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Aquatic Therapy: An Effective Physical Therapy for Children with Autism Water has been used for rehabilitative, rejuvenation and healing purposes for over 100 years. (Irion, 1997). Aquatic therapy has been accepted as a beneficial physical therapy treatment. However, the primary use of aquatic therapy (Fragala-Pinkham, Haley, & O’Neill, 2008) has been for those patients that have had either neuromuscular or musculoskeletal maladies. The purpose of this study is to attempt to evaluate aquatic therapy’s effectiveness in mental conditioning.
The focus is to determine aquatic therapy’s effectiveness in reducing self-stimulating behaviors, (i. e. head banging, rocking and hand flapping), in individuals with a diagnosis of autism or a diagnosis that falls under the umbrella of autism spectrum disorders. Autism and Autism Spectrum Disorders Autism is a disorder that is extremely difficult to define. Pediatricians, psychologists, and psychiatrists have not only argued for many years over the cause of autism and best treatments, but have consistently not agreed on the definition of autism itself.
The generally accepted definition is that autism is a developmental disorder that exhibits in children usually within the first three years of life which causes developmental delay that can range from mild to severe. The DSM-IV (American Psychiatric Association, 2000) requires that children have a total of six deficits that fall under three separate categories to be diagnosed with “classic” autism. Children must have at least two deficits that fall under category A, B, and C, with, (at the very least), two deficits from category A, and, (at the very least), one deficit from category B and one deficit from category C. (Autism Speaks, Inc. n. d. )
A. Impairment in social interaction B. Impairment in communication C. Repetitive and stereotyped patterns of behavior, interests and/or activities. Children that have some of the varying characteristics of autism, but do not have the specifically defined combination of deficits in all three different areas defined by the DSM-IV, are typically labeled with the diagnosis of an autism spectrum disorder. Autism spectrum disorders are also referred to as pervasive developmental disorders, (PDD). In the DSM-IV, individuals that have an autism spectrum disorder, that is not otherwise specified, are diagnosed as having (PDD-NOS).
For example, two disorders that have autistic features, but fall under the umbrella of PDD-NOS are Rhett syndrome and DiGeorge syndrome. For the purpose of this study, we will consider the effectiveness of aquatic therapy on reducing self-stimulating behaviors on children with a diagnosis of autism or a diagnosis that falls under the autistic spectrum disorder category. Self-Stimulating Behaviors in Autism The Importance of Reducing Self-Stimulating Behaviors For the school age child with autism, self-stimulating behaviors can quickly become the main obstacle to their learning.
The relentless presence of these behaviors is a constant distraction for the autistic child. For this reason, finding ways to reduce these self-stimulating behaviors frequently becomes a goal for educators in order to optimize the child’s learning experience. All school age children diagnosed with autism and autism spectrum disorder, have individually specific educational and therapy plans (IEP’s) that school educators and school therapists follow. Due to cost and time constraints, it is imperative for these individually specific plans to include forms of therapy that work best for each child and obtain the optimum result.
Types of Therapy Used for Autistic Children There are many different types of therapy used for children with autism and autism spectrum disorder to reduce the core characteristics of autism, one of which is known as self-stimulating behaviors. Holding therapy, megavitamins, music therapy, auditory integration therapy, facilitated communication, sensory integration therapy, play therapy, immunosuppressant therapy, and medication, are all therapies commonly used in treating children with autism (Bodfish, 2004).
Many of these therapies have been reported as being useful in reducing some characteristics seen in children with autism and autism spectrum disorder, but have not been studied for their effectiveness in specifically reducing self-stimulating behaviors. Aquatic Therapy Aquatic therapy has long been known as being extremely useful in providing a means of resistance strength training without subjecting the patient’s body to further physical stress or injury. Individuals, who have an injury to a limb, are recovering from surgery or have suffered a brain injury, (i. . stroke victim), have also been shown to consistently benefit from aquatic therapy. It is also important to note that water temperatures ranging between 89. 6 and 97 degrees Fahrenheit are known by therapists to be the range that provides the best relaxation, decreased joint pain and reduced muscle stiffness and spasticity (Ruoti, 1997). The main use of aquatic therapy in the past has been as primarily as a physical conditioning therapy. Little is known of water’s benefits as a mental conditioning therapy.
Studies on Aquatic Therapy for Autistic Children In 2006 a preliminary study was performed by aquatic occupational therapists (Vonder Hulls, Walker, & Powell, 2006) to try to determine if there was any benefit from aquatic therapy for autistic children. The focus was not on a defined benefit of aquatic therapy for children with autism, but rather on finding any benefit from aquatic therapy. There were many extreme variables noted in this study. The children participating in this study were from four to ten years of age.
The frequency of the sessions varied from 1 to 8 sessions per month. The length of each session also varied with each child from thirty minutes to one hour. The duration of the aquatic therapy also varied greatly, ranging from three months to two years. Unfortunately, although 78 disabled children participated in this study, only eighteen of the therapists who were administering aquatic therapy were administering aquatic therapy to children with a diagnosis of autism or autism spectrum disorder.
The study, therefore, is based only on those eighteen aquatic therapists’ reports. Although there were many variables in length, frequency and duration, “83% of therapists felt the children performed less self-stimulating behaviors as a result of aquatic therapy. ” (Vonder Hulls et al. , p. 19). An important observation made in reviewing the study was that none of the therapists reported an increase in self-stimulating behaviors or an increase in any other negative characteristics of autism or autism spectrum disorder Summary
It is unknown why autistic individuals perform self-stimulating behaviors or if the stimulation that autistic children receive from performing these behaviors is beneficial to their well-being or not. However, in the school setting, it is often extremely difficult for the autistic child to actively participate in learning when they have ongoing, cease-less self-stimulating behaviors occurring. With the incidence of autism increasing rapidly, and no cure for autism on the horizon, it is important to find effective therapies for autistic children.
While there are not enough documented studies to definitively determine if aquatic therapy reduces self-stimulatory behavior in autistic children, it is apparent that the study performed (Vonder Hulls et al. , 2006) does support the benefits of aquatic therapy. Aquatic therapy provides a multi-sensory approach to therapy. The buoyancy and enveloping effect of water provides a freedom of movement for the body that cannot be reproduced on land. The result of the sensory input and physical freedom is that individuals with complex disabilities (Potter & Erzen, 2008) are more alert in the water, than on land.
The evenly dispersed pressure of warm water on the body seems to have a calming effect on the autistic child (King, 1987). The steady sensation of this water pressure seems to provide the ongoing sensory stimulus that autistic children seek. Physicians, therapists, and educators need to conduct more research on the benefits of aquatic therapy and other therapies on reducing self-stimulating behaviors and other negative behavioral characteristics in the school aged autistic child in order to optimize their learning potential.
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