding supports Ireson ( 15 ) theory of dogs being returned less often by previous generations of guide dog handlers. However, it could not be ascertained what the specific behavioral problems were in the Fuller ( 35 ) study nor whether they related to work and/or NW.

The number of dogs in the present study that were unsuccessfully matched (26.3%), and returned for this reason (19.5%) is comparable to the 25.4% that were withdrawn in Nicholson et al. ( 22 ) UK study. These researchers did not define the reasons dogs were withdrawn. However, conversations with guide dog professionals at symposiums attended during the course of this research, suggest that the current findings reflect the outcome of guide dog programs around the world in terms of numbers, reasons, and trends. These numbers also relate to the 16.0% of pet dogs adopted from animal shelters in New Zealand returned for unacceptable behaviors ( 36 ). Breakdowns in the owner–pet relationship may occur because the owner has unrealistic expectations of the role of a pet and/or is ignorant of breed-specific behaviors, and the time and money required for maintenance ( 37 ). Although guide dogs are provided free of charge in many countries, and guide dog schools protect the dogs’ welfare in cases of hardship, the use of guide dogs can be expensive. Intriguingly, the return rate of dogs is analogous to the 29.3% ( 38 ) abandonment rate of assistance technology devices (excluding dogs). Scherer ( 38 ) found that the most influential factor was a change in needs/priorities of the user, but that the user’s input into the selection of the device was important for a good outcome.

Only the main reasons dogs were returned were identified in the present study. However, it is likely that more than one problem contributed to their return. Future research could establish if handlers return dogs due to an accumulation of problems and if these problems interrelate. For example, if a dog’s level of anxiety increases during its working life, the pace at which it walks may increase resulting in an incompatible match. In addition, an anxious dog may be overly sensitive and have poor social/home behavior, that is, multiple problems stemming from the same underlying concern. Physical attributes such as breed or size may also be linked to behavioral problems. For example, large dogs may be too strong if inclined to pull through the harness. A breed-specific behavioral problem, which confirms the importance of educating handlers about their choices and expectations, is epitomized by the handler who thought that everything would be alright if only her next dog was a Standard Poodle. However, when this eventuated, the Poodle was described as “dizzy” and “unfocussed,” and was subsequently returned for this and other behaviors common within the breed.

Only one dog in the present study was withdrawn primarily for a skin problem, and one was being considered for return as the problem was severe, but “skin” was frequently mention as problematic. Furthermore, fieldwork associated with this research suggested that more dogs appeared to have health issues in recent times than in the past, especially skin problems, This is important, as Caron-Lormier et al. ( 33 ) found that of 14 groups of health problems in 8 of the most common breed (plus “other”) of guide dogs, skin problems had the greatest impact on reducing working life, by an average of 5 years. There was no discernible rise in the small number of dogs being returned for health problems over the years dogs were used in the present study. However, only the main reasons for return were considered and it is possible that health issues were also a major, albeit secondary, concern. Musculoskeletal disorders were the most common reason for dogs being withdrawn prior to retirement in both the Caron-Lormier et al. ( 33 ) and the present study. In-depth examinations of guide dog schools’ records to identify health problems and establish if these are a growing concern would be invaluable for making matching decisions, and for the breeding program if these conditions were heritable.

Not being able to walk at their preferred walking speed was also of concern to handlers in the present study as being forced to walk too fast can be frightening, and too slow frustrating. However, few dogs were returned primarily because of a speed mismatch. This suggests that instructors are adept at matching for speed because (a) they are aware of its importance and (b) because speed is more quantifiable (for human and canine) than many other matching criteria.

Of interest, is that many handlers appeared to feel the need to defend their preferences for physical traits in their dogs, including why they wanted a dog to be good-looking, and how the dog felt to touch (tactility). This concept is supported in a focus group discussion on guide dog usage ( 34 ) concerning the general public sometimes being insensitive to people with a visual disability preferring a dog of a certain color.

Another interesting finding was that three of the handlers who returned their problem dogs did not feel that they had been mismatched because the instructors discussed the potential for these particular problems at the time of matching, thus empowering the handlers to make informed choices. A similar concept exists when handlers do not consider dogs with health problems to be mismatched, if these problems were unforeseen. Conversely, handlers were upset and angry if they subsequently discovered they had been matched with a dog that had been returned by a previous handler for a problem that the new handler was unaware of. Candidness is arguably the best policy for client satisfaction and the opportunity for person and dog to work through problems together may actually strengthen the bond. An important aspect of the relationship is cooperation between dog and handler ( 39 ) with the handler being in control for some tasks but permitting the dog to also use its initiative in making suitable guiding decisions. Allowing the dog some freedom of choice might help a guide dog reach its potential in its working role; it is feasible that dogs that are not afforded some measure of choice have less chance to develop self-control ( 16 ).

Problems between people and their guide dogs are common, and, as with pet ownership, relationships often break down. However, a problem for one person may not be a problem for another, and dogs are returned for reasons that do not preclude them from working with a subsequent handler, for example, ill-health of the previous handler. Twenty dogs in this sample had been rematched, some twice, with a success rate of 75% (i.e., comparable to that of all the dogs in the sample). The remainder were withdrawn from the program and rehomed as pets.

No patterns emerged regarding what might constitute success, as both the successfully and the unsuccessfully rematched groups had been rematched for a variety of issues. However, it is apparent that the rematching of dogs is an appropriate use of resources. Most participants were happy with the notion of being matched with a previously employed dog, provided they were aware of the dog’s history. Fuller ( 35 ) commented that some returned dogs did well when rematched, although he provided no other details. Ledger and Baxter ( 40 ) concluded that successive owners of the same pet dog, which was repeatedly adopted from a UK animal shelter, reported different behavioral problems due to different attitudes and perceptions. Pet owner attitudes are believed to directly affect behavioral problems in dogs, particularly (what was previously known as), dominance aggression and displacement/excitement behaviors ( 41 , 42 ). For these reasons, it would be interesting to compare the experiences of successive handlers of rematched dogs.

Second Dog Syndrome

An unexpected finding was that handlers described inferior relationships with their second dogs compared to their first and third dogs. First-time dogs were favored the most, but there was little apparent difference between the first and third dogs. The term “second dog syndrome” was coined for this discussion ( 32 ).

It is feasible that fewer first dogs were rejected for the same reasons that handlers did not return mismatched dogs, as discussed above. These include expectations being lower due to people not knowing what to expect (having had no other dog to compare), having enough vision to compensate for dogs that did not excel as mobility aids and being more emotionally attached to these dogs. As the use of more than one guide dog is common, it would be interesting for future research to compare people who had only used one dog with those who had used multiple dogs to ascertain if experience has an effect on matching success.

It is understandable why there should be a “first-dog” effect in the handlers’ affections, as this dog was the one to initialize and/or improve independent mobility, thus being the catalyst for life changing events. Another possible explanation provided by Lloyd et al. ( 21 ) is “distortion of memory” where handlers may have forgotten the boisterous behavior of the first dog when it was young, and are comparing a youthful, exuberant second dog to that of the first dog at the end of the partnership when it had matured. It is also possible that guide dog schools might match second-time dog users with less than optimal dogs in the belief that the handler will cope with a dog that is more of a “challenge.” However, anecdotal evidence from this study suggests that some dogs that were returned were successfully matched to first time as well as experienced users, and third dogs were less likely to be returned or deemed to be mismatched than second dogs. Regardless, knowing that a second dog is likely to be perceived as second best is useful knowledge for guide dog instructors to help prepare clients who are about to receive a second dog. Following on from Lloyd et al. ( 21 ) work, Ward and Peirce ( 43 ) created a client- driven information resource for second time guide dog applicants to aid in the transition of dogs.

This research serves to increase awareness of what is happening in guide dog partnerships post-qualification. This research is intrinsically important for the guide dog industry in several ways. It examined, in a real-life setting, the outcome of the matching process; a process that is widely practised, but little assessed, and highlights the need to consider not only working behaviors but also social/home behaviors when making matching decisions. Understanding what makes a successful partnership is becoming increasingly important as there has been a steady increase in the number of handler-guide dog teams graduating around the world, as well as in the number of other service (or assistance) animals. Guide dogs are expensive to produce, as well as being expensive in personal terms for all concerned if a match is unsuccessful, and it may be assumed that the number of unsuccessful matches is likely to increase relative to the total number of matches made. Although feelings at the end of the partnership were not a focus of this study, nearly two-thirds of participants had used more than one dog. As the transition from one dog to the next is a recurring feature, handlers probably experience the end of more relationships than the average pet dog owner ( 22 ). Retiring a guide dog is not only difficult for the handler but also for the handler’s family and friends ( 21 ) and no doubt also for the dog. Every participant in this study was matched successfully at least once, and most dogs that were rematched went on to have a successful relationship with a different handler. This shows that the success of the handler and guide dog partnership does not solely depend on either the person or the dog, but relies on the interplay between them, that is, the match.

