Aquatic Programming for Children with Autism Spectrum Disorder

A Thesis Submitted in Partial Fulfillment of the Requirements of the Renée Crown University Honors Program at

Syracuse University

Grace Hale

Candidate for Bachelor of Science and Renée Crown University Honors

May 2020

Honors Thesis in Exercise Science

Thesis Advisor: _______________________ Dr. Michael Norris

Thesis Reader: _______________________

Lindsey White, PhD Candidate

Honors Director: _______________________ Dr. Danielle Smith, Director

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Abstract

As a requirement of the Renee Crown Honors College, this Honors Thesis project provides a tool for swimming instructors, aquatic professionals, and parents to assist in teaching swimming, specifically to those with Autism Spectrum Disorder. The goals of this project include developing aquatic competency for children with disability as drowning continues to be one of the most common causes of death for children and the number one cause of death for children with Autism (CDC, 2018). This document explains ways children with Autism can develop aquatic safety, while also giving parents and aquatic instructors necessary skills to teach the child in an aquatic environment. The aquatics program described in this paper is designed specifically for families and children with ASD. The outlined activities were compiled into a deliverable booklet that is sorted by skill (low-high). Activities identified in this booklet correlate with skills sourced from the book Assessments and Activities for Teaching Swimming (Lepore, Columna, & Friedlander- Litzner, 2015) and are used as a reference to the work in this thesis. The booklet serves to advise families of children with Autism Spectrum Diagnoses on how to best facilitate aquatic learning and safety.

Key Words: Autism, Swimming, Aquatic Skills, Parents

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Executive Summary

As a part of the Renée Crown Honors Program students are required to complete a

senior thesis project. This project serves to advise families of children with Autism

Spectrum Diagnoses on how to best facilitate aquatic learning and safety. The project was

inspired by my involvement with the Fit Families program and includes two parts: a

written paper and a deliverable, take home booklet for participants of the program to

utilize.

Goals of this project are broad and encompass both aquatic safety and learning.

Drowning continues to emerge as one of the most common causes of death for children and

the number one cause of death for children with Autism (Unintentional Drowning: Get the

Facts, 2016). Children with Autism generally tend to have issues with physical activity, for

a variety of reasons. Swimming and other aquatic activities are a great source of physical

activity for everyone, but especially for children and those with Autism. Swimming is

extremely beneficial as it can have long reaching physical and social effects. This thesis will

provide insight as to why more consistent, goal oriented, and meaningful practice sessions

and swim programs will be beneficial and important. The take-home booklet will be a tool

for families to utilize in hopes of encouraging long lasting learning of aquatic skills as well

as proper implementation and use of them.

This Honors thesis project will provide context as to why these topics are so

important by explaining the benefits of swimming for children with Autism, as well as

highlighting research to support this claim. This document provides an explanation for the

best ways children with Autism can improve their knowledge surrounding aquatic safety.

This requires an understanding of what challenges this population may face in terms of

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learning, social situations, and physical incapabilites. Another goal of this project is to help

parents and aquatic instructors learn the best ways to teach aquatic skills. The book is a

collection of activities which will benefit the target population and is presented in a

manner that is easy for parents and instructors to utilize.

The target audience for this project are parents or instructors of children with

Autism. To clarify misconceptions and define terms throughout this booklet for the reader,

operational definitions based on the literature will provide guides for the use of these

terms throughout the document.

Autism and/or Autism Spectrum Disorder is a developmental neurobiological

disorder characterized by severe and pervasive impairments in reciprocal and social

interactions and communication skills, and by restricted, repetitive, and stereotyped

behavior, interests, and activities (Lubetsky, Handen & McGonigle, 2011). It is referred to

as a spectrum disorder due to the fact that individuals with this diagnosis can have

significant variations in social, communicative, and/or intellectual abilities (Campisi,

Imran, Nazeer, Skokauskas & Azeem, 2018). Many individuals with this diagnosis benefit

from Adapted Physical Education (APE) which refers to any adaptation to the physical

education curriculum that allows for safe, successful, and satisfying participation of a

student with a disability, including specially designed instruction (Lepore, Gayle & Stevens,

