Question:
"I'm wanting to train my dog as a diabetic alert dog being that I'm insulin dependent. My question to you is what training tools do you use to teach the dog how to detect low blood sugar & high blood sugar (sensing)? I've asked numerous trainers on youtube this question, but no one has responded. My dog already does the targeting exercise with flying colors thanks to you and your video. Can you help me? TY :)"
Answer:
Most people use a Tshirt or other clothing that has sweat on it from when they had a low blood sugar reading as the training object and store it in a sealed plastic bag like a ziplock when not using it.

Others breathe on a pad when their blood levels are low or high and seal it in a ziplock type bag or small vial.

Still others prefer to soak a small cotton pad in their saliva as they are having a low. These probably store the best for training purposes and are more accurate for the dogs than using sweat.


If you can get a blood sample, that works well, especially if you can test and know how high or low it is. Blood samples, however, break down quickly so are not as accurate. 


Dogs can be trained to alert to any sugar level you choose. You don't want the sample reading too low when the dog alerts, as you want to be alert enough to be able to still help yourself. Most people use a reading of 70-80 to train their dog asthey are still functioning and able to help themselves. 


In our training videos, replace the sound with the scent. Let the dog smell a small sample of the blood ( in a vial or other quick opening and sealing container) before cuing the alert behavior during training. Most dogs catch on to this quickly since they are so scent-oriented.


Please refer to our 4 blog postings (pt1, pt2, pt3, pt4) and embedded videos on training a one and two way alert.


Good luck!


How to Train a One Way Diabetic Alert


Ideally start by training with the actual diabetic person or you will have to retrain the dog to alert to the other person later.


1. Train and practice the alert behavior separately.


For example: use targeting to teach a nose touch on your leg. Shape it into a hard nose nudge just above your knee. An easy position to start training this behavior is with you in a sit. Then when your dog is successful, change your position to a stand, squat, sit on the floor, face the dog, turn to your side, turn your back etc until your dog can nose nudge you in any position. Add distance.


2. Present the smell of the sweat or blood sample. Click and treat your dog for any interest in the smell (sniff, lick etc). Do not c/t a bark or other noise! Place the smell on your lap, on the ground and other places and see if the dog seeks it out to sniff. When your dog is consistently indicating that she smelled the smell, go to next step.


3. Present the smell and immediately cue nose nudge. (sniff, cue 'touch', dog nose touches, click as nose makes contact, then reward)


4. When your dog is offering nose nudges consistently, fade the cue (touch). Present the smell alternating using the touch cue and not and see if you get the behavior. After several repetitions, the smell alone will trigger the alerting behavior (nose nudge). If not, keep practicing with the cue. Now the smell has become the cue to do the alert behavior. Practice this until your dog nose touches after sound 8/10 times before moving on.


5. Change positions from sitting to standing to facing towards dog and away. Practice crouching, sitting on the couch, sitting at the table, laying down on your bed and other places you might normally be when a low or high blood sugar might occur. When your dog is successful at this level, try doing other behaviors such as pretending to do the dishes, talk on the phone, watch TV etc. while presenting the smell.


6. Next add distance in one foot intervals. You can throw a treat away from you to get the dog away from you. Present the smell beside you.


7. Change positions where the dog is in relation to you (the source of the smell). For example, throw a treat down a hallway, around a corner etc. Then present the smell.


8. Adding distractions such as one, two and more people in the room, TV or radio on, a person standing between you and the dog, person engaging you in conversation etc.


9. Ask a helper to be nearby as a distraction when you present the smell on your body. Decrease distance at first, increase it as your dog is successful (to say where the dog is laying on her dogbed and alerts you from there).

Your dog may want to go to them to alert first. Ask your helper(s) to ignore the dog by avoiding eye contact, not responding to the alert, not petting or otherwise distracting the dog etc. You then give your alert cue "touch" and your dog will come to you to alert. C/t.

You will need to practice this several times before the dog understands that it is only when she alerts you that she gets rewarded. Adding other helpers in the room and training the same way with all of them (prepare them as to what you want them to do if they dog alerts to them). With many repetitions, your dog will learn to search only you out in a crowd.