Ethics Statement

Massey University Human Ethics Committee. The study was carried out in accordance with the recommendations of Massey University Human Ethics Committee with written informed consent from all subjects. The participants in the study were vision impaired.

Author Contributions

All the authors (JL, CB, SL, and KS) on this publication have contributed to the conception and design of this work. The first author (JL) undertook the research and wrote the article with the approval of the other authors (CB, SL, and KS) who have critically revised the content. All the authors (JL, CB, SL, and KS) agreed to be accountable for the content.

Conflict of Interest Statement

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.

Acknowledgments

The authors wish to thank the people who participated in this study, and the staff of the Blind Foundation’s Guide Dog Services for their support throughout the process. Thanks are also extended to Professor Nigel Perkins for his advice on statistical matters. The authors would like to note the contribution of the doctoral dissertation “Exploring the match between people and their guide dogs” ( 32 ). Support for this publication has been provided by Douglas Pharmaceuticals Ltd. The views in this publication do not necessarily reflect the views of Douglas Pharmaceuticals Ltd.

Supplementary Material

The Supplementary Material for this article can be found online at https://www.frontiersin.org/article/10.3389/fvets.2016.00114/full#supplementary-material .

• ^ A sexually intact working guide dog is rare; permission was granted from the participant who used this dog to be identified in this manner.
• ^ A discriminant functional analysis (Defining Matching Success) supported that “matching success,” as defined by the handler, was a suitable outcome (dependent) variable for the ICC analysis.
• ^ Dogs that stopped working at age eight and older were classified as “retired,” including dogs that died after this age.
• ^ The term “returned” pertains to a dog that is less than 8 years old, which did not succeed as a guide for a particular handler. Many dogs that are returned are re-matched to other people with varying degrees of success. Dogs that were returned but not re-matched are classified as “withdrawn.”
• ^ “Emotional” is defined as a psychological response that could not be classified as either behavioural or physical.
• ^ The category “handler” incorporates the effects of Dahlgren and Whiteheads’ ( 28 ) socioeconomic model where the handler’s decision regarding the return of a dog may have been influenced by social or environmental factors not of the handler’s choosing, such as a dog not being wanted by family or work-mates.
• ^ Only one dog worked for 13 years, and this was an unusual case that had a very limited workload for the last few years of its working life.

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Keywords: guide dogs, matching success, human–animal relationships, vision impairment, blind mobility

Citation: Lloyd J, Budge C, La Grow S and Stafford K (2016) An Investigation of the Complexities of Successful and Unsuccessful Guide Dog Matching and Partnerships. Front. Vet. Sci. 3:114. doi: 10.3389/fvets.2016.00114

Received: 04 April 2016; Accepted: 29 November 2016; Published: 16 December 2016

Reviewed by:

Copyright: © 2016 Lloyd, Budge, La Grow and Stafford. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Janice Lloyd, janice.lloyd@jcu.edu.au

This article is part of the Research Topic

Working Dogs: Form and Function

The emotions and feelings experienced by guide dog owners in the application, training and working of their guide dogs

Author: Christopher Muldoon

• Thesis download: MuldoonThesis2022.pdf     [ 2.1 MB ]  

Muldoon, Christopher, 2022 The emotions and feelings experienced by guide dog owners in the application, training and working of their guide dogs , Flinders University, College of Nursing and Health Sciences

Terms of Use: This electronic version is (or will be) made publicly available by Flinders University in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. You may use this material for uses permitted under the Copyright Act 1968. If you are the owner of any included third party copyright material and/or you believe that any material has been made available without permission of the copyright owner please contact [email protected] with the details.

The guide dog is recognised worldwide as serving a primary role in providing safe, effective mobility for a person who is blind or vision impaired and can be the mobility aid of choice for a number of reasons (Gravrok et al., 2018; IGDF, 2011; Li et al., 2019). One reason is the relationship established between the guide dog owner and their guide dog, which can be a deciding factor for the choice to pursue guide dog mobility over other choices, such as the long cane or the use of technology to achieve independent mobility.

There is a dearth of research and associated literature investigating the emotions and feelings of people who are blind or vision impaired in their journey to guide dog mobility, in particular across the longitudinal process of applying for, training and working with a guide dog. Whilst recognising the primary role of the guide dog as a mobility aid, the purpose of this study was to stipulate the existence of a secondary role, by exploring the impact of a guide dog on the emotional wellbeing of guide dog owners. In doing so, this study sought to explore how the guide dog contributed to emotional wellbeing, for those who are blind or vision impaired across the process of applying for, training, and ultimately working with a guide dog. It was intended that the conclusions arrived at in this study would support in reflecting upon the wider significance of emotional wellbeing, framing and informing the work of organisations supporting those who are blind or vision impaired.

This longitudinal study adopted a phenomenological theoretical perspective to support an understanding of the lived experience of guide dog ownership, more specifically the impact of a guide dog on the emotional wellbeing of guide dog owners. A mixed (predominantly qualitative) methods approach was applied. Data were collected using semi-structured interviews and a Beck Depression Inventory (BDI) questionnaire. Following an initial pilot study to determine the feasibility of the chosen methods, a main study of six participants from South Australia who are blind or vision impaired took place during the years 2011-2014. The main study collected data at four key milestones; the application process, the training with a guide dog, six months post training and twelve months post training. Findings of the study were presented as case studies, followed by thematic analysis examining self-reported emotions and feelings experienced throughout the longitudinal process. Results indicate the presence of factors that challenged participant’s emotional wellbeing in the earlier milestones (application and training), however participants reported a substantially higher incidence of emotions and feelings associated with a more positive affect at the final milestone where they had been working with their guide dog for twelve months. This was largely due to the way participants’ expressed the value of the guide dog in addressing challenges with daily living due to blindness or vision impairment, which contributed to feelings of increased confidence, independence, security and companionship. The recognition of the less-established secondary role of the guide dog in contributing to improved emotional wellbeing was also evidenced in a reduction in BDI scores and self-reported emotions and feelings of depression in the majority of participants, from the point of application to working with the guide dog for twelve months post-qualification.

This thesis is the first longitudinal study undertaken in Australia investigating the emotional complexities of guide dog mobility and provided valuable information in assessing the potential impact on emotional wellbeing that is evident in working with a dog guide.

Subject: Disability Studies thesis

Thesis type: Doctor of Philosophy Completed: 2022 School: College of Nursing and Health Sciences Supervisor: Dr Fiona Rillotta

Award: Doctor of Philosophy -->

Flinders University Theses Collections

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The End of the Partnership With a Guide Dog: Emotional Responses, Effects on Quality of Life and Relationships With Subsequent Dogs

Janice lloyd.

1 Discipline of Veterinary Sciences, James Cook University, Townsville, QLD, Australia

Claire Budge

2 College of Health, Massey University, Palmerston North, New Zealand

Steve La Grow

Kevin stafford.

3 Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand

Associated Data

The datasets for this article are not publicly or otherwise available due to issues of confidentiality. However, Supplementary Material can be found online at https://www.frontiersin.org/article/10.3389/fvets.2016.00114/full#supplementary-material .

Guide dogs are mobility aids that facilitate independent travel of people who are blind or visually impaired. Additional benefits imparted to the guide dog handler include companionship, and increased: social-function, self-esteem and confidence. Some evidence shows that the end of the guide dog partnership can result in reduced mobility, and may have profound psychosocial effects on the handler due to feelings of bereavement and loss of self-esteem. However, this evidence is limited. This study examined the experiences and feelings of 36 people across New Zealand, who experienced the ending of at least one partnership with a guide dog (77 pairings), to explore issues arising at the end of the partnership and how this may impact on relationships with subsequent dogs. Results indicate that the majority of handlers experienced a reduction in their quality of life due to a decrease in independent mobility followed by the loss of a friend and companion, curtailment of social interactions, and loss of self-esteem/confidence. The end of the partnership affected people in different ways. Most handlers “accepted” the partnership had ended, but some felt guilty or angry with the guide dog school. Most applied for another dog immediately, as the need for mobility was high, while others preferred to wait and a smaller number did not reapply. Feelings at this time also affected the handlers' relationships with subsequent guide dogs, with over a quarter expressing a negative effect. Retiring a guide dog (for whatever reason) is not only difficult for the handler, but also for the handler's family, friends, co-workers, and doubtlessly, the dog. The majority of handlers expressed feelings of extreme grief when the partnership ended, whether it was successful or not. Feelings of extreme grief were more common for first than subsequent dogs. The depth of emotion was compared to losing a family member or other loved one, which has been reported in some person and pet relationships. A better understanding of issues surrounding the end of the partnership, including the human-animal bond, will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog users and the pet owning community.

