Sensory Supported Swimming for Autism Spectrum Disorder

(SSS Trial)

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Disqualifiers: Sensory impairments, Aggressive behaviors, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 8 weeks

500 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of Sensory Supported Swimming is to provide a sustainable, low cost recreational swim program for children with ASD. A secondary purpose is to train general recreation providers and swim instructors to meet the unique needs of children. Specific aims include both program development and research aims as described below. Specific Aims: 1. Provide more opportunities for families of children with ASD to access a recreational swim program at low cost. (program development) 2. Increase the capacity of swim instructors and general recreation providers working with children with ASD. (Research) 3. Increase physical activity for children with ASD in a way that is a good match for their individual sensory needs. (Research) 4. Increase safety among children with ASD in and around the water so they and their families can swim safely. (Research) 5. Transition swimmers with ASD from a learn-to-swim program to an inclusive swim team. (Program Development) Hypotheses 1. The Sensory Supported Swim Program will increase physical activity of children with ASD. 2. The Sensory Supported Swim Program will increase safety of children with ASD in and around the water. 3. The Sensory Supported Swim Program will increase the capacity of general recreation providers and swim instructors to serve children with ASD.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Sensory Supported Swimming for Autism Spectrum Disorder?

Research shows that aquatic therapy, which includes swimming, can improve motor skills, emotional responses, and social skills in children with Autism Spectrum Disorder (ASD). Additionally, aquatic programs have been effective in enhancing water safety skills, which are crucial for preventing drowning, a significant risk for children with ASD. ^{1 2 3 4 5}

Is Sensory Supported Swimming safe for individuals with Autism Spectrum Disorder?

Research on aquatic therapy and swimming programs for individuals with Autism Spectrum Disorder (ASD) suggests that these activities are generally safe and can improve swim skills and water safety, which are important for preventing drowning. However, there is a risk of injury and drowning, especially if challenging behaviors occur in the pool, so supervision and proper management are crucial. ^{2 4 6 7 8}

How does Sensory Supported Swimming treatment differ from other treatments for Autism Spectrum Disorder?

Sensory Supported Swimming is unique because it combines swimming with sensory integration, which can improve motor skills, emotional response, and social integration in children with Autism Spectrum Disorder. Unlike other treatments, it provides a noninvasive, engaging environment that enhances brain development and functional adaptation through structured aquatic activities. ^{2 3 4 8 9}

Research Team

Lisa Mische Lawson, PhD

Principal Investigator

University of Kansas Medical Center

Eligibility Criteria

This trial is for children with an Autism Spectrum Disorder diagnosis. It aims to provide a low-cost recreational swim program tailored to their sensory needs. Children with sensory impairments like blindness or deafness, or those who show aggressive behaviors that could be unsafe in the program, may not participate.

Inclusion Criteria

Order of response

Autism diagnosis (any autism spectrum diagnosis)

Exclusion Criteria

Participants that display aggressive or harmful behaviors may be excluded for safety purposes (based on the discretion of the program directors)

My child has a sensory impairment such as blindness or deafness.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Sensory Supported Swimming lessons, which include eight 30-minute sessions tailored to individual sensory needs

8 weeks

8 visits (in-person)

Follow-up

Participants are monitored for changes in swimming and water safety skills, as well as physical activity and safety around water

16 weeks

Treatment Details

Interventions

• Sensory Supported Swimming

Trial Overview The Sensory Supported Swimming program is being tested for its effectiveness in increasing physical activity, safety around water, and the ability of recreation providers and swim instructors to support children with ASD.

Participant Groups

Group I: SSS Intervention Experimental Treatment 1 Intervention

Sensory Supported Swimming-eight, 30 minute lessons

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

Findings from Research

Ayres Sensory Integration® (ASI) therapy shows strong evidence of improving individualized functioning and participation goals for children with autism, based on a systematic review of five studies including randomized controlled trials.

There is moderate evidence that ASI can lead to improvements in autistic behaviors and reduce the need for caregiver assistance in self-care activities, although evidence for enhancements in play, sensory-motor, and language skills is still emerging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Occupational Therapy Using Ayres Sensory Integration&#174;: A Systematic Review. Schaaf, RC., Dumont, RL., Arbesman, M., et al.[2022]

A 10-month multisystem aquatic therapy program significantly improved functional adaptation, emotional response, and social integration in children with Autism Spectrum Disorders (ASD) compared to a control group.

