December 2018: Aquatics & Congenital Disorders



Content courtesy of the National Swimming Pool Foundation


There are many compelling reasons for choosing to treat children with congenital disorders in the pool, not the least of which may be the child’s own preference. Children generally find the pool fun and often do not seem to notice that they are doing therapeutic activities, working hard and making progress in their functional skills. As anyone who works with children knows, play is a child’s work. Since they see aquatic activity as play, they’re motivated to participate. 

That said, there are excellent reasons to choose the pool for children with special needs. On land, children who cannot control their head or trunk often require the use of special seating systems for positioning. In water, the skilled therapist or instructor can position a patient in a vertical, upright position without the use of special floats or a second pair of hands. It can be extremely encouraging for kids to work in such a freeing environment. When working on head and trunk righting or control, the water allows more time for the body to give and receive feedback in order to make an appropriate physical response. 

What’s more, the pool often permits children to participate in activities that are unachievable on land. As just one example, the water is an excellent medium to elicit weight shifting. A weight shift can occur accidentally or be initiated by the child or treating therapist, but movement is always a result and it stimulates righting reactions. Practice shifting their weight without falling helps children improve overall postural control. Buoyancy aids in the child obtaining proper postural alignment with less handling and greater ease. Proper alignment increases the child’s ability to promote motor learning and recruit proper muscles for improved head and trunk righting and control.

Impeded head and trunk control often results in reduced movement control overall. The pool provides a “viscous” (think sticky) environment in which to work; this environment then slows any movements (including falling) and constantly provides feedback to falling. In other words, the pool helps the child take risks without catastrophic consequences, thus allowing freedom to play, explore, and act as all children act on occasion—without restraint!


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