Introduction

Guide dogs are primary mobility aids intended to enhance the lifestyle of people with a visual disability (blind or visually impaired) by facilitating independent travel. Additional benefits imparted to the guide dog handler include friendship, companionship, increased social-function, and improved self-esteem and confidence ( 1 – 10 ). More has been published about guide dog usage in the scientific literature than about other types of service/assistance dogs. According to York and Whiteside ( 11 ) this work has leaned toward aspects of training, health and reproduction, and benefits to mobility and well-being, with less on the experience of owning a guide dog. Compatibility and the success or failure of the relationship between a person and their first guide dog was assessed by Lloyd et al. ( 12 ), and the complexities of successful and unsuccessful guide dog matching and partnerships were examined by Lloyd et al. ( 13 ) and Lloyd et al. ( 14 ). These, and other studies ( 11 , 15 ) indicate that factors other than orientation and mobility, such as the dog's social behavior in and out of the home environment, need to be considered in the process of matching a dog to its new owner to promote a successful outcome. However, limited evidence exists that discusses how the handler might be affected when a guide dog retires, is returned to the guide dog training establishment (for whatever reason) or dies.

The end of the guide dog partnership can result in reduced mobility ( 1 , 2 ) and may have profound psychosocial effects on the handler due to feelings of bereavement ( 6 , 16 – 19 ), and loss of self-esteem ( 17 , 20 , 21 ). A seminal study by Nicholson et al. ( 22 ) examined distress arising from the end of a guide dog partnership and concluded that the emotions experienced by the handler at this time could be likened to feelings that follow the death of a pet, the loss of a close friend or relative or the loss of sight. These findings are supported by Kwong and Bartholomew ( 23 ) who explored individuals' relationships with an assistance dog and concluded that when confronted with the loss of their dog, people experienced intense grief consistent with the loss of a caregiving relationship. More recently, Uccheddu et al. ( 24 ) conducted a comprehensive analysis of grief responses in dog owners after the death of a pet dog and found that owners tended to humanize their pets and experienced a negative view of life after the death of their pet. The grief response to losing a dog, be it a pet or an assistance dog, is still an underestimated issue. Given the increasing number of service/assistance dogs being used across the world ( 25 – 27 ), this type of grief is of major concern for the welfare of the people who use them.

The present study 1 builds on these findings by discussing how feelings at the end of the guide dog partnership affect the handlers' relationships with subsequent guide dogs, and indicates trends in the dataset concerning multiple dog use. The effects of being without a guide dog, after experiencing guide dog mobility, on quality of life will also be discussed. A better understanding of the effects of the end of the partnership will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog organizations and pet (companion) dog ownership as the impact of the separation is similar in some aspects ( 28 ).

Participant Recruitment

Customarily, guide dogs are well-accepted in New Zealand and guide dogs are provided to a wide-range of applicants with varying visual conditions and mobility needs ( 17 ). In order to apply for a guide dog, the applicant should be eligible to receive services from Blind Low Vision NZ (formerly Blind Foundation/Royal New Zealand Foundation of the Blind) by being blind or markedly sight impaired. Blind Low Vision NZ Guide Dogs is a member school of the International Guide Dog Federation (IGDF), and as such is accredited to the highest international standards. The population of interest, as previously described in Lloyd et al. ( 1 ), was all people living in New Zealand who were, or had been, clients of Blind Low Vision NZ Guide Dogs since its establishment in 1973. At the time of participant recruitment, this was ~210 people. No exclusion criteria were applied. For reasons of privacy, a Blind Low Vision NZ staff member mailed the invitations to participate on behalf of the researcher (first author). The invitations consisted of an information document (supplied in the person's preferred format of Braille, audiotape, e-mail, or regular or large print), plus a consent form and a pre-paid, addressed envelope. Potential participants returned the signed consent form directly to the researcher, thus maximizing confidentiality and anonymity. Seventy two percent ( n = 151) of the target group responded, from which 50 participants were randomly selected (i.e., around one quarter of the entire population of guide dog users in New Zealand at this time). Those not selected were notified and thanked.

Participants

Fifty people from across New Zealand (as described above) who had used one or more guide dogs were interviewed by the researcher either by telephone (78%) or face-to-face (22%) regarding their experiences with guide dogs. The total sample (people and dogs) is described in Lloyd et al. ( 13 ) and Lloyd et al. ( 14 ). Of these 50 people, 36 had experienced the ending of at least one partnership. These 36 people constitute the participants for the present study that explored experiences associated with the end of the guide dog partnership and how they affected subsequent matches. Just over half the sample identified as female (20, 55.6%), and the majority (25, 69.4%) identified themselves ethnically as New Zealanders of European decent, 6 (16.6%) as Māori (the indigenous people of Aotearoa/New Zealand), and the remainder as “other.” They ranged in age from 28 to 80 years, with a mean age of 50.6 years (SD = 14.0). All were registered members of Blind Low Vision NZ, with an affiliation from 4 to 66 years, and an average membership of 29.1 years (SD = 15.9). These characteristics were in accordance with Blind Low Vision NZ's estimation of its client base at the time of the study. At the time of the study 27 of the 36 participants were currently using a dog. Nine were not, and of these, seven had decided not to use a dog in the future due to not wanting a dog currently ( n = 3) or at all ( n = 3), or due to having a poor relationship with the guide dog school ( n = 1). The other two were on the waiting list for a replacement dog. Nearly all participants (32, 88.9%) had used more than one dog, the average being 2.9. Consequently there were more handler-dog partnerships than there were participants in the study. Of the 36 participants; 17 had experienced a single partnership end (dog loss), 11 had experienced two losses, three had experienced three, one had experienced four, five and six losses, respectively, and two people had experienced the ending of seven partnerships. This makes a total of 77 ends of partnerships that were rated by the 36 participants.

Data Collection

All 36 participants had encountered the ending of at least one partnership with a guide dog. Participants were asked to rate their experiences in terms of (a) what became of the dog (the dog's fate), (b) their feelings when the partnership ended, (c) how this affected their application for a subsequent dog, and (d) how the end of the partnership influenced the relationship with subsequent dogs. Issues concerning how being without a guide dog, after having experienced using one, affected quality of life were also explored. Participants were asked to describe, in order of importance, how the absence of the dog affected their quality of life in general. All questions were open ended. Thus, the participants provided unique, unanticipated answers, which were recorded in written form and analyzed descriptively to show how often a response was given via measures of frequency, including count and percent.

Results: the End of the Partnership

Fate of the dog.

Participants ( N = 36) had experienced the ending of at least one and up to seven partnerships with dogs, giving a total of 77 “losses” ( Table 1 ). Of these 77, 13 dogs (16.9%) were kept as pets by their handlers 2 and another 24 were retired to live with a friend (10, 13.0%), family member (2, 2.6%) or rehomed by the guide dog school (12, 15.6%). Twenty-three (29.9%) of the dogs were returned to the guide dog school; Of these, 19 were rematched with another handler, three were withdrawn from the guide dog program and rehomed by the guide dog school, and one had a successful “change of career” with a different national working dog program. The remaining 17 (22.1%) dogs died of old age, underwent euthanasia for health problems or had a fatal accident before reaching retirement. Following the end of the majority of the partnerships (57, 74.0%) the handlers either wanted to or did keep in touch with their dogs. It was notable that people were most likely to want to retain contact with their first dog.

Issues regarding the end of the handler-dog partnership ( n = 77) for the handlers' first (1st dog) and subsequent guide dogs (up to the 7th dog used).

No missing responses .

