December 2017: Autism Spectrum Disorders
Spotlight on Aquatics & Autism Spectrum Disorders
THE POOL IS CUSTOM-MADE FOR TREATING CONDITIONS ASSOCIATED WITH AUTISM
Content courtesy of the National Swimming Pool Foundation
Recent PUBLICATIONS WHICH show how WATERWORKS for autism
Therapists and caregivers have a powerful weapon in their fight against autism: water. The bathtub, shower, or public pool can offer countless opportunities to tame transitional stresses, promote social encounters, correct out-of-kilter motor systems, and promote sensory integration. In water, children have the power to harness buoyancy, viscosity, turbulence, surface tension, refraction, and thermal shifts. Aquatic therapy offers so much promise for this population that entire therapy pools have been designed with these children in mind.
As always in the field of physical medicine, research lags behind anecdotal evidence. Intuitively, many pediatric clinicians believe in the power of the pool. In the literature, clinicians have reported a substantial increase in swim skills, attention, muscle strength, balance, tolerating touch, initiating/maintaining eye contact, and water safety during their sessions with young children with autism. Providers who require assistance creating aquatic treatment ideas and skill-specific challenges can benefit from reading their findings.
To date, there are few gold-standard clinical trials which support aquatic therapy for the treatment of autism. This is interpreted—in all probability, prematurely—by some as a reason to deny aquatic therapy for this diagnosis. This represents a fundamental misunderstanding of what aquatic therapy is. Insurers who deny aquatic therapy, yet readily approve of their land-based counterparts, do not understand that the pool is just another tool. Much like a therapeutic ball, a bolster, a mat or a swing, the pool is a means to an end, not a treatment in and of itself.
Truly, there is no such procedure as aquatic therapy. Instead, there is neuromuscular re-education, trained in the water. Or therapeutic exercise performed in a space dominated by buoyancy. Or sensory training practiced in a room overloaded with warm, viscous molecules. Insurers who would never consider denying therapists the right to use a splash-table or bucket in the clinic have little leg to stand on when denying those same clinicians the right to a “really big” pail.
Many clinicians believe that children with autism have difficulty with change because they are unable to distinguish relevant from irrelevant information, resulting in huge difficulties with decision-making. Such kids often cannot “make up their minds” or make a simple A-versus-B choice. These kids have a need for sameness and have a strong need for rituals and routine. Free time is very difficult for them to manage. Additionally, children with autism have organizational and sequencing problems. These children don’t know where to start, what comes next, or when a task is finished. The child’s life can become one long series of tragic interruptions.
Enter the pool. In addition to the normal therapy pursuits of strengthening, balance training, and range of motion (ROM), the pool is an excellent location to work on:
- Transitional stress
- Social interactions
- Body awareness and kinesthesia
- Tactile processing
- Vestibular processing, and
- Visual processing
Water activities can provide autistic children with the opportunity to embrace change. Even the act of entering the pool from the deck is a massive leap into uncertainty, and parents looking for ways to promote acceptance of change can use the pool for this end …and beyond.
RECENT ANNOTATED REFERENCES
Alaniz, M. L., Rosenberg, S. S., Beard, N. R., & Rosario, E. R. (2017). The effectiveness of aquatic group therapy for improving water safety and social interactions in children with autism spectrum disorder: a pilot program. Journal of Autism and Developmental Disorders, 47(12), 4006–4017. Retrieved from https://link.springer.com/article/10.1007/s10803-017-3264-4
Benedita, M., Pardo, L., & Israel, V. L. (2014). Hydrotherapy: Application of an Aquatic Functional Assessment Scale ( AFAS ) in Aquatic Motor Skills Learning. American International Journal of Contemporary Research, 4(2), 42–52. Retrieved from https://ri.ufs.br/handle/riufs/7382
Bukowski, E. (2017). Aquatic Exercise. In C. Kisner, L. A. Colby, & J. Borstad (Eds.), Therapeutic Exercise: Foundations and Techniques (pp. 295–316). Retrieved from https://books.google.com/books?hl=en&lr=&id=yZc6DwAAQBAJ&oi=fnd&pg=PA295&dq=autism+and+aquatic&ots=Neq3DXjCUf&sig=RgHY4U6QviovWtc2xo-Vup6bGmI#v=onepage&q=autism%20and%20aquatic&f=false
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