1998). In APE, children, with or without special needs, participate in a physical activity

evaluation, they are evaluated on their fundamental motor skills. These are the basic

movements that are considered to be the building blocks for more advanced movement,

allowing individuals to function fully and independently in their environment, contributing

to cognitive, social, motor, and physical growth (Robinson & Goodway, 2009). The Fit

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Families program was created by Dr. Luis Columna at Syracuse University. The program

is designed to increase physical activity opportunities for children with Autism across a

host of physical activities including aquatics where children and their parents were taught

to use adaptive equipment and given instructions to stimulate interest in games and

activities (Columna, 2016). In this program, children were given an assessment called The

Test of Gross Motor Development II which is widely used to evaluate the children’s

fundamental motor skills, including both locomotor (run, jump, hop, skip, etc.) and

manipulative skills (throw, strike, kick, etc.) (Garn & Webster, 2018). The test measures the

gross motor abilities which develop earlier in life, in children ages three to ten years old,

and can be taught to children in preschool, early elementary, and special education classes

(Ulrich, 2000). These skills are predictors of physical activity development over time for

children for land physical activities.

The Fit Families program provided an adapted aquatic program for the children and

their families. Adapted aquatics is a comprehensive label for programs serving individuals

with disabilities that use swimming, water safety, and aquatic recreational activities to

promote health and rehabilitation. Such programs encompass more than swim strokes, but

do not include therapeutic water exercise, hydrotherapy, or aquatic therapy (Lepore et al.,

1998).

During Fit Families program, the Texas Woman’s University (TWU) Assessment was

used to evaluate the skills of the participants and their parents. The TWU is an Aquatic

Assessment, designed by Carol Huettig in 1998 (Lepore et al., 2015). This assessment

divides aquatic skills into five categories, and six levels of difficulty with level 1 being the

simplest and level 6 being the most advanced. These skills range in difficulty from pool and

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water orientation, to floating, swim strokes, jumping, treading, diving, and more. The use

of this tool helped program facilitators understand how best to work with each child based

on their individual needs and skill set.

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Table of Contents

Acknowledgements ................................................................................................................................... 8

Introduction ............................................................................................................................................... 9

Literature Review .................................................................................................................................... 15

Methods ..................................................................................................................................................... 22

Conclusion ................................................................................................................................................. 25

References ................................................................................................................................................. 26

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Acknowledgements

I would like to acknowledge everyone who has helped and guided me through my time at Syracuse University. Most importantly, Dr. Michael Norris, who has been an incredible advisor and mentor over the past two years. He has taught me so much and I have immensely enjoyed the opportunity to work with him. I would also like to thank Dr. Luis Columna who introduced me to the Fit Families project and encouraged me to continue to research and work with him, ultimately inspiring this project. Thank you to Dr. Beth Myers and Lindsey White, who have served as my project readers, helping me edit and improve my work to its highest quality. I would also like to acknowledge all of the faculty in the Renée Crown Honors College and the Syracuse University School of Education who have encouraged my learning both in and out of the classroom. Lastly, I would like to thank my family and friends, who continue to support all of my academic and nonacademic endeavors.

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Introduction

Autism Spectrum Disorder (ASD) is a developmental disability characterized by

social, communication, and behavioral challenges (CDC, 2018). Since this disorder has so

much variability in the way it presents itself, it is considered a spectrum disorder, meaning

that it can range from mild impact to severe impact. Most individuals with ASD may show

reduced interest in other people or objects, may have trouble relating to peers, sometimes

avoid eye contact, and may have difficulty expressing their wants and needs using typical

words or motions (CDC, 2018). ASD also presents with social difficulties, as well as

repetitive and restricted interests and behaviors (Pan, 2011). One example of this is

stimming, in which individuals with Autism use behaviors such as hand flapping, body

rocking, pacing, word repetition, chewing, or biting to soothe themselves (Masiran, 2018).