Application for a Replacement Dog

Overall, the end of a partnership did not put handlers off applying for another dog immediately in 62 (80.5%) of the 77 cases ( Table 1 ). However, on six (7.8%) occasions people were put off indefinitely and nine (11.7%) chose to wait from a couple of months up to 5 years. Most of the people who had experienced a mismatch and who had applied for a replacement dog stated that they were optimistic about getting a better dog next time.

The people who wanted a replacement dog immediately had wanted guide dog assisted mobility as soon as possible and/or had kept their previous dogs as pets. For most this was the right decision, even if they had experienced an unsuitable dog, but some regretted not taking more time to come to terms with the loss of their previous dog before acquiring its replacement. On six occasions people indicated they would never get another dog and this was because they did not expect to get over the loss of their previous dog and/or they did not wish to repeat the painful experience of receiving an unsuitable dog. One who had initially felt this way declared that the guide dog school had “forced” another dog on her, which she was ultimately grateful for as it turned out to be a very good match. When people elected to wait some time before requesting another dog they did so as they needed time to grieve, wanted a break from the responsibility of owning a dog or had temporary changes in personal circumstances such as increased social support or an alternative means of travel.

Of the 36 participants, 26 predicted using another guide dog at some point, seven people did not, and three people said they would consider it. Of the 26 wanting to use another dog, eight did so solely because they preferred a dog to a long cane as a mobility aid, while 16 people, who also preferred the dog to the long cane, gave equal importance to the companionship and social interactions that the dog provided. Reasons given by the seven people not envisaging the use of a dog in the future included: changed mobility needs ( n = 2); lack of trust in the guide dog school ( n = 2); considered it not worth the effort of retraining with a new dog ( n = 1); felt there was no difference in life with and without a guide dog ( n = 1); or was in an unsuitable living environment ( n = 1). The three participants who were undecided were enjoying a break from dog ownership ( n = 1), unsure about future need ( n = 1) or under pressure from family not to get another dog ( n = 1).

Six participants (16.7%) were currently on the guide dog school's waiting list for a replacement dog; three currently had no dog, one had a temporary dog, another a poorly matched dog and the remaining person had a dog that was due to retire. The other 30 participants not currently on the waiting list comprised 19 people who were happily using their current dogs, three who were debating returning their current dogs (mainly for canine reasons of distraction, aggression and poor health), and eight who had previously used a dog and decided not to use another, or were having a break, as described earlier.

Feelings at the End of the Partnership

Amongst the 36 participants, the end of 77 guide dog/handler partnerships (losses) had been experienced. Table 2 presents the responses to the question of how people felt at the end of a partnership with a guide dog with responses to the loss of the first (column 2) and subsequent dogs (columns 3-8) provided separately. The combined (total) responses are presented in column 9. From the total column it can be seen that the main feelings experienced at the end of partnerships were acceptance, extreme grief and feeling reassured about the dog's future home. There was a high degree of acceptance expressed, because people had enjoyed a successful relationship, and/or understood the rationale for an early ending to the partnership and/or needed another dog for mobility. Extreme grief was expressed at the end of around half of the relationships and was likened to losing a family member or other loved one. Grieving was not limited to the handlers; many of those expressing profound grief said that their family members and some work colleagues who had spent a good deal of time with the dog also suffered a great loss. Feelings of extreme grief were expressed at the end of 38 partnerships and the fate of these 38 dogs was: rehoming ( n = 15); death during working life ( n = 15); being rematched to another handler by the guide dog school ( n = 5); and remaining with their handlers as pets ( n = 3). While feelings of extreme grief were very common, experiencing a lesser degree of grief or feeling neutral was rare. Relief was expressed at the end of several partnerships (16.9%)—all of which were considered to be poor matches. It is notable that feelings of extreme grief were expressed most often after the loss of the first dog and feelings of relief that the partnership had ended were lower for first dogs compared to subsequent dogs combined.

Feelings expressed about the end of the handler-dog partnership according to number of losses experienced (1–7).

Acknowledging that the working relationship was over was easier for the majority of participants if they knew the dog was going to a good home. This was especially true if the dog was being replaced because of work, or was being kept as a pet. A few people found the situation very hard to accept, and resented and in some cases denied that the dog was getting too old to work. Loss of mobility was a concern at the end of eight partnerships as people worried about losing their freedom and independence.

Anger directed toward the guide dog school was experienced at the end of 19 partnerships because people felt that they had not been supplied with a suitable dog in the first place and/or were not fully informed that a dog had a problematic history. Other reasons for ire at this time came from people who felt abandoned when their partnerships ended because of the dogs' ill health, due to a perceived lack of emotional support from the guide dog school. Guilt was experienced at the end of 14 partnerships, 11 of which were first dogs, not only due to having to give up the “old” for the “new,” but in some cases where dogs had died people felt guilty that the dog had not been able to enjoy retirement and when a partnership had failed, some people felt guilty that it may have been their (or their family's) fault. “Failure” had not been an option considered by the 11 people who were shocked when their relationship did not work out necessitating in the return of the dog.

Relationships With Subsequent Dogs

Not everyone continued on to use another guide dog when a partnership was over so responses to the question of how a relationship with a previous dog had influenced the next was relevant following the end of 71 partnerships. Of these, 19 (26.8%) were reported to have had a negative effect in that the old dog was considered to be a better mobility aid and/or less puppy-like in general, and/or that the memory of the old dog inhibited bonding with the new. The latter was reason enough to put a few handlers off acquiring a replacement dog indefinitely. There were 13 (18.3%) examples of a positive effect through the handler knowing what to expect through experience and realizing that the new dog was an improvement over the previous one. No comparison was made following the end of 12 (16.9%) partnerships as the dogs were appreciated as individuals despite the associated feelings of loss. However, the largest number 27 (38.0%) were said to have had no effect on the subsequent relationship. Breed-specific behaviors also played a role, as exemplified by two people saying they did not want to repeat the experience of having a Labrador retriever due to the scavenging behaviors exhibited.

Post-guide Dog Assisted Mobility: Effects on Quality of Life

Responses to the question of how quality of life was affected by being without a guide dog after experiencing guide dog mobility are presented in Table 3 . Most people provided more than one response so the number of comments (89) was greater than the number of participants ( N = 36) and percentages add to more than 100. Seventy-six of the 89 comments (85.4%) indicated that quality of life was reduced when participants were without a dog after experiencing guide dog mobility. This outcome was mainly due to a reduction in independent mobility for 31 (86.1%) participants, followed by losing a friend and companion for 21 (58.3%). Other reductions in quality of life included the effect on social interactions for 10 (27.7%) and loss of self-esteem and/or confidence for six (16.7%). Quality of life had increased for the three (8.3%) who enjoyed a break from the responsibilities of looking after a dog, the two (5.6%) who appreciated not having to deal with an unsuitable dog and the one (2.8%) whose long cane skills improved through the opportunity to practice. The remaining seven comments indicated that quality of life did not change with four people (11.1%) explaining that their requirement for a dog had altered as a result of a change in circumstances re their mobility needs, and three (8.3%) said that they were good cane travelers and had not felt particularly emotionally attached to the dog. In responding to this question participants were asked to describe the most important effect first and, as shown by the asterisks in Table 3 , the results mirror the overall findings. Not only was loss of individual mobility the most commonly cited effect of no longer having a canine guide, it was also considered to be the most important effect on quality of life. This was followed by loss of friend or companion being the second most important effect and the curtailment of social interactions the third most important and frequent.

The participants' ( N = 36) comments on how being without a guide dog after experiencing guide dog assisted mobility affected quality of life.

Total percent does not add to 100 due to open-ended questions/multiple responses .

One way of understanding humans' relationships with companion animals is through attachment theory i.e., the concept that we become emotionally attached to our companion animals in a similar way as we do to people. The human-animal bond has existed for thousands of years. The American Veterinary Medical Association (AVMA) defines this bond as “a mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors essential to the health and well-being of both. This includes, among other things, emotional, psychological, and physical interactions of people, animals, and the environment.” ( 42 ). Dogs (and other animals) have been helping people with physical disabilities and providing emotional support for centuries ( 25 , 29 ). The results of the present study shows that the existence of this bond has major significance for the well-being of both the handler and the dog as it influences how people feel about getting a subsequent guide dog and the relationship formed between the dyad, as well as directly impacting on the handlers' well-being at the end of the partnership.