The therapy not only enhanced behavioral and emotional skills but also effectively taught swimming skills, indicating its broad benefits beyond just swimming training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of a Multisystem Aquatic Therapy for Children with Autism Spectrum Disorders. Caputo, G., Ippolito, G., Mazzotta, M., et al.[2020]

The multi-systemic aquatic therapy (CI-MAT) program was effective in improving gross motor skills and social behaviors in three adolescents with Autism Spectrum Disorders (ASD) over a 12-week period.

Participants showed significant gains in locomotor and object control skills, as well as improvements in social interactions, particularly in sensitivity to others and eye contact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of a Specific Aquatic Program on Social and Gross Motor Skills in Adolescents with Autism Spectrum Disorders: Three Case Reports. Battaglia, G., Agrò, G., Cataldo, P., et al.[2021]

An aquatic therapy program significantly improved water safety skills in children with Autism Spectrum Disorder (ASD), with a notable p-value of 0.0002 after just 8 hours of intervention, highlighting its potential for drowning prevention.

Despite the improvements in water safety skills, the program did not show any significant effect on enhancing social skills among the participants, as indicated by a p-value of 0.6409.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social Interactions in Children with Autism Spectrum Disorder: A Pilot Program. Alaniz, ML., Rosenberg, SS., Beard, NR., et al.[2018]

The iCan Swim program significantly improved swim skills in children and teenagers with autism spectrum disorder (ASD), with participants showing a notable increase in swim level after a 5-day course (n = 86).

Children with ASD who also had co-occurring ADHD demonstrated even greater improvements in swim skills, suggesting that ADHD may positively influence the effectiveness of swim training in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in Swim Skills in Children with Autism Spectrum Disorder Following a 5-Day Adapted Learn-To-Swim Program (iCan Swim). Munn, EE., Ruby, L., Pangelinan, MM.[2021]

The study demonstrated that using differential reinforcement without extinction effectively reduced challenging behaviors and transition latencies for two participants with Autism Spectrum Disorder (ASD) when moving from the pool, with effects lasting up to 2 months after treatment.

Lifeguard staff found the intervention highly acceptable and reported significant improvements in the participants' behavior, highlighting the intervention's practical benefits in aquatic settings for individuals with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment and treatment of high-risk challenging behavior of adolescents with autism in an aquatic setting. Dowdy, A., Tincani, M.[2021]

Children with autism spectrum disorder (ASD) and their families reported positive swimming experiences and skill acquisition when instructional methods were tailored to the child's specific needs, highlighting the importance of individualized approaches.

As children's swimming skills improved, parents felt more confident about their safety in the water, suggesting that effective swimming instruction can enhance both competence and perceived safety for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Qualitative Investigation of Swimming Experiences of Children With Autism Spectrum Disorders and Their Families. Mische Lawson, L., D'Adamo, J., Campbell, K., et al.[2022]

Early swimming intervention significantly improved social and stereotyped behaviors in a rat model of autism (Shank3 knockout), suggesting a potential noninvasive treatment approach for autism spectrum disorder.

Transcriptomic analysis revealed that swimming altered 534 genes related to synaptic structure and function in the striatum, indicating that the mechanism of improvement may involve enhancing synaptic development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Early Swimming on the Behavior and Striatal Transcriptome of the Shank3 Knockout Rat Model of Autism. Meng, Y., Xu, D., Zhang, W., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Efficacy of Occupational Therapy Using Ayres Sensory Integration&#174;: A Systematic Review. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of a Multisystem Aquatic Therapy for Children with Autism Spectrum Disorders. [2020]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Influence of a Specific Aquatic Program on Social and Gross Motor Skills in Adolescents with Autism Spectrum Disorders: Three Case Reports. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social Interactions in Children with Autism Spectrum Disorder: A Pilot Program. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

The Effects of Aquatic Versus Kata Techniques Training on Static and Dynamic Balance in Children with Autism Spectrum Disorder. [2021]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Improvements in Swim Skills in Children with Autism Spectrum Disorder Following a 5-Day Adapted Learn-To-Swim Program (iCan Swim). [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Assessment and treatment of high-risk challenging behavior of adolescents with autism in an aquatic setting. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

A Qualitative Investigation of Swimming Experiences of Children With Autism Spectrum Disorders and Their Families. [2022]

9. New Zealand pubmed.ncbi.nlm.nih.gov

Effect of Early Swimming on the Behavior and Striatal Transcriptome of the Shank3 Knockout Rat Model of Autism. [2022]