Journal of Autism and Developmental Disorders

, Volume 47, Issue 12, pp 4006–4017 | Cite as

The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social Interactions in Children with Autism Spectrum Disorder: A Pilot Program

  • Michele L. Alaniz
  • Sheila S. Rosenberg
  • Nicole R. Beard
  • Emily R. Rosario
Original Paper

Abstract

Drowning is the number one cause of accidental death in children with Autism Spectrum Disorder (ASD). Few studies have examined the effectiveness of swim instruction for improving water safety skills in children with moderate to severe ASD. This study examines the feasibility and effectiveness of an aquatic therapy program on water safety and social skills in children with mild to severe ASD (n = 7). Water safety skills were evaluated using the Aquatics Skills Checklist and social skills were measured using the Social Skills Improvement Scale. We provide preliminary evidence that children with ASD can improve water safety skills (p = 0.0002), which are important for drowning prevention after only 8 h of intervention. However, social skills did not respond to intervention (p = 0.6409).

Keywords

Aquatic therapy Autism spectrum disorder Social skills Occupational therapy Swimming Drowning prevention 

Notes

Acknowledgments

The authors would like to thank Dr. Loverso and the Casa Colina Board of Directors, Cindy Sendor and the Casa Colina Centers for Rehabilitation Foundation for supporting this research. We would also like to thank Gabriel Alaniz, Aisha Babb, Amber Gray, Christina Kang, Michelle Lam, Michelle Lee, Genesis Lopez, Kyra Ray, Alexis Smith, and Lacy Wright for their involvement in study recruitment and testing.

Funding

This research followed all accepted principles of ethical and professional conduct. Funding for this study was provided by Casa Colina Centers for Rehabilitation Foundation.

Authors’ Contribution

MLA conceived of the study, participated in the design and coordination of the study, performed the measurement, participated in the design and interpretation of the data, and drafted the manuscript; SRR participated in the design and coordination of the study and of the data, performed the statistical analysis and helped to draft the manuscript; NRB participated in the design and coordination of the study, performed the measurement, and helped draft the manuscript; ERR participated in the design and interpretation of the data, performed statistical analysis and helped draft the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