Distress at the End of the Partnership

Almost all the participants had used more than one dog. As the transition from one dog to the next is a recurring feature, guide dog handlers probably experience the end of more relationships than the average pet dog owner ( 22 ). Retiring a guide dog is not only difficult for the handler, but also for the handler's family and friends, and doubtlessly the dog. Most people expressed feelings of grief when a working partnership ended, whether it was successful or not. Extreme grief was the feeling most frequently reported and this was shared by family members, friends and co-workers. The depth of emotion was compared to losing a family member or other loved one; a comparison that was also reported by Fogle ( 30 ) and Stewart ( 31 ) at the end of some person and pet relationships, and more recently by Uccheddu et al. ( 24 ). The distress caused by the end of the partnership between a handler and a guide dog might be more intense than that experienced between a person and a pet ( 8 ) due to the interdependent nature of the relationship ( 7 , 10 ), the time spent together and because the dog helps the handler to do things that could not be accomplished alone. However, the grieving process over the loss of any companion animal may be hampered by the lack of validation for the mourning of non-human animals by the general public and some professionals, as well as the lack of socially sanctioned grief rituals that typically accompany the loss of a human ( 32 ). Many guide dog schools around the world recognize this significance and have memorial gardens for people to visit, remember and honor their guide dogs who have passed.

A study by Barnard-Nguyen et al. ( 33 ) that measured people's responses to the loss of a pet (dog or cat), rather than a human, found that people had different types of grief (sorrow, anger, and guilt). While a reaction of sorrow on the loss of the pet was considered to be part of a “normal” psychological process, some people developed “complicated” grief manifesting as depression and other mental health problems. From the attachment theory perspective, it would be expected that people with a stronger attachment to their guide dog or pet would feel more grief when the pet dies, which was the case in both the present study and Barnard-Nguyen et al. ( 33 ) study. Barnard-Nguyen et al. ( 33 ) found people who were more emotionally attached to their pet reported more grief and sorrow, and also more feelings of anger (e.g., toward the veterinarian for not being able to save the pet), but not guilt. This contrasts somewhat with the end of the working relationship with a guide dog as described in the next paragraph.

The participants that described the end of the partnership with their guide dog as a relief were commenting on dogs that they felt they had been mismatched with, suggesting a strong emotional bond had not been formed. This finding was also discussed in a focus group prior to the present study ( 34 ). However, some participants in the present study reported anger at being mismatched, shock in having “failed,” guilt in case it had been their fault, and a few lost self-esteem and confidence. This was true even if the team had not bonded. These findings parallel those of Nicholson et al. ( 22 ) who found that the end of the partnership was an upsetting experience, even if there had been problems in the relationship. The exception to this was mismatches that ended after a relatively short period with no real bonding.

A related study by Lloyd et al. ( 13 ) and Lloyd et al. ( 14 ) on the complexities of successful and unsuccessful guide dog partnerships found that most dogs that were considered to be mismatched were returned to the guide dog school by the handler after just 3 months. An earlier study by the same authors ( 34 ) reported that the bond between a handler and their new guide dog could take 6 months or longer to develop. Therefore, guide dog instructors should inform handlers who may be frustrated with a new partnership that the relationship might take from 6 months up to a year to improve. Lloyd et al. ( 13 ) and Lloyd et al. ( 14 ) also found that some handlers who returned their problem dog did not feel that a mis-match had occurred because the guide dog instructor discussed potential issues at the outset, thus enabling the handlers to make informed choices. Hence, the opportunity for person and dog to work through problems together may actually strengthen the bond.

The grieving process was easier if handlers were reassured about the dogs' destiny, an outcome also reported by Nicholson et al. ( 22 ). This held true whether dogs were being kept as pets or were going to approved retirement homes. As Sanders ( 6 ) illustrated, the latter option was seen as a better alternative for dogs in that they were not expected to cope with the presence and/or the role of a new guide dog. It is noteworthy that almost all who experienced the death of a dog in the present study while it was still working experienced feelings of extreme grief at the end of the partnership. This may not only be due to attachment dynamics but may also be due to the loss of the equally important caregiving relationship as described by Kwong and Bartholomew ( 23 ). According to Bowlby ( 35 ), the care giving system is designed to provide protection and support to a dependent—goals that are no longer viable on the death of a dog and which may lead to feelings of intense despair. Identifying those who may be at greater risk for problematic grief reactions is of considerable value to guide dog schools. While guide dog schools should be prepared to support all clients in their grief responses, recognizing that someone is highly attached to their dog or that the dog died during its working life should trigger additional support.

Applying for a Replacement Dog

As for those who mourn the end of a relationship with humans, feelings of grief for the end of the relationship with a service dog or pet dog should be acknowledged and respected. The need for a period of adjustment before committing to a relationship with a new service dog or pet vs. prompt replacement is controversial. A study by Jarolmen ( 36 ) compared grief and bereavement responses of children, adolescents and adults who had lost a pet within a 12-month interval. Her findings indicated that children and adolescents are similarly attached to their pets and that children grieved more than adults did. Jarolmen ( 36 ) also concluded that the more recent the loss the more intense the response, but if the loss is anticipated grief is allayed. In her doctoral thesis abstract, Jarolmen ( 37 ) makes the interesting statement that those who have another pet in the home at the time of loss grieve the same for the lost pet as those who do not have another pet in the home, but those who replace the pet have a higher grief response. Unfortunately, it was not possible to obtain a copy of the entire thesis to read more about this relationship. Stewart's ( 31 ) findings suggested that deferring replacement was not warranted, even when a highly significant pet died, provided the pet's death was not trivialized and the new pet was introduced in a sensitive manner.

The majority of handlers in the present study said that they would continue to use guide dogs in the future, as they preferred and/or had become dependent on guide dog assisted mobility. Those who did not anticipate using another dog had a limited workload, unsuitable living conditions, family pressure, or did not have a trusting relationship with the guide dog school. Others, who were undecided, enjoyed not having the responsibility of ownership, were concerned that they might experience another mismatch or were impartial concerning cane or dog. Although the grief response was high, this did not preclude most handlers from applying for another dog right away, including those who had experienced a mismatch. The decision about when to replace a dog is personal, but some handlers regretted replacing their dog before adjusting to the loss of the previous one. Regardless, it appears that the need for mobility is the force behind the desire to replace a dog quickly.

Many handlers felt that the end of the partnership with the previous dog had a negative effect on the relationship with the new one. This was due to the old dog being considered a better mobility aid, less puppy-like and the memory of the previous dog inhibiting bonding. The role of the guide dog instructor re the human-animal bond is vital at this time to maximize the potentials of the relationship between their clients and their new dogs. Practical implications for the guide dog industry include that feelings of grief at the end of a partnership should not be trivialized and the new dog should be introduced in a sympathetic manner. Guide dog schools that offer grief-counseling sessions to enable handlers to share their feelings over the loss of the previous dog, have found that these handlers form a healthy relationship and train more quickly with the replacement dog (J. Campbell, Leader Dogs for the Blind, Michigan, USA, personal communication, August, 2000). Thus, the grief response and its expression may in fact be necessary in order for the next bond to form.

Quality of Life

Lloyd ( 17 ) showed that using a guide dog improved the quality of life for handlers due to enhanced mobility, social interactions, fitness, mental and physical health, and adjustment to loss of vision. These findings were echoed by a recent longitudinal study by McIver et al. ( 38 ) who demonstrated that guide dog owners perceived their quality of life to increase over time in similar terms. However, as shown by the present study, quality of life can also decrease at the end of some partnerships. Lessening of quality of life in the present study was due to a reduction in independent mobility followed by the loss of a friend and companion and curtailment of social interactions. People experience a reduction in the quality of their independent mobility for a variety of reasons. For example, Lloyd et al. ( 2 ) found that it was troublesome for those who were accustomed to guide dog assisted mobility to be without a dog because their cane skills had deteriorated. The present study also reveals that confidence and self-esteem were reduced when an unsuitable dog was received, or when a dog was retired or died. These effects were also found in children ( 39 ) and adults ( 32 , 40 ) who mourned the loss of a pet, and are described for guide dog owners in Schneider ( 21 ) and Gosling ( 20 ).

It would behoove guide dog schools to be empathic to the emotional and practical challenges their clients face at this time. Many guide dog schools provide access to councilors or information sources that may be helpful to people dealing with the loss of a guide dog such as helplines, books, on-line resources etc. Since this research was conducted Blind Low Vision NZ set in motion a client-driven national system for grief management, including sharing memories/experiences, for members who have lost or retired a guide dog, and Ward and Pierce ( 19 ) created a client driven information resource for second time guide dog applicants to help them transition to a new dog.

