One of the most frequent questions we get asked in the Medical Alerts Workgroups is "What Alert Behaviors Work Best?"
First we want to discuss what the criteria is for an alert to be considered a task.
These might vary from trainer to trainer, but the Canine Coaches believe in keeping this simple.
Sometimes it gets confusing as to whether a behavior is an alert or response. Simply put, an alert behavior would be done when the handler is unaware of a medical need and a response behavior would be done to stop the behavior or reduce the impact of the medical episode. For POTS a dog might give the alert behavior to tell the handler to sit or lay down and the response might be giving DPT until the episode passes. The alert behavior must be something you have trained your SD to do. It may start as a natural behavior that we then shape to be more precise and accurate.
The alert behavior should be noticeable by the handler, but should be very subtle or hardly observed by the general public. We call these passive alerts. The alert behavior itself should not impact the environment around them and instead function as a way to communicate with the handler only. A bark, while easy for the handler to interpret, also disturbs the environment around the team and therefore is not suggested as an alert behavior.
The medical alert must involve an action the handler can take that mitigates their behavior. In the POTS example above the handler sits or lays down which prevents falling that easily leads to injury. if the dog alerts to a migraine after the handler takes their response meds, this would not impact the medical condition. If the dog alerts to an episode and there is not an action the handler can take, there is no reason to train the medical alert.
Medical alerts must have a clear cue that signals the behavior to start. We train a dog using a verbal cue, but eventually you have to transition away from a verbal cue to a naturally occurring cue which could be based on a scent the dog smells, a behavior the handler does, or something the dog is observing in the environment around them. If you have migraines triggered by the scent of smoke or specific cleaner, you can train the dog to alert you to that scent to help you avoid coming close enough for that scent to impact you. The C2C Canine Coaches has a class that focuses on teaching dogs to alert to visual cues the handler gives before or during a medical episode and a different class that focuses on teaching dogs to alert based on a chemical change in the handler.
Almost any behavior that you can train your dog to do can become an alert behavior. C2C Canine Coaches teach a “dog to handler” body target as the first method of alert. Your dog will always be with you when they give a medical alert where other behaviors such as touching a button or standing on the arm of your couch or recliner may not always be possible in some environments. Penny taught her first SD to do a chin rest body target to alert to migraines which worked wonderfully at home or where Penny was sitting down, but was problematic in situations where Penny was standing up or walking. Thus Penny had to teach a different alert behavior for these situations which can be confusing to the dog. Cindy had planned to train Nick to do a Bow as an alert behavior for diabetic lows, however she realized that most alerts would be done while she was sleeping and a Bow behavior wouldn’t wake her up. Here are a few “dog to handler” body targets that we’ve used or taught.
Penny teaches all her dogs and clients to do this hand target for directional cues thus it’s not good for alerts if the dog is going to be doing it for other reasons all day.
Dog’s Nose to Human Leg Azul targets Penny’s Thigh for a migraine alert.
Dog’s Nose to Human Nose This needs to be done for alerts where the human is fully conscious and aware of surroundings or it could become an accidental headbutt.
Basically a Dog’s Nose to any human body part would work if the dog could access that body part easily.
Dog’s Paw to Human Leg This can lead to accidental scratching, especially if done while standing/walking, but can be good for people with a nervous bouncing leg as the dog’s paw can stop the leg from bouncing.
Dog's Paw to Human Hand/Arm This is basically the shake trick so it's super easy to teach. This is a common alert behavior that mixes with an interruption behavior for issues that cause picking, itching or other forms of self harm.
Dog’s Paw to Human Foot Azul does this to alert Penny's dizziness to tell her to stop walking and sit down. This is nearly impossible to ignore!
Dog’s Paws on Human Back/Shoulders Can work if dog’s size allows and human position when alert is most frequently needed is appropriate. Beware if the desired alert is for the dog to jump on the human and put paws on handler’s back in a public place, this can look as though the dog is out of control or misbehaving.