Stimming is a self-regulating mechanism which may help to relieve overwhelming

emotions such as excitement, fear, and anger and is thought to help prevent individuals

with Autism from getting to overwhelmed or upset (Masiran, 2018). Echolalia is another

behavior that individuals with Autism often engage in. It is a verbal action which is a

repetition of the words of others (Grossi, Marcone, Cinquegrana & Gallucci, 2013). Both of

these are examples of mechanisms that people with Autism can use to make themselves

feel secure and comfortable and may be observed in an aquatic environment.

Many individuals with this disorder have difficulties with motor development.

Although this is not a primary category for classifying or diagnosing Autism, it is a

commonality that individuals with ASD will have delays in gross motor development, fine

motor development, motor control, and visual motor tasks (Pan, 2011). These delays limit

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opportunities for growth and development as well as academic achievement, and can stick

with people for life, seriously impacting their physical health (Pan, 2011). Since individuals

with Autism often have social challenges, they may not enjoy sports and other activities.

This is because of motor development delays; these individuals may not have much success

with physical activity and become easily frustrated. This leads to serious health

implications as individuals do not get adequate exercise and become increasingly at risk for

chronic health issues such as cardiovascular disease, obesity, hypertension, and joint pain

(Hill et al., 2015). These challenges can be physically taxing on the body and lead to a

decrease in quality of life and an increased morbidity rate. The goal in working with

individuals with Autism is to increase physical activity and one way to do this is in a fun

environment such as swimming.

Drowning is currently the second leading cause of death in children ages 1-14 (CDC,

2019) and the number one cause of accidental death in children with Autism (Alaniz et al.,

2017) highlighting the importance of the need for safety in aquatic environments.

Teaching children basic aquatic skills can help to reduce the likelihood of drowning as they

become more confident in themselves and their abilities in an aquatic setting. Swimming is

an important skill for children to acquire as it offers a myriad of benefits such as enhancing

physical health, providing opportunities for social interaction, and it is a generally

enjoyable activity (Alaniz et al., 2017). Many children with Autism enjoy swimming; it

offers more benefits and is often easier than other sports or physical activities (Prupas et

al., 2006). For example, aquatic activities offer individuals the ability to practice

movements in a weightless situation, removing some physical body constraints. This will

likely lead to more success and enjoyment over time (Prupas et al., 2006). Parents also

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found swimming to be a favorable activity since it is available in the community and can

continue over the lifespan in many capacities (Prupas et al., 2006). Since swimming offers

many social, physical, and health beneficial opportunities for growth and development to

children on the Autism Spectrum, introducing them to an aquatic environment at a young

age allows them to progress and continue to reap benefits from this activity throughout

their lives.

Swimming is an excellent option for physical activity for those both with and

without ASD. It is an activity which involves movement of the entire body with strength

and endurance components and can be done inside or outside and year round. It can also

be adapted to suit the most basic to the most advanced skill levels. For people with motor

difficulties, swimming is an ideal activity primarily due to the fact that the buoyancy of the

water and the decreased effect of gravity lead to less environmental constraints, making it

easier for a person to control and manipulate their body (Prupas et al., 2006). Children

with autism who normally struggle with proprioception and control and coordination of

movements of the body can be more successful in an aquatic environment. Proprioception

refers to the perception of joint and body movement and positioning in space and can be

very difficult for individuals with a variety of special needs (Ribeiro & Oliveira, 2007).

These experiences in the water are more likely to leave a lasting positive impression of

such activities and make individuals more likely to want to participate again in the future.

Swimming also presents opportunities for social interaction as most aquatic

environments are typically communal spaces, and many swim lessons take place in a group

of children around the same age and/or skill level. When swim instructors incorporate

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social interactions into activities, intentional interactions are more successful, and the

number of spontaneous social interactions increases (Alaniz et al., 2017). Swimming

includes many benefits for individuals with and without Autism, specifically by enhancing

physical health and social well-being.

The Fit Families program was created by Dr. Luis Columna at Syracuse University.