10. Use a timer to cue you to present the smell on you at unpredictable times during the day. Ideally, try not to let your dog see you set the alarm or she will anticipate that you are doing it. For example have it set to go off when she is relaxing next to you, or on her bed, when she is playing quietly with a toy, when she is sleeping lightly, when she is sleeping soundly. Ideally, she should jump up from a sound sleep and run to you to give the alert. If she is sound asleep, she may hesitate and she may be disoriented, but give her up to to 6 seconds the first few times (count one one thousand, two one thousand in your head) to assess what is going on and to start moving towards you before helping her by cueing the 'touch' cue. Do not say the cue if she starts moving towards you before that time. As she gets more practice, allow her less time decreasing in one second intervals (but always allowing at least 3 seconds to orient on her own).


11. Generalize the behavior by training at different locations, starting from the beginning at each location.

 
Your dog can be taught to alert to many different sounds using the same alert behavior. Start from the beginning with each new sound, pairing the sound with the desired behavior. Then train your way through the process.

The more sounds you train for (each trained separately until the behavior is complete) the faster your dog will generalize the behavior to that sound. For example, when I started training Jessie for a door knock after learning the wake alarm, the first behavior she offered was a nose nudge.

In this situation, Jessie was also offering the nose nudge as a default behavior in a situation where she didn't know what I wanted. She was smart enough to try to offer the sound alert behavior in response to a new sound. THIS is what generalizing is.

If those first few sound alerts of the new sounds are immediately reinforced, you’ll get the alerting behavior for the new sound more quickly. If you ignore them or don’t reinforce them, your dog will be confused and not be confident in what you are asking her to do and may offer other behaviors.

If you do not use some specific sounds on a regular basis, you will need to review training on a monthly basis to keep the behavior current.

What other ways can a one and two way alert be used by Assistance Dogs?
 

This alert teaches the dog to let you know there is a specific sound and to take you to the source of the sound.

The order that the dog does (whether alert you first or alert the location of sound first) is up to the task, your preference or even your dog's natural tendancy as long as the order is consistent for that sound so you know what to expect. You may have to adapt the order of the training below. For example, some people prefer their dog runs to the source first, instead of to the person. It doesn't matter as long as the dog is doing both alerts in a chain.

To strengthen your preferred order, start training the first behavior first and perfect it before moving on to the second behavior. Also more heavily reward when your dog does the first preferred behavior first so the dog is not getting more highly rewarded for the second.

1. Train the one way alert (see pt2), choosing an appropriate alert behavior for the sound.

2. Teach the dog the 'take me to' behavior separately. You can use the cue 'show me' 'find it' or 'where is?' (See our shell game video) Choose one cue and use it consistently through out training. The 'show me' behavior indication may be a nose nudge of the object as for the sound alert, a paw touch, a sit near the object, laying down beside the object, or other behavior as appropriate.

3. Place the sound at dog level if possible. Place a covered bowl of treats at the sound source but above the dog's nose level. Also ensure you have treats on you to reward the sound alert.

4. Pair the sound with the 'show me' by setting the sound off first, allowing dog to do their sound alert (nose nudge) rewarding the nose nudge, then cue 'show me', then give the dog time to respond.

The first few training sessions it helps if you review each of the sound alert and the show me behaviors separately, before bringing them together. The dog will then more naturally blend the behaviors into a chain.

5. When doing both the sound alert and the show me behaviors together consistently, start about 2 feet away, set off the sound, reward a sound alert and cue “Show me?” and follow dog toward sound.

6. Add distance in one foot increments. Very quickly, the dog will likely check to ensure you are following her to the sound source.

7. Move around a corner (but still close) and indicate “show me” to the next room

8. Add distance into other rooms

9. Decrease distance and add distractions one at a time.

10. Next set the time for the sound to go off for longer intervals, then unexpectedly (for the dog) in the same room. Then unexpectedly (for the dog) from another room, while the dog is laying down, resting, then later even playing or sleeping.


Check out our video on training a 2 way alert.



