Recreation Therapy Treatment Program

Rationale and Purpose of Treatment Program: The program I am using for this assignment is
an Aquatic Therapy Program for individuals with Autism Spectrum Disorder Level 1 or 2, with
or without an intellectual impairment. Autism Spectrum Disorder (ASD) is an umbrella term
used to describe a complex group of disorders in brain development that cause significant
challenges in social, behavioral, and communication abilities. With the release of the Diagnostic
and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) all autism disorders (i.e.,
autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not
otherwise specified [PDD-NOS] and Asperger syndrome) were merged under ASD.
ASD often affects an individuals social and verbal communication skills, gross and fine motor
skills and/or sensory processing. Because of this, an increasing number of studies have shown
aquatic therapy to be beneficial for those with ASD. Aquatic therapy provides these individuals
with an environment in which they feel safe and supported. Since these persons may have
significant sensory impairments they can often over or under react to stimuli. The hydrostatic
water pressure can be soothing for them and relax their muscles. Aquatic-based activities provide
opportunities for social interaction, which stimulates positive social behaviors. It can be argued
that these activities improve verbal communication skills, acclimation to social settings, and
facilitate self-determination while providing an environment for early educational intervention.
The buoyancy of the water also allows independent movement that may not be achieved on land
and as a result enhances the performance of gross and fine motor skills. The purpose of this
treatment program is to provide psychological and physiological improvements while
encouraging independent leisure participation

Staff Requirements/Competence: In addition to competencies in basic aquatic therapy training,

the Certified Therapeutic Recreation Specialist (CTRS) conducting this program is
recommended to have Aquatic Therapy Rehabilitation Industry Certification (ATRIC) and
Aquatic Exercise Association instructor certification.
Entrance Criteria / Diagnosis and systems to be treated: As stated above, this treatment
program is designed for children (ages 4-10) with Autism Spectrum Disorder Level 1 or 2, with
or without an intellectual impairment. It would be beneficial if clients have had prior exposure to
a pool environment or swimming lessons.
Exit Criteria: At the end of the treatment the client should experience physiological
improvements and inward feeling of relaxation.
Safety Considerations: To ensure client safety, it may be necessary to include another instructor
who is trained in handling seizures for assistance. Also, making sure the pool is not overcrowded
will help place the client at ease.
Client Risks: Although this is a low risk program, clients who are prone to epileptic seizures
must have medical approval for participation in this program.
Environmental Risks: The recreational therapist must evaluate the water temperature and
distractions in the aquatic environment in order to avoid discomfort and negative experiences.
Because these children are very sensitive to sensory input, the water temperature must be warm
and comfortable, or the child will not respond favorably. Lighting is another important factor.
Children with ASD are very sensitive to light and have been known to react poorly to certain
types of lighting, especially bright florescent lights. Noise can be an additional factor as most
pool environments are noisy.
Facility Required: This treatment program can be conducted in any facility with a pool.
However, indoor pools are most ideal as it is easier to control the environment.
Equipment Required: No particular equipment is necessary except a heated pool (to control the
water temperature) and swimwear.
Outcome Criteria (Expected change): The client will experience improved balance,

equilibrium and posture and increased muscular strength and endurance, body awareness, and
range of motion. Also, decreased muscle spasm and heart rate.

SESSION (NAME/TITLE): Aquatics for Kids

SESSION DESCRIPTION: The aquatic therapy program will be conducted 2 times per week
in a quiet pool environment (in warm water). It will include a minimum of two participants and a
maximum of four. The program will be broken down into three modules: a 15-minute comfort
and balance exercise, a 30-minute therapeutic swimming lesson and a 15-minute relaxation
induced exercise.
SESSION OBJECTIVES: 1. To facilitate vertical rotation and motor performance. 2. To
improve mental adjustment, balance control, and movement. 3. To increase range of motion and
circulation, while inducing relaxation and reduction of stress.

SESSION LIFE SKILLS: Facilitate language development and self-concept. Also, improve
adaptive behavior and provide an appropriate setting for early educational intervention.

SESSION TIME: Approximately 60 minutes.

SESSION MATERIALS: Swimwear, Styrofoam floats and swim fins.

SESSION PROCESS: The recreational therapist will lead by example in demonstrating

techniques, ensuring all participants comprehend the instructions. For the comfort and balance
exercise, the therapist will assist the participant in maintaining a vertical position while
controlling breathing and gradually try to destabilize the individual to teach balance and

recognition of buoyancy. For the therapeutic swimming lesson, the therapist will place
Styrofoam floats on the participants back and swim fins on their feet. Then, encourage
participant to move their arms and legs by physically patterning the movements. Also, encourage
the participant through positive reinforcement. As participants progress remove the Styrofoam
floats and fins. For the relaxation induced exercise, the therapist will instruct the participant to
float on their back and once in position, the therapist will stabilize the individual. Then, perform
stretches and joint movement by moving different parts of the body.

SESSION CONTENT: The Aquatics for Kids treatment program is designed for children (ages
4-10) with Autism Spectrum Disorder Level 1 or 2, with or without an intellectual impairment.
This program will implement three different activities to improve social and verbal
communication skills as well as physiological improvements (i.e. range of motion, balance and
endurance). When conducting aquatic therapy exercises it is important to know the participants
strengths, weaknesses, and how much room is required to complete the activity safely.

References
Autism Speaks (2015). What Is Autism? Retrieved from https://www.autismspeaks.org/whatautism
Centers for Disease Control and Prevention (CDC) (2015). Facts About ASD. Retrieved from
http://www.cdc.gov/ncbddd/autism/facts.html

Dattilo, J., & McKenney, A. (2011). Facilitation Techniques in Therapeutic Recreation. State
College, PA: Venture Publishing, Inc.
Jake, L. (2003). Autism and the role of Aquatic Therapy in Recreational Therapy Treatment
Services. Therapeutic Recreation Directory. Retrieved from
http://www.recreationtherapy.com/articles/autismandquatictherapy.htm
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), 928.