The program is designed to maximize physical activity opportunities for children with

Autism and their families (Davis et al., 2017) by using adaptive equipment and instructions

to stimulate interest in games and activities (Columna, 2016). Participants in the program

and their families came to Syracuse University to be evaluated on their baseline skills using

the Test of Gross Motor Development, 2nd edition (TGMD-2). The TGMD-2 is a commonly

used evaluation tool that measures motor ability; the criteria are divided into locomotor

skills and ball control skills (Kim et al., 2014). Embedded in the program were five

workshops: sensory integration, communication, physical activity and motor skills, aquatic

opportunities, and sports (Davis et al., 2017). During each workshop, the parents and

children have time to be instructed separately, then there is time for parents to teach and

work with their children on activities they learned (Davis et al., 2017). Each of the skills

taught in the workshops have corresponding activities and games which relate to each of

the skills included in the TGMD-2. Families are then given a booklet of the presented

activities, as well as all of the necessary equipment to take home with them, in hopes that

they will promote physical activity at home. A majority of the equipment they are given is

adapted, catering towards children with special needs including stomp rockets, Bosu balls,

and sensory balls. The booklets are a comprehensive guide that include instructions for all

the games, as well as links to videos demonstrating each activity. The purpose of this

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booklet is to make practice at home easier to facilitate in hopes of more frequent practice

sessions. The goal of Fit Families for children with Autism is to develop a consistent

practice schedule of these activities with the hopes of leading to a faster progression of

skills and more success with gross development in the long run.

This thesis emerged from my experience with Fit Families. During the third week of

the program, the families participate in an aquatic workshop. Participants have the

opportunity to enter the water and learn some games to help with basic safety and water

proficiency skills. Participants are evaluated using the TWU Aquatic Assessment, designed

by Carol Huettig in 1998 (Lepore et al., 2015). This assessment divides aquatic skills into

five categories, and six levels of difficulty with level 1 being the simplest and level 6 being

the most advanced. Unlike the land-based gym portion of the program, there is no take

home booklet or equipment following the aquatic portion. My goal for this honors thesis is

to synthesize a deliverable resource/guide, similar to the one that families receive when

they finish the gym portion of the program. It will include aquatic games, divided up by

skills that are featured in the TWU assessment. The original intent was to include images

which would correspond with each activity in the book1. Links to videos demonstrating

each skill were added in an attempt to supplement the written instruction. The goal for

this project is that families will take the book home to use whenever they go swimming and

for them to look to the section corresponding to the skill the child is developing and initiate

activities which target the development of that specific skill. This will hopefully reinforce

1 The original intent for this booklet was to photograph each activity with designated volunteer models to provide a visual guide of how each aquatic skill or activity should look in the pool setting, however, due to circumstances beyond our control, that option was not feasible. The materials in the booklet are referenced by web location and were added to supplement the written instruction and directions.

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the lessons learned in the workshop and lead to more successful and consistent practice

sessions and more improvement in the long term.

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Literature Review

The Department of Health and Human Services and the Department of Education

(2000) compiled a report for the president titled “Promoting Better Health for Young

People Through Physical Activity and Sports”. The report covers a general range of topics

including the general health status of young people in our country. The main conclusion is

that young people today are inactive, unfit, and increasingly overweight. The lack of

physical activity by young people reverses all of the work that has been done in hopes of

reducing cardiovascular disease, and it also places a significant financial burden on the

national health care system. The report states that young people will benefit the best from

families who model and support participation in activities, school programs which educate

and provide opportunities for quality physical education, afterschool programs which

facilitate regular active play, and community and structural environments which make it

safe and easy to walk, ride, and play outside. The report also states that children are

influenced by media campaigns which motivate them to exercise and be healthy. It is

important to understand that when health is poor amongst neurotypical children, those

with intellectual disabilities tend to have even more struggles.