No conflicts of interest, financial or non-financial, were identified.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Aleksandrovic, M., Jorgic, B., Block, M., & Jovanovic (2015). The effects of aquatic activities on physical fitness and aquatic skills in children with autism spectrum disorders: A systematic review. Physical Exercise and Sport, 13(3), 351–362.Google Scholar
  2. APA (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  3. Bellini, S., & Peters, J. K. (2008). Social skills training for youth with autism spectrum disorders. Child & Adolescent Psychiatric Clinics of North America, 17(4), 857–873. doi: 10.1016/j.chc.2008.06.008.CrossRefGoogle Scholar
  4. Brenner, R. A., Saluja, G., & Smith, G. S. (2003). Swimming lessons, swimming ability, and the risk of drowning. Injury Control and Safety Promotion, 10(4), 211–216. doi: 10.1076/icsp.10.4.211.16775.CrossRefPubMedGoogle Scholar
  5. Brenner, R. A., Taneja, G. S., Haynie, D. L., Trumble, A. C., Qian, C., Klinger, R. M., et al. (2009). Association between swimming lessons and drowning in childhood: A case-control study. Archives of Pediatrics and Adolescent Medicine, 163(3), 203–210. doi: 10.1001/archpediatrics.2008.563.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Christensen, D. L., Baio, J., Van Naarden Braun, K., Bilder, D., Charles, J., Constantino, J. N., et al. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years–autism and developmental disabilities monitoring network, 11 sites, United States, 2012. Morbidity and Mortality Weekly Report Surveillance Summaries, 65(3), 1–23. doi: 10.15585/mmwr.ss6503a1.PubMedGoogle Scholar
  7. Chu, C., & Pan, C. Y. (2012). The effect of peer- and sibling-assisted aquatic program on interaction behaviors and aquatic skills of children with autism spectrum disorders and their peers/siblings. Research in Autism Spectrum Disorders, 6, 1211–1223.CrossRefGoogle Scholar
  8. Dellinger, A., & Gilchrist, J. (2017). Leading causes of fatal and nonfatal unintentional injury for children and teens and the role of lifestyle clinicians. American Journal of Lifestyle Medicine. doi: 10.1177/1559827617696297.Google Scholar
  9. Doig, E., Fleming, J., Kuipers, P., & Cornwell, P. L. (2010). Clinical utility of the combined use of the Canadian occupational performance measure and goal attainment scaling. American Journal of Occupational Therapy, 64(6), 904–914.CrossRefPubMedGoogle Scholar
  10. Ennis, E. (2011). The effects of a physical therapy-directed aquatic program on children with autsim spectrum disorders. The Journal of Aquatic Physical Therapy, 19(1), 4–10.Google Scholar
  11. Fragala-Pinkham, M. A., Haley, S. M., & O’Neil, M. E. (2011). Group swimming and aquatic exercise programme for children with autism spectrum disorders: a pilot study. Developmental Neurorehabilitation, 14(4), 230–241. doi: 10.3109/17518423.2011.575438.CrossRefPubMedGoogle Scholar
  12. Gilchrist, J., Parker, E. M., Centers for Disease Control & Prevention. (2014). Racial/ethnic disparities in fatal unintentional drowning among persons aged </= 29 years - United States, 1999–2010. Morbidity and Mortality Weekly Report, 63(19), 421–426.PubMedGoogle Scholar
  13. Gresham, F. M., & Elliott, S. N. (2008). Social skills improvement system: Rating scales. Bloomington, MN: Pearson Assessments.Google Scholar
  14. Howlin, P., Savage, S., Moss, P., Tempier, A., & Rutter, M. (2014). Cognitive and language skills in adults with autism: A 40-year follow-up. Journal of Child Psychology and Psychiatry, 55(1), 49–58. doi: 10.1111/jcpp.12115.CrossRefPubMedGoogle Scholar
  15. Lawson, L. M., & Foster, L. (2016). Sensory patterns, obesity, and physical activity participation of children with autism spectrum disorder. American Journal of Occupational Therapy. doi: 10.5014/ajot.2016.021535.PubMedGoogle Scholar
  16. Little, L. M., Sideris, J., Ausderau, K., & Baranek, G. T. (2014). Activity participation among children with autism spectrum disorder. American Journal of Occupational Therapy, 68(2), 177–185. doi: 10.5014/ajot.2014.009894.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Mactavish, J. B., Lutfiyya, Z. M., & Mahon, M. J. (2000). “I can speak for myself”: Involving individuals with intellectual disabilities as research participants. Mental Retardation, 38(3), 216–227. doi: 10.1352/0047-6765(2000)038<0216:ICSFMI>2.0.CO;2.CrossRefPubMedGoogle Scholar
  18. Mailloux, Z., May-Benson, T. A., Summers, C. A., Miller, L. J., Brett-Green, B., Burke, J. P., et al. (2007). Goal attainment scaling as a measure of meaningful outcomes for children with sensory integration disorders. American Journal of Occupational Therapy, 61(2), 254–259.CrossRefPubMedGoogle Scholar
  19. McDougall, J., & Wright, V. (2009). The ICF-CY and goal attainment scaling: Benefits of their combined use for pediatric practice. Disability and Rehabilitation, 31(16), 1362–1372. doi: 10.1080/09638280802572973.CrossRefPubMedGoogle Scholar
  20. McIIwain, L., & Fournier, W. (2012). Lethal outcomes In Autism Spectrum Disorders (ASD) Wandering/Elopement. Attleboro Falls: National Autism Association.Google Scholar
