AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY
BY H. BARRY WALDMAN DDS, MPH, PHD, BEVERLY L. MUNTER,
STEVEN P. PERLMAN DDS, MSCD, DHL (HON), MATTHEW COOKE, DDS, MD, MPH
“Mitchell Slaugh takes his parrot, Kai, with him everywhere because he is his registered support animal. Saturday, Mitchell was kicked out of the WinCo on Clearwater for bringing his parrot inside. ‘She’s my baby. She’s a companion…I need her and she needs me.’ Mitchell is cleared by doctors to have her on his shoulder as his support system as he deals with anxiety.” 1
“…her doctor told her to get a dog for emotional support. Alton, 65, still can’t work, but Scrappee Anne, her miniature schnauzer, makes it possible for her to socialize and cope with the anxieties of clinical depression and posttraumatic stress disorder… Alton’s case sets two rights in conflict – her right to cope with her medical condition and the landlords’ right to control and maintain their property. 2
Alton is part of a growing trend of people with mental illnesses relying on what are known as therapy, comfort or “emotional support” animals to stem the symptoms of their illness. However, the confusing patchwork of state and federal laws makes landlords and other businesses vulnerable to lawsuits if they impose restrictions. 2
EMOTIONAL SUPPORT ANIMAL
An emotional support animal is not a pet. It is a companion animal that provides therapeutic benefit to an individual with a mental or psychiatric disability. The person seeking the emotional support animal must have a verifiable disability (the reason cannot just be a need for companionship). Emotional support animals or comfort animals are often used as part of a medical treatment plan as therapy animals, Specifically, these support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities. Even though some states have laws defining therapy animals, these animals are not limited to working with people with disabilities and therefore are not covered by federal laws protecting the use of service animals. The animal is viewed as a “reasonable accommodation” under the Fair Housing Amendments Act of 1988 to those housing communities that have a “no pets” rule. Most times, an emotional support animal will be seen as a reasonable accommodation for a person with such a disability. 3
All domestic animals can quality as emotional support animals, including “…cats, dogs, mice, rabbits, birds, snakes, hedgehogs, rats mini pigs, ferrets, etc. and they can be of any age (young puppies and kittens, too).” 4
DIFFERENCE BETWEEN A SERVICE ANIMAL AND AN EMOTIONAL SUPPORT ANIMAL
Service animals are defined as dogs that are individually trained to do work or perform tasks for people with disabilities. These tasks can include things like pulling a wheelchair, guiding a person who is visually impaired, alerting a person who is having a seizure, or even calming a person who suffers from Post-Traumatic Stress Disorder. Service dogs may accompany persons with disabilities into places that the public normally goes. This includes state and local government buildings, businesses open to the public, public transportation, and nonprofit organizations open to the public. The law that allows a trained service dog to accompany a person with a disability is the Americans with Disabilities Act (ADA). 5
TYPES OF SERVICE DOGS FOR CHILDREN
“Especially with children, there can be a tendency to think of service dogs as Lassies… Lassie does not exist! She’s a fictional character and isn’t even just one dog! In order to do all of the cool things she does on TV and in movies they have to use several dog actors. Dogs are not humans in fur suits, they do not think the same way that humans do. They are dogs, which are wonderful in itself, but we need to be realistic about what dogs are really capable of doing.” 5
Hearing dogs: To help individuals who are deaf or hard of hearing by responding to sounds such as a knock on the door, alarm clocks and the child’s name, by alerting their human partner to these sounds. Hearing dogs work best when the child can respond independently to the information provided by the dog.
Traditional service dogs: To help those who use aids including wheelchairs, canes, crutches and walkers by picking up almost any dropped item, turning a light switch on or off and carrying items.
Seizure alert dogs: Identify when a seizure (e.g. from epilepsy) is about to happen and alert their partner.
Guide dogs: The oldest type of service dog and the most commonly known by the general public. These dogs are trained to negotiate obstacles, overhangs, barriers, street crossings and public transportation to help individuals with sight impairments.
Dogs for psychiatric disabilities: The Americans with Disabilities Act allows for dogs to help individuals with psychiatric or other mental disabilities by preventing or interrupting destructive behavior. For example, a dog would nudge the handler when a behavior such as body rocking caused by anxiety starts to happen, so that the handler would become aware of the behavior and then be able to control the anxiety response. A dog is individually trained for youngsters and adults who have an emotional or psychiatric disability so severe that it substantially limits ability at least for one major life task.
Walker or balance dogs: These are generally large breed dogs that wear harnesses to help an individual balance in a standing position or to get up or down from a standing position, while others are trained to help prevent falls while the individual is walking.