This can be great for passive alerts that happen while mostly sitting down, but not so great for alerts that might be needed while walking.
Dog’s Chin On Human Foot Again problematic if walking, but can be great as an alert to someone approaching from behind while a dog is in a settled position. This can be great if the dog is trained to settle with their chin on the human's foot and simply raising their head becomes an alert that someone is approaching from behind.
Dog’s Head to Human Hand This one is a bit unusual, but it seems to work really well for those who require an anxiety based alert. It’s easy to do in any situation provided the dog can reach the handler’s hand. Dog basically thrusts the top of their hand into the handler’s palm almost as if asking for pets. That’s why it works so good as an anxiety alert as that often helps the handler de-escalate before their anxiety gets extreme.
Dog’s Body Leans Into Human Leg This is often used to tell the handler that someone is approaching. For example if the dog is sitting between the handler’s legs in the middle position or standing beside the handler and can shift their body weight slightly into the human to alert to someone coming up behind them.
Any dog body part that you can teach a dog to control their use of can be a target to any human body part they have access too.
Other target based alerts
Bringsels This is where a small cord, cloth or other tab hangs from the dog’s collar or from the handler and the dog grabs the item and holds it in their mouth to alert the handler. This is a very clear signal that doesn’t often happen naturally so it’s great for clear communication. However if you don’t have that tab for the dog to grab, the dog isn’t able to alert.
Dog’s Paw Target on Specific Surface This can work well for full time wheelchair users who mainly use their own mobility devices. The dog might target a foot rest, armrest or other part of the mobility device. It can become challenging if the hander uses multiple devices as there is a lot more generalization that needs to be done. And extra challenging if the handler is a part time chair user and a part time walker as the dog may need to alert in both situations but the target object might not be available.
This can also be used by hearing impaired handlers, especially at home. If the target is in a place where the handler can see it, the dog can be trained to alert a spouse coming home with one target and a stranger coming to the door with another target.
Dog’s Doing Behaviors
These can be applied to nearly any type of alert you need provided you can feel, see, or hear the dog doing the specific behavior. Be careful not to choose an alert that the dog does naturally or that the handler cues frequently. For example; you wouldn’t use a sit behavior because dogs sometimes just decide to sit and humans ask for this regularly. The same would be true for laying down unless you paired it with something else unique to the situation.
Bow Behavior - Dog lowers front half of body, keeping hind end up in the air.
Dog Spins - Dog moves in a tight circle often stopping facing the handler.
Dog Circles the Human - This is sometimes called an orbit task, but can also be used as an alert.
Sit Pretty - Dog sits up on hind legs
Stand UP - Dog raises from a sit to a stand.
Dances on Hind Legs - Dog stretches front legs into the air.
Again, any behavior you can teach the dog to do can be used. Often a behavior chain of multiple behaviors in a row can make the signal even clearer.
Retrieve Tasks can Also Be Alerts The dog can be trained to grab specific items to indicate a need. A dog might retrieve a meds bag for the handler to take necessary meds. A dog might retrieve ear buds if the handler is experiencing sensory issues and needs to drown out some background noise. A dog might retrieve a bottle of juice as an indicator of a sugar issue. The options here are endless!
Finding the right alert behavior for your team can be challenging. The C2C Canine Coaches suggest you spend some time trying to train a few different behaviors to find out what your dog loves to do and how easily that behavior is to do and a wide variety of settings before pairing any specific behaviors to a medical alert.
Occasionally if a dog has shown a natural alert tendencies we might start with the behavior they offering and shape it into a behavior that is more defined and not naturally occurring. But if there hasn't yet been any indication of a behavior that you and your dog might love and while pair nicely with your need for a medical alert, then you can start fresh with just about any behavior you want. It's important that the medical alert behavior is something that your dog loves to do because often it is hard for us to reinforce medical alerts in the moment therefore the behavior itself needs to be self reinforcing so that your dog loves to do it enough that they will continue to do it even with delayed reinforcement.