March 2018: Autism and Sensory Disorders

Spotlight on Aquatics & Autism & Sensory Disorders

Swimming and AutismThe pool is a special place for children on the autism spectrum. For one, the potential for sensory modulation in the pool is almost unlimited. When working in water, it is possible for therapy to resemble fun and not exercise, especially if music and games are used to promote goals such as relaxation of facilitation. In the pool, it is possible to include both the mind and body in programming and thus tap into sensation, emotions, creativity, imagery, and relaxation. 
Aquatic sessions can even become family events where siblings and parents are able to engage with children in an environment that serves as the great equalizer. Here are just a few of the benefits of aquatics available to the pediatrics population:
  • Application of weight-bearing in a graded or progressive manner;
  • Increase in proprioceptive awareness during exercise and functional task simulation;
  • Application of resistance in a graded or progressive manner;
  • Assistance in limb movements against gravity (assisted by buoyancy);
  • Encouragement of socialization in a “normal” recreational environment which offers noncompetitive fun and socialization;
  • Provision of safe environment in which to “fail”;
  • Provision of environment where competition and emulation of peers is natural;
  • Provision of environment where hydrostatic pressure provides natural resistance to inspiration;
  • Retardation of muscle atrophy and contractures which may occur in the absence of exercise;
  • Decrease in muscle tone and spasticity;
  • Provision of an environment which can eventually be “barrier-free” and free of assistive devices;
  • Provision of an environment in which it is possible to treat multiple problems at once without seeming like “work” to the child;
  • Provision of safety education in water to promote follow-through as adults.
Even schools are getting into the mix, with specialized “pool classrooms” being designed into autism rehabilitation centers. Although the pool is not a panacea, it does offer a unique opportunity to couple ease and effort, stimulation and relaxation and much more. And these amazing benefits can be as close at hand as the neighborhood swimming pool.
Recent publications: Systematic Reviews & Meta-Analysis
Aleksandrovic, M., Jorgic, B., & Block, M. (2016). The effects of aquatic activities on physical fitness and aquatic skills in children with autism spectrum disorders: A systematic review. Education and Sport, 13(3), 351–362. Retrieved from
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
Busst, C. (2015). Exercise as an intervention for children with Autism Spectrum Disorder: Perspectives of education professionals. Birmingham City University. Retrieved from
Case-Smith, J., Weaver, L. L., & Fristad, M. a. (2014). A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism: The International Journal of Research and Practice, 19(January), 133–48.
Caputo, G., Ippolito, G., Mazzotta, M., Sentenza, L., Muzio, M. R., Salzano, S., & Conson, M. (2018). Effectiveness of a Multisystem Aquatic Therapy for Children with Autism Spectrum Disorders. Journal of autism and developmental disorders, 1-12.
Pan, C. Y. (2010). Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders. Autism, 14(1), 9-28. 
Eversole, M., Collins, D. M., Karmarkar, A., Colton, L., Quinn, J. P., Karsbaek, R., … Hilton, C. L. (2016). Leisure Activity Enjoyment of Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 46(1), 10–20.
Fabrizi, S. (2015). Splashing Our Way to Playfulness! An Aquatic Playgroup for Young Children With Autism, A Repeated Measures Design. Journal of Occupational Therapy, Schools, & Early Intervention, 8(4), 292–306. Retrieved from
Franzen, K., & Tryniszewski, P. (2013). Effectiveness of Aquatic Therapy for Children with Neurodevelopmental Disorders: Systematic Review of Current Literature. The Sage Colleges. Retrieved from 
Grosse, S. (2014). Aquatic safety for individuals with autism spectrum disorders. International Journal of Aquatic Research and Education, 8(3), 295–301. Retrieved from
Jackson, J., Cosbey, J., & Meyer, W. (2015). Influence of Adaptive Water Sports Programs on Quality of Life Perceptions for People with Disabilities: A Feasibility Study. University of New Mexico. Retrieved from
Jull, S., & Mirenda, P. (2015). Effects of a Staff Training Program on Community Instructors’ Ability to Teach Swimming Skills to Children With Autism. Journal of Positive Behavior Interventions, 18(1), 29–40.
Kafkas, A. Ş. A., Gökmen, Ö., & Özen, G. (2015). Teaching of Swimming Technique to Children with Autism: A Pilot Study. Journal of Rehabilitation and Health on Disability, 1(1), 12–20. Retrieved from
Kensinger, K., Bates, S., Breuer, S., Johnson, E., Rhode, K., & Webber, D. (2018). The benefits of aquatic therapy as determined by a Pairwise Thematic Content Analysis of the peer-reviewed journals in therapeutic recreation. American Journal of Recreation Therapy, 16(4), 13-21.
Klein, N., & Kemper, K. (2016). Integrative approaches to caring for children with autism. Current Problems in Pediatric and Adolescent Health Care, 46(6), 195–201. Retrieved from
Lisa Mische Lawson, P. C., Megan Mazurowski, O., Sarah Petersen, O., & Lawson, L. M., Mazurowski, M., & Petersen, S. (2017). Sensory processing patterns and swim skill acquisition of children with autism spectrum disorder. American Journal of Recreation Therapy, 16(2), 29–40. 
Menear, K., & Neumeier, W. (2015). Promoting Physical Activity for Students with Autism Spectrum Disorder: Barriers, Benefits, and Strategies for Success. Journal of Physical Education, Recreation & Dance, 86(3), 43–48. Retrieved from
Mortimer, R., Privopoulos, M., & Kumar, S. (2014). The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: A systematic review. Journal of Multidisciplinary Healthcare, 7, 93–103.
Najafabadi, M. G., Sheikh, M., Hemayattalab, R., Amir, M., Rezaii, M., & Hafizi, S. (2018). The effect of SPARK on social and motor skills of children with autism. Pediatrics & Neonatology.
Oriel, K. N. K., Kanupka, J. W. J., DeLong, K. S., & Noel, K. (2014). The Impact of Aquatic Exercise on Sleep Behaviors in Children With Autism Spectrum Disorder A Pilot Study. Focus on Autism and Other Developmental Disabilities, 31(4), 254–261.
Shams-Elden, M., & Mohamed, S.-E. (2017a). Effect of aquatic exercises approach (Halliwick Therapy) on motor skills for children with austism spectrum disorders. Ovidius University Annals, Series Physical Education and Sport, 17(2), 490–496. Retrieved from Mohamed 1.pdf
Tanner, K., Hand, B., O’Toole, G., & Lane, A. (2015). Effectiveness of interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with autism spectrum disorder: A. The American Journal of Occupational Therapy, 69(5), 12. Retrieved from
Yanardag, M., Erkan, M., & Yılmaz, İ. (2015). Teaching advance movement exploration skills in water to children with autism spectrum disorders. Research in Autism Spectrum Disorders, 9(1), 121–129. Retrieved from