In the doctoral dissertation titled “Physical Activity Patterns and Factors Influencing

Physical Activity Participation Among Adolescents with Physical Disabilities in Urban

Communities,” Ortiz-Castillo (2011), examines how outside determinants can impact the

way that young people view and participate in physical activity. The project works to

validate components of scales for use with adolescents with physical disabilities. It hopes

to construct a scale based on the Theory of Planned Behavior to assess determinants which

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promote and hinder activity participation in adolescents with disabilities, specifically in

urban communities. The results revealed that most participants did not meet the

established guidelines for the amount and duration of exercise they were completing,

making it clear that professionals need to work to find the best ways to encourage

participation in physical activity amongst this population. Ortiz-Castillo found that the

most important factors for adolescents with disabilities included perceived control over

doing the activity, having the appropriate resources, trusted figures encouraging

participation, and having desirable and important outcomes or consequences. These

results suggest that researchers and professionals should consider these determinants and

develop health promotion, physical activity, and education programs that are appropriate

for adolescents with physical disabilities. They should also work towards strategies which

can assist in encouraging participation. Ortiz-Castillo suggests that future researchers can

continue these studies by increasing their specificity and finding differences based on

gender, disability type, location, grade level, race/ethnicity, and functional characteristics

of students. This paper highlighted the importance of accounting for the many factors

which can influence students’ desire to participate in physical activity.

Obesity and Autism, written by Presmanes-Hill, Zuckerman, and Fombonne (2015)

examines the association between obesity and Autism. As obesity becomes increasingly

prevalent in the general population, specifically in children, it has been identified as a risk

factor for many chronic diseases. It has also been proven that there is a relationship

between obesity and ASD, such that those with an ASD diagnosis are at a higher risk for

unhealthy weight. In this study, the authors selected a sample of over 5000 children with

Autism from around the United States. Data were collected for each participant to examine

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possible relationships between variables. The data collected included information such as

sociodemographic, BMI, treatments received for ASD, general functioning and ability, and

other comorbid problems. The results of the study indicate that in children aged 2 to 17

years old, rates of obesity and overweight were significantly higher amongst those with an

ASD compared to those without. Other characteristics which showed higher risk of obesity

included older age, Hispanic or Latino ethnicity, less educated parents, and sleep problems.

The results of the study show that there is a significantly greater risk for obesity in children

with Autism, specifically aged 12-17 adolescents. Since it is known that children with

Autism have a greater risk for obesity in a population that already has a weight issue, these

results prove the need for more programs such as Fit Families. These initiatives aim to

stimulate patterns of physical activity and health in children at a young age, so they adapt

activities as part of their lifestyle and are healthier throughout their lifetime.

The book Assessments and Activities for Teaching Swimming, written by Lepore,

Columna, and Litzner (2015) is an extremely valuable tool for aquatic professionals

everywhere providing The Modified TWU Aquatic Assessment (Huettig, 1998). The tool

examines water adjustment skills, flotation skills, basic propulsion and breathing skills,

strokes, and entry and exit skills. This book discusses the importance of evaluation and

assessment, as it is a way to measure progress and improvement and to set and maintain

appropriate goals. The book then divides the TWU Aquatic Assessment into each skill and

provides activities to develop each skill. The activities are meant to be enjoyable, with

hopes that they will encourage participants to continue to practice and improve their

aquatic skills. The activities in the booklet that were created for this project are drawn

from this book. This source was an extremely valuable tool throughout this thesis. It is a

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comprehensive, easy to follow manual that can be easily used by swim instructors and

aquatic professionals in many settings.

Pan (2011), examines the impact of an aquatic program on fitness status for

children with Autism and their typical siblings in the study titled The efficacy of an aquatic

program on physical fitness and aquatic skills in children with and without autism spectrum

disorders. The article begins by discussing the implications of lack of physical activity for

children with Autism. It explains that children with Autism tend to have motor difficulties,

more so than their typical peers. If they do not participate in physical activity throughout

their childhood, they will continue to fall more behind, essentially setting themselves up for

a sedentary lifestyle. This can lead to high risk for many chronic diseases such as obesity,

diabetes, mental health problems, and cancers. Sibling sets were selected to participate in

this study. The siblings had to both be seven to twelve years old, and one had to have an

Autism spectrum diagnosis, while the other did not. They were split into two groups, an

experimental group, which received the fourteen week program, and the control group

which did not. Both groups were evaluated at the start of the program and again at the end.

The data show significant improvement from the initial evaluation to the final evaluation in

the group who received the fourteen week program while no significant improvement was

seen in the control group. Other findings showed that the typical siblings were generally

stronger and more skilled than their siblings with Autism. This suggests that children with

Autism start with a physical disadvantage when compared to their peers. The use of a

program such as this one can be extremely influential in helping children with Autism

develop into healthy and physically fit individuals.