Practical implications for the guide dog industry can also be found in a practice report written by an experienced guide dog handler ( 21 ). Schneider suggests: being honest, letting the person know that one is open to hearing about one's grief, and reminding others that all dogs were once new and young. Allen ( 16 ) has written a heart wrenching account entitled “Letting go of the harness for the last time” that provides advice for guide dog schools and for veterinarians who care for guide dogs (and thus the person-dog team). Allen ( 16 ) study illustrates how peoples' experiences can influence broader social issues including policies for agencies that provide guide dogs, and the role of the veterinarian when it is time to make decisions about retiring or euthanizing the dog.

First vs. Subsequent Dogs

“Second dog syndrome” (SDS) is a phenomenon seen whereby a person's second guide dog is significantly less favored than the first dog ( 17 ) and is apparent on a number of levels in the present study. Lloyd ( 17 ) found that handlers' expectations regarding mobility were met less often and handlers were less compatible with their second dogs than their first dogs, with little apparent difference between the first and the third dog. Lloyd et al. ( 13 ) Lloyd et al. ( 14 ) showed that the number of dogs that were deemed to be mismatched and/or returned to the guide dog school were highest for second dogs compared to first or third. Similar trends were apparent in the present study regarding the handlers' feelings at the end of the partnership with their first dogs compared to subsequent dogs, where people grieved more; reported more feelings of guilt and less of relief when the partnership ended; and more desire to keep in touch with their first dogs. As explained in Lloyd et al. ( 13 ) and Lloyd et al. ( 14 ), it is understandable why there should be a “first-dog” effect in the handlers' affections; this dog initialized/improved independent mobility, thus being the catalyst for life changing events. Another explanation proposed by Lloyd et al. ( 18 ) is “distortion of memory” where handlers may have forgotten that their first dog was as boisterous and exuberant in its youth as the new dog now was, and that it took time for the dog (and the partnership) to mature. In addition, handlers may forget or deny that the previous dog made the same mistakes as the inexperienced new one, or harbor the unrealistic expectation that the new dog can take over precisely where the old dog left off ( 41 ). This is exemplified in a touching and elegantly written account by a graduate of Leader Dogs for the Blind on her experiences concerning the loss of several guide dogs:

Jack was my second dog. As I was training with him, we waited for the [traffic] light to change… I stepped from the curb with confidence. Jack executed a perfect (sic) diagonal crossing… [( 41 ), pp.10-11].

Although this experience left the handler “dazed and frightened at the (wrong) corner,” this “green” dog eventually grew into a conscientious worker and Smith ( 41 ) emphasizes the importance of patience and understanding within any new relationship. Allen [( 16 ), p.9] suggests that SDS can happen with any dog as “left overs from a previous dog can get in the way of accepting a new dog.” Knowing that a second, or any subsequent, dog is likely to be considered second best is valuable knowledge for guide dog instructors to help prepare clients to receive their next dog. Knowing that SDS is a tangible occurrence may alleviate some negative feelings the replacement dog engenders simply by not being the other dog.

Conclusions

This study has contributed to the small body of literature concerning how the end of the partnership with a guide dog affects the handlers' quality of life and their relationships with subsequent dogs. Results support the negative view of life after the loss of a guide dog ( 16 , 22 ) or other assistance dog ( 24 ), and mirrors many aspects of grief responses in pet dog ownership ( 28 , 30 , 31 , 33 , 36 )—issues that remain underestimated. Although the grief response was high, this did not preclude most handlers from applying for a replacement dog quickly as the need for mobility was high. Future research could attempt to further tease apart any differences in a guide dog handler's reactions to the loss of their subsequent dogs—an exercise that was not feasible with the small number of successive dogs used in this study. It would also be beneficial to look at the experiences of handlers at various stages of working with dogs vs. having a break from guide dog use. Concerning how individuals handle the end of the partnership with their guide (or other) dogs: in the words of Gosling [( 20 ), p. 12] “there is no right or wrong; it just is.” However, findings from the present study will help inform the guide dog industry regarding how best to support their clients during this time and when transitioning to another dog. Understanding the importance of the human-animal bond and implementing strategies to help clients grieve to support quality of life when experiencing the loss of a guide dog may be applied to other assistance/service dog users and the pet owning community.

Data Availability Statement

Ethics statement.

The studies involving human participants were reviewed and approved by Massey University Human Ethics Committee. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

JL undertook the research and wrote the article with CB with the approval of the other authors who have critically revised the content. All authors on this publication have contributed to the conception and the design of this work, and agree to be accountable for the content.

Conflict of Interest

The authors declare that this study received funding from Douglas Pharmaceuticals Ltd. and the Palmerston North Medical Research Foundation. The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

Acknowledgments

The authors wish to thank the people who participated in this study, and the staff of Blind Low Vision NZ (formerly Blind Foundation/Royal New Zealand Foundation of the Blind) Guide Dogs for their support throughout the process. We would like to note the contribution of the doctoral dissertation Exploring the match between people and their guide dogs ( 17 ).

1 Preliminary results of the present study were published in the proceedings of the 13th International Mobility Conference ( 18 ).

2 According to some participants in this study, before 1988 the guide dog school regulations did not always permit handlers to apply for a replacement dog if they kept a retired guide dog as a pet, nor was contact between the former handler and the person/family that adopted a retired guide dog allowed.

Exploring the match between people and their guide dogs : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Veterinary Science at Massey University, Turitea, Aotearoa/New Zealand

Open Access Location

Journal title, journal issn, volume title, description, collections.

Introducing Theia: The Handheld Robotic Guide Dog

Guide dogs provide visually impaired individuals with many benefits. However, they aren’t always appropriate, with cost, space and allergies all potential barriers to ownership. But new technology being developed at Loughborough University could see all a guide dog’s functions channelled into a handheld, robotic device for the visually impaired. Called Theia, the innovative device is the brainchild of Anthony Camu, a final year Industrial Design and Technology student at Loughborough University. Anthony says Theia gets its inspiration from virtual reality gaming and autonomous vehicles. Despite being just a prototype, Theia is capable of guiding users through outdoor environments and large indoor spaces with minimal user input. After stating their intended destination via a voice command, users are then guided by Theia in much the same way as they would be by a guide dog. That’s because Theia guides their hands using a form of force feedback via a control moment gyroscope (CMG), which is comparable to holding a guide dog’s brace. As a result, users are literally guided in the right direction, with Theia tackling obstacles, such as elevators, stairs, entrances, shops, and pedestrian crossings, along the way.

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Guide dog Luker visits St Bartholomew’s School in Newbury after pupils raise £25,000 for national charity Guide Dogs

S econdary school students who raised £25,000 for a national animal charity were treated to a special visit from a guide dog in training.

St Bartholomew’s School pupils in Patterson house have been fundraising for Guide Dogs for nine years and during that time they have donated enough money to support and name nine puppies.

Their latest sponsored dog is an 18-month-old Labrador golden retriever cross called Luker who visited the school with her trainer Charlotte on the afternoon of Wednesday, March 20, to show off her skills that she will eventually use to support a blind or partially sighted person.

Luker – who is named after the first headmistress of Newbury Girls’ School, Janet Luker – showed herself on stage to be skilful in her work and fantastic in social situations, unfazed by the hundreds of pupils and staff watching on as she identified empty seats and stopped in front of a pedestrian crossing.

This was the first time that Patterson pupils had been able to see the life-changing work their donations had been able to fund.

Over the nine years of supporting Guide Dogs, the money has been raised through various different activities such as cake sales, sponge throwing sessions at teachers and a recent chocolate raffle that raise around £300.

Head of Patterson Jonathan Rabin said: “It is fantastic to see the commitment from all the students and just the constant enthusiasm from all the year groups, new students and old students as well.

“This is my first year doing it and to see that, it is lovely.

“It is inspiring and it’s a real credit to them as people.”

Year 10 student Harvey Robinson has been a key fundraiser for Patterson over the past two years, having raised £1,500 by selling handmade Christmas baubles filled with either dog or cat treats.

He said: “It feels really good. It’s quite surprising because when you combine it all together there is a big total, but individually at each event it’s a lot lower.

“You don’t really realise how much you’ve raised altogether until you add it all up.”

Harvey hopes to own a dog one day, but he doesn’t think his cat would be too happy if he got one soon.