Social dogs: Help those children who cannot assume total responsibility for a working dog, but who can benefit from the assistance of a dog can help to learn important social skills. These dogs encourage social interaction between the child, the dog, and other individuals. This style of work is most often successful in children with the Autism spectrum disorder.6 Specifically, these dogs act as constant companions to children with autism to help them improve social interactions and relationships, expand verbal and nonverbal communication, teach life skills, increase interest in activities and decrease stress within the family.7 However:
“A dog has the mentality and the cognitive ability of a three year old human child… Would you send a three year old out to cross the street alone? Would you put a three year old in charge of another child to lead that child across the road? A service dog should not be given more responsibility than a three year old human child. Service dogs need adult supervision too.
Service dogs are wonderful helpers, but they are not guardians, they are not nannies, and they are not babysitters. In the human/service-dog partnership, the human MUST be emotionally mature. If you would not hand off a three year old human child into the care of the would-be service dog handler, then please, do not give that person a service dog.” 6
“(Reality)… The dog arrives and the kid falls in love. At first, there is the honeymoon period driven by hope. Then reality sets in… Now, not only does the parent have to take control of both the dog and the child, if the parent wants to maintain the dog’s training, the parent have to stop right then and there and train… Gee: how confusing for the dog! Sometimes he or she is controlling the kid, sometimes the kid is controlling him or her, and most of the time no-one is really in control. ” 7
Nevertheless, children with autism often lack the skills to decipher human emotions. However, a dog’s presence is difficult to ignore and once interaction with the dog begins, the child starts to develop empathy. The dog’s presence also gently encourages the child to shift attention from the inanimate to the animate. Playing a simple game of rolling a ball back and forth to the dog may open up social avenues with other children. Now the child has a “draw” for the interest of other kids who would like to interact with the dog and join in the game. 8
THINK YOU CAN CLAIM YOUR PET IS AN “EMOTIONAL SUPPORT ANIMAL”?
Maybe – the law is murky and the answer depends heavily on your animal’s skills, your frailties and your conscience. Governments and businesses increasingly sort companion animals into several categories.
“Numbers on companion animals of all kinds are hard to come by, but a JetBlue spokesman said more than 25,000 of its passengers boarded with animals in the first 11 months of 2014. That was 11% more than all of 2013.”9
• “According to airlines, hotels and government agencies, many pet owners are describing their animals as emotional support animals (ESAs). Some carry letters from licensed health professionals attesting that they suffer mental or psychological disabilities that are eased when their pets are present…
• Some who work with animals, however, see the ESA situation as a growing problem because of the pet owners who distort their infirmities (or stretch the truth) to get their pets better access. Several companies sell ESA evaluations, letters, registration cards and other accessories on the Web, sometimes requiring telephone interviews, sometimes operating on the honor system…
• In fact, federal laws are conflicted when it comes to ESAs. Some, including the landmark Americans with Disabilities Act, give no extra privileges to people with ESAs. Yet other federal laws do, which is why airlines see so many furry fliers… Therapy dogs get no particular perks outside the schools and hospitals where they work, except for miniature horses (which typically weigh about 70 pounds).
• The federal Air Carrier Access Act, on the other hand, allows ESAs to fly in the passenger cabin on commercial flights at no extra charge, usually on the passenger’s lap or in a carrier under the seat. The federal Fair Housing Act permits ESAs in condos or apartments that ban pets. That law doesn’t cover hotels, but many upscale lodgings accept ESAs, including some that ban conventional pets.
• As for the Americans with Disabilities Act, the U.S. Justice Department decided in 2011 that it should apply only to people with disabilities who are accompanied by service dogs and, ‘where reasonable,’ miniature horses.
• But under the ADA, businesses can ask only two questions when trying to determine whether an animal is truly a service dog: Is it required because of a disability? What work or task has it been trained to perform?
Facing such complexity, many businesses have decided to just say yes to ESAs.” 9
Our conclusion: A parrot is not a service animal. It is an emotional support animal.•
ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; E-mail: email@example.com
Steven P. Perlman, DDS, MScD, DHL (Hon) is Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Beverly L. Munter is Vice President, retired, Health Care Corp., Plainview, NY
Matthew Cooke, DDS, MD, MPH is Associate Professor, Departments of Anesthesiology & Pediatric Dentistry University of Pittsburgh School of Dental Medicine Pittsburgh PA; Assistant Clinical Professor, Departments of Oral & Maxillofacial Surgery and Pediatric Dentistry Virginia Commonwealth University School of Dentistry, Richmond, VA.
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AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE AND DENTISTRY
The American Academy of Developmental Medicine and Dentistry (AADMD) was organized in 2002 to provide a forum for healthcare professionals who provide clinical care to people with neurodevelopmental disorders and intellectual disabilities (ND/ID).
The mission of the organization is to improve the quality and assure the parity of healthcare for individuals with neurodevelopmental disorders and intellectual disabilities throughout the lifespan.