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Prupas, Harvey, and Benjamin (2006) examine the effects of an early intervention

aquatics program on children with Autism Spectrum Disorders. They explain that the

number of early intervention programs for children with Autism has increased over the

years as there has been more successful early intervention and diagnosis of Autism in

young children. Many of these early intervention programs include occupational and

physical therapies, social opportunities, communication therapy, diet consulting, and other

treatments. In this particular study, participants were provided with thirty minutes of pool

time each week over an eighteen week period. Aquatic professionals provided

individualized instruction to each child. The goal of the aquatic portion was to improve

family functioning and teach the parents techniques to be easily implemented after the

program’s completion. Interactions between the instructor, the parents, and the children

as well as physical and social skills were assessed for two to three sessions. These

observations were then used to formulate goals for each child in the form of an individual

treatment plan. At the conclusion of the program, the participants showed a general trend

of improvement in both physical aquatic and social skills. Parents were thrilled by the

newfound connections they made with their children through aquatic activities. Since

children with Autism tend to be interested and more successful in aquatic environments,

they had better morale overall. The children also showed improved confidence. The

aquatics program elicited many positive effects on the participants, and the improved

morale and confidence acted as a gateway for bonding and good communication between

parents and children. This study further supports the notion that swimming and other

aquatic activities elicit many benefits in this population.

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The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social

Interactions in Children with Autism Spectrum Disorder: A Pilot Program (2017) evaluated

the impact that an introductory swimming program may have on both aquatic and social

skills in children with Autism. Drowning is the number one cause of death in children with

Autism, and swim lessons are associated with an 88% reduced risk of drowning, stressing

the importance of aquatic skills in children, particularly those with Autism. Alaniz,

Rosenberg, Beard, and Rosario (2017) use the Aquatic Skills Checklist, and the Social Skills

Improvement Scale to evaluate seven participants. The participants in the program were

children aged three to seven, all with a diagnosis on the Autism Spectrum. Children were

evaluated using these two scales at the start of the program. Based on these baseline

measurements, the evaluators worked with the children and their parents to set goals for

both social and swimming skills. The goals were set using goal attainment setting (GAS)

which is a criterion based method for setting goals. This method is useful for measuring

change between the start and the end of the program. Participants then began intervention

programs and completed up to three phases (24 hours) or lessons. At the end of the

program, progress was assessed in terms of the previously set goals. There were clear

improvements shown for the swimming skills goals, however the data were inconclusive

regarding social skills. Though the lessons did provide opportunities for social interaction,

it is unclear if participants’ social skills improved through these interactions. One

limitation of the study could be the very limited sample size. The results of the study

suggest that there is, however, a direct relationship between participating in swim lessons

and the improvement of swimming skills. Also, though the data were inconclusive

regarding whether the swim lessons improved social skills, it did provide opportunities for

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social interaction. These data are important as they provide evidence that enrolling

children with Autism Spectrum diagnoses in a swim lesson program can improve their

aquatic skills, and greatly reduce the number of children with Autism who drown each

year.

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Methods

This thesis serves to be an extension of the Fit Families program, as well as a tool

that any parent or instructor can use when teaching swim lessons. While progressing

through this project, the main goal was to answer the following questions:

1. Why is swimming such an important skill for individuals to hold, especially

children with Autism?

2. What are the best activities, games, and equipment to use when teaching and/or

practicing specific aquatic skills?

3. What is the best way to deliver this information to parents or swim instructors

so they can facilitate efficient and meaningful lessons?

This project is developed from the aquatic portion of the Fit Families program. I am

passionate about this program for many reasons, primarily because many drownings are

easily preventable. Through personal anecdotal evidence, children thrive and grow

physically and socially from participation in aquatic environments, specifically swimming

lessons. At Fit Families, only one of the five workshops include the aquatic component.