At the end of the assembly, Mr Rabin announced that Patterson had raised enough to support and name a 10th guide dog, something Luker seemed particularly excited about when she barked in response.

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The best Thief build for beginners in Dragon’s Dogma 2

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The Thief vocation is undoubtedly the most unorthodox vocation in Dragon’s Dogma 2 , at least among the four starting vocations.

However, don’t let that deter you. Beyond the fact that you can change vocations if you don’t like it, the Thief is a lot of fun in combat and can deal plenty of damage with its acrobatic tricks. In fact, we even named it as the best vocation to choose at the start of Dragon’s Dogma 2 .

When you’ve ranked up the Thief vocation a few times, more weapon skills, core skills, and augments will become available to you for purchase at any Vocation Guild, bolstering its nimble playstyle. You’ll also need to consider which equipment to use.

It’s all a lot to juggle, so here’s the best Thief build for beginners in Dragon’s Dogma 2 .

Best Thief weapon skills to get first in Dragon’s Dogma 2

With the Thief, there are two viable playstyle options. You can either focus on the stealth aspect, darting about in the shadows and striking when the time is right as your foes focus on your pawns, or you can go on the all-out offensive with constant dodges to avoid taking too much damage. Our build mostly focuses on the latter because it’s a little more beginner-friendly, but you can easily adapt it to include one stealth-minded skill if needed. Also, make sure you upgrade each skill to the advanced variant as soon as you can.

• Biting Wind
• Helm Splitter
• Powder Charge

Biting Wind (and its advanced variant, Cutting Wind) is an absolute must no matter how you construct your Thief build. It should be your primary attack, because it consumes next to no stamina and allows you to close the gap between yourself and an enemy in an instant, slashing them with your daggers as you pass. You’re also nearly impossible to hit while in this state. The only worry is if you’re fighting near a cliff or in a tight space and you accidentally Biting Wind yourself too far, because you glide and dance around the battlefield without too much control over the direction.

When you’re taking on any flying or enormous foes, Helm Splitter is a godsend — it’s one of the only ways you can reliably harm large enemies as a Thief. The move sends you flying into the sky directly where you stand, rolling forward in mid-air like a Droideka to deal a flurry of hits. Timed well, you can take down flying enemies like this, but it’s especially useful against ogres, cyclopes, and the like.

Powder Charge is the only area-of-effect attack the Thief has, allowing you to plant an explosive in the ground then remotely trigger it from afar. This is useful against big groups of smaller enemies, or perhaps even more impressive is that the Thief is renowned for its ability to climb upon the backs of bigger foes. You can stick the Powder Charge into an ogre, leap off, then detonate the charge and send the big guy flying.

Finally, we have Ensnare , which is the only skill here that doesn’t deal direct damage. Instead, this is your most reliable tactic against flying enemies, as you can essentially stick a rope on them then pull them to the ground, where you can unleash melee attacks. However, much like Powder Charge, this can also be used on larger targets to knock them off balance.

Best Thief core skills and augments in Dragon’s Dogma 2

There are four core skills for the Thief, one of which is an absolute necessity and should come pre-unlocked as soon as you get your hands on the vocation: Scarlet Kisses . This is your basic attack, but it allows you to deal lots of reliable damage in quick succession. Controlled Fall is also very useful when you get knocked over, if you can react quick enough.

When it comes to augments, Subtlety is by far the best Thief choice, because it means you’re less likely to be the target of your foes. You’re somewhat of a glass cannon as a Thief, so limiting the amount of damage you’re likely to take is helpful. If you’ve ranked up your Fighter vocation, the Mettle and Thew augments are also incredibly useful to the Thief. Mettle increases your defense stat, while Thew increases inventory size , as you naturally have less capacity being a nimble Thief.

Best Thief equipment in Dragon’s Dogma 2

As this build is aimed at beginners in Dragon’s Dogma 2, it’s tough to recommend very specific pieces that will elevate the build massively because your options are limited. Eventually you’ll find bits and pieces through exploration and completing side quests, but at the start you’re better off forking out some cash at Bjorn’s Armory and Roderick’s Smithy in Vernworth. These are the best armor and weapons available there for the Thief vocation.

There’s only one feasible choice for the helmet, and that’s the Unseen Shadow (4500 gold). The other option, the Hard-Leather Helm, is subpar in every regard. For the body armor, go for the Ranger’s Vest (7900 gold) because it’s half a kilo lighter than the more expensive Scaled Jacket, and offers more resistances. Finally, the Sprinter’s Boots (7900 gold) are the best option for leg armor, because even though they’re a little heavier than the other options, they offer impressive knockdown resistance which is a huge help for the Thief.

When it comes to weaponry, both the Stilettos (5300 gold) and the Snagdaggers (14800 gold) are worthy options. The Snagdaggers deal much more damage, but they’re considerably heavier, so it’s worth weighing up the options if you’ll pardon the pun.

Without giving away any spoilers however, if you do choose to play as the Thief vocation, you should prioritize the main quest, in particular the tasks Captain Brant asks of you. You’ll eventually stumble upon some very nice Thief gear indeed.

For more Dragon’s Dogma 2 guides , see our suggestions for the best Fighter build and best Mage build for beginners. We also have explainers on how to unlock the Warrior and Sorcerer vocations, how to change your vocation , and a list of all vocations .

Dragon’s Dogma 2 guides, walkthroughs, and explainers

• How to import a pre-made character
• Beginner’s tips before starting
• How to hire and use pawns
• Combat tips for new players
• How to delete your Dragon’s Dogma 2 save files (PC only)
• What vocation to pick + all vocations list
• Best augments and augments list
• How to change your vocation
• How to unlock the Warrior vocation
• How to unlock the Sorcerer vocation
• How to unlock the Magick Archer vocation
• How to unlock the Mystic Spearhand vocation
• How to unlock the Trickster vocation
• How to unlock the Warfarer vocation
• The best Archer build for beginners
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• The best Mage build for beginners
• How to change your appearance
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• Best quest order for Captain Brant
• When to go to the ‘Feast of Deception’ coronation
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• ‘The Arisen’s Shadow’ quest walkthrough
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Cat & Dog parents guide: Is the movie on Netflix appropriate for kids?

Cat & Dog might be an animated film, but does this mean it's okay for kids to watch? Find out here!

By Crystal George | Mar 19, 2024

Cat & Dog is one of the top movies on Netflix at the moment, with tons of people streaming it. In fact, it's sitting at the No. 4 spot on the streamer's top 10 movie list as of March 19. If you haven't already watched this film and are looking forward to doing so soon, then we must share the parents guide and age rating with you. That way, you’ll know if it’s okay for kids to watch.

Cat & Dog is a French animated/live-action film that was released on Netflix on March 15. It was directed by Reem Kherici from a screenplay she and Tristan Schulmann wrote together. Actually, Kherici also stars in the movie in one of the leading roles as Monica.

Monica is the owner of the internet star cat, Diva. While on her way to New York for a business deal with Diva in tow, Monica ends up separated from Diva. Meanwhile, jewel thief Jack has been separated from his dog Chichi, who isn't really his dog. Chichi ate Jack's stolen ruby, so Jack holds him hostage until he poops it out. But unfortunately for Jack, he loses Chichi while on his way to New York as well. With both of their pets missing, Monica and Jack team up to recover them. But it won't be easy with a determined cop hot on their tails.

French actor and comedian Franck Dubosc stars as Jack, the ruby thief, while other talented French actor Philippe Lacheau, stars as the cranky cop, Brandt. In addition, Inès Reg voices the role of Diva, while Artus voices Chichi.

What is Cat & Dog rated on Netflix?

You would think Cat & Dog would be rated something like TV-G, TV-PG, or PG since most animated films about animals are usually given one of these maturity ratings. However, this isn't the case for Cat & Dog . Surprisingly, it's rated TV-MA, meaning it's only meant to be watched by mature audiences. Why? Well, it has strong language in it. At least, that's what Netflix says.

However, I watched the film in its entirety and there was only one curse word that was used by a character. It was the word "f*cking." So, I wouldn't say "language" is an issue when it comes to this movie. However, I will say that there's partial nudity shown at one point in the movie. A woman's breast is briefly shown, but is quickly blurred out. The shot is from afar and you can't see her areola.

There is some animated animal abuse shown as well such as a dog being kicked by a human and a cat getting shot by a human with a gun. There's also a quick shot of an animated dead animal's remains. Its skeleton is shown. Lastly, an animal almost drowns in this film.