  21. Miller, L. J., Coll, J. R., & Schoen, S. A. (2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy, 61(2), 228–238.CrossRefPubMedGoogle Scholar
  22. Morrongiello, B. A., Sandomierski, M., Schwebel, D. C., & Hagel, B. (2013). Are parents just treading water? The impact of participation in swim lessons on parents’ judgments of children’s drowning risk, swimming ability, and supervision needs. Accident Analysis & Prevention, 50, 1169–1175. doi: 10.1016/j.aap.2012.09.008.CrossRefGoogle Scholar
  23. Ottenbacher, K. J., & Cusick, A. (1993). Discriminative versus evaluative assessment: some observations on goal attainment scaling. American Journal of Occupational Therapy, 47(4), 349–354.CrossRefPubMedGoogle Scholar
  24. Pan, C. Y. (2010). Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders. Autism: The International Journal of Research and Practice, 14(1), 9–28. doi: 10.1177/1362361309339496.CrossRefGoogle Scholar
  25. Pan, C. Y., Tsai, C. L., & Chu, C. H. (2009). Fundamental movement skills in children diagnosed with autism spectrum disorders and attention deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 39(12), 1694–1705. doi: 10.1007/s10803-009-0813-5.CrossRefPubMedGoogle Scholar
  26. Pan, C. Y., Tsai, C. L., & Hsieh, K. W. (2011). Physical activity correlates for children with autism spectrum disorders in middle school physical education. Research Quarterly for Exercise and Sport, 82(3), 491–498. doi: 10.1080/02701367.2011.10599782.CrossRefPubMedGoogle Scholar
  27. Rogers, S. J., Young, G. S., Cook, I., Giolzetti, A., & Ozonoff, S. (2010). Imitating actions on objects in early-onset and regressive autism: Effects and implications of task characteristics on performance. Development and Psychopathology, 22(1), 71–85. doi: 10.1017/S0954579409990277.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Schnake, E. M., Peterson, N. M., & Corden, T. E. (2005). Promoting childhood water safety: The physician’s role. The Wisconsin Medical Journal, 104(2), 45–49.PubMedGoogle Scholar
  29. Shavelle, R. M., Strauss, D. J., & Pickett, J. (2001). Causes of death in autism. Journal of Autism and Developmental Disorders, 31(6), 569–576.CrossRefPubMedGoogle Scholar
  30. Staples, K. L., & Reid, G. (2010). Fundamental movement skills and autism spectrum disorders. Journal of Autism and Developmental Disorders, 40(2), 209–217. doi: 10.1007/s10803-009-0854-9.CrossRefPubMedGoogle Scholar
  31. Steenbeek, D., Ketelaar, M., Galama, K., & Gorter, J. W. (2007). Goal attainment scaling in paediatric rehabilitation: A critical review of the literature. Developmental Medicine & Child Neurology, 49(7), 550–556. doi: 10.1111/j.1469-8749.2007.00550.x.CrossRefGoogle Scholar
  32. Trombly, C. A., Radomski, M. V., Trexel, C., & Burnet-Smith, S. E. (2002). Occupational therapy and achievement of self-identified goals by adults with acquired brain injury: Phase II. American Journal of Occupational Therapy, 56(5), 489–498.CrossRefPubMedGoogle Scholar
  33. Weiss, J., & American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. (2010). Prevention of drowning. Pediatrics, 126(1), e253–e262. doi: 10.1542/peds.2010-1265.CrossRefPubMedGoogle Scholar
  34. Whyatt, C. P., & Craig, C. M. (2012). Motor skills in children aged 7–10 years, diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders, 42(9), 1799–1809. doi: 10.1007/s10803-011-1421-8.CrossRefPubMedGoogle Scholar
  35. Yanardag, M., Akmanoglu, N., & Yilmaz, I. (2013). The effectiveness of video prompting on teaching aquatic play skills for children with autism. Disability and Rehabilitation, 35(1), 47–56. doi: 10.3109/09638288.2012.687030.CrossRefPubMedGoogle Scholar
  36. Yanardag, M., Erkan, M., Yilmaz, I., Arican, E., & Duzkantar, A. (2015). Teaching advance movement exploration skills in water to children with autism spectrum disorders. Research in Autism Spectrum Disorders, 9, 121–129. doi: 10.1016/j.rasd.2014.10.016.CrossRefGoogle Scholar
  37. Yilmaz, I., Birkan, B., Konukoman, F., & Erkan, M. (2005). Using a constant time delay procedure to teach aquatic play skills to children with autism. Education and Training in Autism and Developmental Disabilities, 40(2), 171–182.Google Scholar
  38. Yilmaz, I., Birkan, B., Konukoman, F., & Yanarda, M. (2010). Effects of most to least prompting on teaching simple progression swimming skill for children with autism. Education and Training in Autism and Developmental Disabilities, 45(3), 440–448.Google Scholar
  39. Yilmaz, I., Yanarda, M., Birkan, B., & Bumin, G. (2004). Effects of swimming training on physical fitness and water orientation in autism. Pediatrics International, 46(5), 624–626. doi: 10.1111/j.1442-200x.2004.01938.x.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Children’s Services CenterCasa Colina Hospital and Centers for HealthcarePomonaUSA
  2. 2.Casa Colina’s Research InstitutePomonaUSA
  3. 3.Curative New Berlin TherapiesNew BerlinUSA
  4. 4.Children’s Services CenterUniversity of Southern CaliforniaLos AngelesUSA

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