Parents are typically in a classroom setting in the morning, where they learn different

techniques to be safe and have fun in the water with their child, all the while their kids are

participating in different activities in the gym. In the second half of the session, all of the

kids get in the water with their parent, as well as a student volunteer who will help direct

and guide them through the activities. Similar to the gym portion, the different skills from

the assessment tool (TWU) are introduced and evaluated first. Following this introduction,

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the student volunteer will explain some games which incorporate each skill. The idea is

that the games will be an enjoyable way for the child to become engaged in the activity,

enabling more successful practice. If the child uses a fun activity to practice with, they will

hopefully continue to improve with their aquatic skills. Literature suggests that

improvements lead to more overall success which is linked to positive memories with each

activity thereby resulting in continued participation in aquatics (Prupas et al., 2006).

In the gym portion of the program, families receive a comprehensive booklet that

includes information about the skills they are working to improve upon, as well as

activities designated to help with each skill. The resulting booklet from this project will be

geared towards the aquatic portion of the Fit Families program. Skills were selected from

the TWU and activities were then selected to be paired with each skill. These activities

were taken from Assessments and activities for Teaching Swimming, by Lepore, Columna,

and Friedlander Litzner (2015) and then added to the document. Each page of an activity

includes the skill that the activity correlates with, the level of difficulty, and the equipment

needed to play. There are also instructions for preparation, formation, student directions,

and teacher directions. These prompts help to set up the most aspects of the activity and

attempt to eliminate confusion from written instructions. The proposed plan included

photographs of participants completing different activities in an attempt to provide visual

cues to supplement the written cues. Due to unforeseen circumstances this was not a

possibility at the time the project was due. Instead, photos of the skill and links to videos

with demonstrations of the skill were added to the booklet in an attempt to supplement the

written instructions. In addition, there is a section in the beginning of the book called

“Instruction and Delivery”, which provides information about teaching aquatic skills to

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children, but specifically to those with ASD. This section contains information on how to

engage participants in the activities, as well as how to modify activities if necessary.

Participants of Fit Families will be given this proposed booklet following completion of the

aquatic session.

Though it may seem like a small addition to the program experience, having access

to such the aquatic tool has the potential to reinforce the learning that occurred in the Fit

Families aquatic experience. Many families, when at home, do not have regular access to a

pool and likely will not get the chance to practice the skills and activities they learned in the

Fit Families aquatic sessions. With lack of consistent practice, the children are less likely to

retain their skills, and the next time they are in the pool they will have to start over again

with their learning. The same remains true for families who have not participated in the Fit

Families program but have a child with Autism they are trying to teach aquatic skills. This

book can be used to assist parents and other instructors with teaching aquatics to children

with ASD. Using this booklet, when families have access to a pool, they can facilitate more

meaningful and focused practice/play sessions. This resource has strategies to make the

lessons fun, so they do not feel like work. The goal is that this tool will make pool time

enjoyable, efficient, and informative.

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Conclusion

It has been enjoyable to develop and outline resources to help families of children

with ASD become more comfortable with aquatics. Drownings are seemingly more

frequent, specifically for children and those with ASD (CDC, 2019). Many people, including

parents, physical education teachers, adapted physical education teachers, and aquatics

professionals fulfill the role of instructor when working with children with ASD, thus it is

imperative that there are options to assist instructors with teaching swimming for this

population and that the materials are easy to comprehend and utilize by all, particularly

people who may or may not have previous knowledge of teaching aquatics. If the teacher

has a foundational understanding of the aquatic activity, they will be able to provide clear

instructions to their student, resulting in better learning. It is my hope that all parents,

especially those who have children with Autism Spectrum Disorder, are able to use this

book to help their child attain a basic proficiency level in aquatics that allows them to be

safe and have fun in and around the water.

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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. https://doi.org/10.1007/s10803-

017-3264-4

Amaral, D., Dawson, G., & Geschwind, D. (2011). Autism Spectrum Disorders. Oxford

University Press.

http://libezproxy.syr.edu/login?url=http://search.ebscohost.com/login.aspx?direct

=true&db=e000xna&AN=375069&site=ehost-live

AutismFactSheet.pdf. (n.d.). Retrieved December 18, 2018, from

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