Some parents might not want their kids watching content like this, and that's totally understandable. That's why we recommend putting on kid-friendly content for them before you start watching Cat & Dog . Luckily, Netflix has a great selection of kid movies. Some kid movie recommendations on Netflix that center around animals include Dog Gone , Rescued by Ruby , Benji and Think Like a Dog . Those are all live-action films. When it comes to animated movies centered around animals, we recommend movies like Pets United , Back to the Outback , Dog Gone Trouble and Leo .

Check out the trailer below for a sneak peek of the film!

Although some people might not consider Cat & Dog a family movie since it's rated TV-MA, I think it would be okay for the whole family to watch. When it comes to the inappropriate scenes, which there are barely any, just make sure to cover the younger kids' eyes and ears. That should be good enough.

Cat & Dog is now streaming on Netflix . Will you be watching the comedy film?

Next. Netflix Movies Watch/Ski[. 52 best Netflix movies to watch (and 20 to skip). dark

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Great Dog Breeds for Grownups: A Guide to Choosing a Pup to Match Your Personality

Whether you’re a homebody or traveling in retirement, there’s a good canine companion for you.

Jennifer Ortiz,

Dogs are cute, cuddly and good for your physical and mental health . They bring companionship, boost your daily step count and time outside, and can get you interacting with other dog lovers, says Lorraine Rhoads, director of health and safety at Dogtopia, a provider of dog day care, boarding and grooming services throughout North America.

For the 11.1 percent of adults 65 and older living alone, or for those who just would like a fur baby to have around , getting a dog may be a good idea. But there are many lifestyle factors to consider before jumping into dog ownership with both feet (and all paws).

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Rhoads says the financial commitment (food, vet visits, grooming), time commitment (longevity, walks, playtime, vet visits) and both the human’s and the dog’s energy levels are important to keep top of mind.

“I think that you have to match the personality of the pet to the personality of the person. I think that’s first and foremost,” says Dr. Carol Osborne, a veterinarian at Chagrin Falls Veterinary Center & Pet Clinic in Chagrin Falls, Ohio.

Just like humans, every pup has its own unique personality, but there are generalities that can be made about different breeds. The American Kennel Club recognizes 201 different breeds and divides them among seven categories based on the function they were bred to perform, says Jerry Klein, AKC’s chief veterinary officer. For example, sporting dogs are typically athletic and love to play, while hounds are focused, stubborn and loyal, and herding dogs love having a job to do, expands Klein. Whatever your lifestyle and abilities look like at 50 and older – whether you’re planning to travel extensively in retirement or want to spend your golden years with your toes in the sand – there’s a breed or a mix of breeds that would suit your preferences. Here’s a guide to matching your personality to a pup.

For the homebody

If you’re more of an indoorsy grownup who values time spent at home – say, snuggling with a book or watching a movie on the couch – Rhoads suggests a cocker spaniel. She describes cocker spaniels as naturally gentle and sweet (but they do have long coats that require regular grooming). The Cavalier King Charles spaniel is also a good option, she says; they are a toy breed that can range from small to medium size, and they have fewer grooming needs than the cocker spaniel. Rhoads says they require low exercise and are “happy to cuddle for a big portion of the day.” 

Osborne recommends other dogs with shorter coats: French bulldogs or Boston terriers. If you live in a climate that can get hot, be sure to keep in mind that flat-faced breeds (like pugs and bulldogs, including French bulldogs) can have compromised respiratory systems, which means they may encounter breathing issues in the heat.

For the outdoorsy grownup

If you like to hike, go on long walks, tend to your garden and spend as much time outside as you can, Osborne recommends any of the retriever types – golden retrievers or Labradors. Rhoads concurs but also would add greyhounds to the mix.

Within those breeds, you’ll find varying energy levels, but all three breeds love spending time outdoors. While Rhoads admits that a greyhound may seem counterintuitive for a grownup “because you think they’re just going to be runners, and some of them maybe have a tendency to have a high prey drive,” she says they are also gentle, affectionate dogs that are the perfect garden companion.

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For retirees who love to travel

For the jet-setters who want an adaptable (portable) companion, Rhoads recommends smaller dogs who are well-trained, friendly and social (you may encounter fellow travelers who want to pet them).

“If travel is definitely on the list of your lifestyle, I would consider smaller breeds that are just easier for you to pick up and go,” says Rhoads, adding that more hotels are becoming dog-friendly , but both hotels and airlines may have restrictions on pet size.

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Osborne says most dogs are willing to do anything and everything they can to please their owner – even when traveling – so most dogs are fine to travel with you. But there are some breeds that will be particularly difficult on the road — especially “nervous, high-strung breeds” like vizslas, salukis and some sighthounds.

The city fashionista

If you’ve downsized your home, perhaps in the city, Rhoads suggests shih tzus, Maltese and bichon frises. All three breeds are small and have low energy that won’t require a lot of play within a small home. But do note that all three have frequent grooming needs.

Osborne says poodles are also very popular among the fashionable set over 50 “because they’re big and stylish” (but they also require a lot of grooming). While standard poodles are high energy, their smaller counterparts, toy poodles, are just as stylish and have lower energy — and a better fit for a small space. The experts say these polished pooches need a lot of regular grooming and upkeep; and as with any high-fashion item, you’ll want to consider the cost.

For snowbirds

For retirees fleeing frigid temperatures, Osborne recommends short-coated breeds. “The Labrador retriever is appealing to just about anyone, anywhere,” she says, adding that they have medium exercise requirements and love the water, as do golden retrievers.

While bulldogs and other short-legged, short-coated dogs are generally great choices for older adults, Osborne says it’s important to note that breeds with short legs aren’t naturally swimmers — and hotter climates might be difficult on their breathing if they’re outside for too long.

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Other factors to consider

Dog coats and climate : “In general, when it comes to cost, the bigger the pet and the longer the hair, the more it’s going to cost,” says Osborne about grooming costs. It’s important to consider a dog’s coat and where you live.

For example, she says, “If you live in Alaska, you wouldn’t want to get a Mexican hairless – the little guy would be freezing all the time. If you live in Florida, a hot, humid climate, especially by water, you wouldn’t want to get a husky or a malamute. A breed that has long hair doesn’t do well with heat and humidity, and doesn’t care for the water.”

Age — an older dog can be a great fit for grownups: Osborne says adopting a senior dog (age 7 and older) may be a great move for older adults, since puppies may be a lot of work. She says senior dogs, many of which are surrendered to shelters and rescues “for the wrong reasons,” are typically already house-trained, spayed or neutered, and have many of the vaccines that are necessary to get as a puppy.

“You’d be surprised how many of these older dogs in shelters … it’s kind of like they know that you gave them a second chance,” says Osborne. “In many cases, those can be just the best dogs you could even ask for.” 

Commitment is long term: Osborne says that grownups should also consider that a dog is a lifelong commitment. A dog’s lifespan varies by breed and size; smaller dogs can live to around 15 or more years, while larger dogs live up to 13, according to Klein. Much like humans, dogs are highly social creatures and shouldn’t be left alone for long periods of time, says Rhoads. 

“If you find that there’s time in your life and space in your life, bringing a dog into that is so recommended,” she says. “Older adults often live alone or face some levels of loneliness. Companionship makes a big difference.”

Where you should get your dog: If you’re ready to jump in and find your perfect companion, and you definitely want a particular purebred dog, check the breed’s national, or parent, breed club, suggests Klein.

“Within each of these parent club’s websites should be a list of dedicated, responsible breeders in various parts of the country,” he adds, noting that many of these clubs have organizations that rescue purebreds from shelters around the country.

Osborne says you shouldn’t overlook shelters and rescues, advising it might even be your first stop. They sometimes have purebred dogs that have been surrendered by families who can no longer care for them. They also are likely to have mixed-breed dogs, which Osborne says sometimes inherit the best traits of all their breed mixes.

Most shelters and rescues offer trial periods with the pet – where potential owners can see if a dog is a good fit for their family and lifestyle. If a shelter dog is a good fit, the adoption fees will certainly be lower than the price tag from a breeder.

Whatever route you take, it’s important to do your research and be very mindful about potential pet scams .

Jennifer Ortiz is an associate editor at aarp.org. She previously covered personal finance, careers and other consumer topics as an editor at  U.S. News & World Report  and was a news writer and editor at WTOP News in Washington, D.C.

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