Here is a video of training a hearing dog to do a 2 way alert around a corner. Note that the dog is eating (is distracted) and then runs to do paws up on legs as the alert behavior. The owner follows the dog quickly to the location and the dog alerts the location of the sound.

11. Generalize the behavior by training at different locations, starting from the beginning each time.

To strengthen the whole chain of behaviors or to increase enthusiasm, try using the dog's full meal as a reward or play a rousing game of tug after she completes the whole task. You can also use these as jackpot rewards anytime your dog has a breakthrough at a challenging spot.

Examples of two way alert: cell phone ringing, oven timer, kettle whistling, door bell, knock, baby crying, dryer buzzer, dropped keys, medication pump monitor alarm, and Alzheimer’s patient movement alert (where the dog lays near the patient, and if the patient gets out of his chair, runs to alert the caregiver and leads her back to the patient (who may be headed out the door).

Check out the AAIDP website (scroll down to hearing task list) for more ideas.

One way alerts include any time the dog needs to get your attention, but you do not want her to take you to the source of the sound. For example, for a smoke detector or fire alarm just telling you that they are going off is enough. You do not want to be led back into a fire to learn it is the smoke detector going off. It is helpful to train a separate alert behavior for safety issues so you will know which specific sound your dog is alerting to (such as laying down at your feet for smoke detector, refusing to move for oncoming cars etc.)

You want your dog to alert only to you, not to helpers, family members or other people so only reward the dog when she alerts to you. if she tries to alert to anyone esle, ask them to ignore the alert and verbally redirect your dog by cuing the alert behavior. Reward that behavior.

1. Train and practice the alert behavior separately
For example: use targeting to teach a nose touch on your leg. Shape it into a hard nose nudge just above your knee. An easy position to start training this behavior is with you in a sit. Then when your dog is successful, change your position to a stand, squat, sit on the floor, face the dog, turn to your side, turn your back etc until your dog can nose nudge you in any position. Add distance.

2. Set off the sound (optional: use only for dogs that are not sensitive to sounds) Click and treat your dog for any indication that your dog heard the sound (ear flick, turning head, looking at source. Do not c/t a bark or other noise!
When your dog is consistently indicating that she heard the sound, go to next step.

3. Set off the sound and immediately cue nose nudge. (set off sound, cue 'touch', dog nose touches, click as nose makes contact, then reward)

4. When your dog is offering nose nudges consistently, fade the cue (touch). Set off the sound and alternating using the cue and not and see if you get the behavior. After several repetitions, the sound alone will trigger the alerting behavior (nose nudge). If not, keep practicing with the cue. Now the sound has become the cue to do the alert behavior. Practice this until your dog nose touches after sound 8/10 times before moving on.

Check out this video for an idea of what this looks like. This person started with no cue and is shaping the dog to nose nudge on the sound only.

5. Change positions from sitting to standing to facing towards dog and away. Practice crouching, and even laying down. When your dog is successful at this level, try doing other behaviors such as pretending to do the dishes, talk on the phone, watch TV etc. while setting off the sound.

6. Next add distance in one foot intervals. You can either throw a treat away from you or have a helper make or start the sound from increasing distances away.


7. Change positions where the dog is in relation the sound. For example, throw a treat on the opposite side of the sound to where you are standing, then you back up so the dog must pass the sound to come to you to do the alert. (This prevents the superstition that the dog must come first to the source of the sound or be near it before alerting you). Only reward when the dog walks by the sound to alert you.

8. Adding distractions such as another person in the room, TV or radio on, two people in room, a person standing between you and the sound, person engaging you in conversation etc.

9. Ask a helper to set off the alarm. Your dog may want to go to them to alert first. Ask your helper to ignore the dog by avoiding eye contact, not responding to the alert, not petting or otherwise distracting the dog etc. You then give your alert cue "touch" and your dog will come to you to alert. C/t. You will need to practice this several times before the dog understands that it is only when she alerts you that she gets rewarded. Adding other helpers in the room and training the same way with all of them (prepare them as to what you want them to do if they dog alerts to them). With many repetitions, your dog will learn to search only you out in a crowd.

10. Use the timer on your alarm to set the alarm off at unpredictable times during the day. Ideally, try not to let your dog see you set the alarm or she will anticipate that you are doing it. For example have it set to go off when she is relaxing on her bed, when she is playing quietly with a toy, when she is sleeping lightly, when she is sleeping soundly. Ideally, she should jump up from a sound sleep and run to you to give the alert. If she is sound asleep, she may hesitate and she may be disoriented, but give her upto to 6 seconds the first few times (count one one thousand, two one thousand) in your head)to assess what is going on and to start moving towards you before helping her by cueing the 'touch' cue. Do not say the cue if she starts moving towards you before that time. As she gets more practice, allow her less time time decreasing in one second intervals (but always allowing at least 3 seconds to orient on her own).

11. Generalize the behavior by training at different locations, starting from the beginning at each location.

You can use a one way alert to teach your dog to alert you to: fire alarm, smoke detector, wake up alarm, someone calling your name, horn honking, car backing up, etc.

This same process can also be used to train a low blood sugar (diabetic) alert. If your dog will be doing both sound and diabetic alerts, it is helpful to train different alert behaviors for each so you know which the dog is indicating.

Watch our video to see the process in action!

One and Two Way Alerts can be used to train assistance dogs for people who are deaf or hard of hearing, diabetics (high or low blood sugar levels), and to alert an Alzheimer caregiver of movement by their patient. All these are taught using the same basic process.

It is very important before and during the training process to avoid saying “no” or otherwise discourage an alerting behavior in any context. You can ignore uncued behaviors such as a nose nudge for attention (especially if given when not during training sessions) so the dog will stop doing the behavior but do not punish or verbally scold the dog for doing it. Punishing or otherwise discouraging alerting behavior may affect your dog’s willingness to do that behavioral alert in the future.

Tips:
A. Use this Basic Process to Train your Dog to Alert to Any Sound.
For the actual alert, you can use a firm nose nudge, chin rest on hand or lap, pawing your arm, laying on your feet, face licking, jumping in front of you, jumping in your lap etc. Before training, choose whichever behavior is appropriate for the level of alert required for your dog to get your attention. Avoid using barking as an alert as it is disruptive when in public. The only time you might use a bark alert is when the dog needs to get you help from strangers during an emergency.

B. Having a helper (for at least the middle part of the training process) to make the sound or set off a gadget from other locations makes your job much easier and is clearer for the dog.

C. Choose Your First Sound Carefully.
If this is your first time training this behavior, it is a good idea to train a sound that is not likely to be heard in your environment (home, work or play). This way, you can use it to learn to train a basic alert and can learn from your mistakes before training more important alerts.

Ensure the gadget you choose:
-Is one that you can turn on and off quickly and easily with no fumbling
-The gadget making the sound will not wear out before you are done training
-The gadget can be set to go off at whim and in one minute (or less) intervals

Probably the easiest sound to start on is a knock (on the door) that needs no equipment.

When choosing a gadget that makes a sound, choose a sturdy one with big buttons. The first alarm clock I used was a small travel alarm and it was difficult to set and wind quickly and wore out after just three training sessions. I then tried to use sounds from the a computer but that was awkward, didn’t allow me to set them off as quickly as I needed to keep my dog’s interest at first and I wasn’t able to move the computer around to generalize the sound to different locations/rooms. I also tried a digital alarm but that combined the drone alarm with the radio noise and this was not a pure enough sound for my dog to understand what I wanted.

From a second hand store, I bought an old sturdy wind up alarm clock and that saw us through training the first 1 and 2 way sound alerts. This worked well enough when I was first training one way alerts and when I had a helper for distance and two way alerts. It worked well enough to train my dog when I was training alone from other rooms but it took a minimum of 10 minutes to go off after being set.

Ideally, sound alarms should be ones that can also be set to go off within a minute of setting it and more as your dog progresses in training.

It really helps your dog get the idea if the rate of repetitions is high for the first few training sessions until your dog understands what to do for the basic behavior. Once your dog understands the behavior, then you can use other new sounds that are harder to replicate.

See also posts (alert 1.1, 1.2, 1.3)