Swim Instruction for Autism

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Disqualifiers: Uncontrolled epilepsy, Aggressive behaviors, others

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

Compensation: Varies

Number of Visits: 18

Duration: 8 weeks

50 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to compare the effects of a specialized swimming and water-safety program (Sensory Enhanced Aquatics) and standard swimming lessons for autistic children. The main question\[s\]it aims to answer are: * Do Sensory Enhanced Aquatics and standard swimming lessons improve swimming and water-safety skills of autistic children? * Which participant characteristics are associated with the highest post-intervention swim skills and water safety across both groups? Participants will: * Complete questionnaires, motor, and swim tests before the intervention. * participate in 16, 30-minute Sensory Enhanced Aquatics lessons. * Complete a swim test after the intervention. * Complete an interview. Researchers will compare with participation in standard swim lessons to see if which bests teaches swimming and water-safety to autistic children.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Sensory Enhanced Aquatics, Sensory Supported Swimming, Standard Swim Lessons, Traditional Swim Lessons, Conventional Swim Instruction for children with Autism Spectrum Disorders?

Research shows that aquatic therapy can improve motor skills, emotional responses, and social skills in children with Autism Spectrum Disorders (ASD). It also enhances water safety skills, which are crucial for preventing drowning, a significant risk for children with ASD. ^{1 2 3 4 5}

Is swim instruction safe for individuals with autism?

Swim instruction for individuals with autism is generally considered safe, but there is a risk of injury and drowning, especially if challenging behaviors occur in the pool. Lifeguard staff found safety procedures helpful and satisfactory in managing these risks. ^{2 4 5 6 7}

How does the Sensory Enhanced Aquatics treatment for autism differ from other treatments?

Sensory Enhanced Aquatics is unique because it combines swimming lessons with sensory support to improve motor skills, emotional response, and social integration in children with autism, unlike traditional swim lessons that focus solely on swimming skills. ^{2 3 4 5 8}

Eligibility Criteria

This trial is for autistic children to see if specialized swimming lessons (Sensory Enhanced Aquatics) are more effective than standard swim lessons. Children must be able to complete questionnaires, motor and swim tests before the intervention, participate in 16 sessions, and do a post-intervention swim test.

Inclusion Criteria

I am between 5 and 9 years old and have been diagnosed with autism.

A Social Responsiveness Scale-2 (SRS-2) T-score of ≥ 60

I can understand instructions and express my choices.

Exclusion Criteria

Aggressive behaviors that would put instructor safety at risk

My swim test score is 23 or higher.

I do not have uncontrolled seizures.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-Intervention Assessment

Participants complete questionnaires, motor, and swim tests before the intervention

1 week

1 visit (in-person)

Treatment

Participants undergo 16, 30-minute Sensory Enhanced Aquatics lessons or standard swim lessons over 8 weeks

8 weeks

16 visits (in-person)

Post-Intervention Assessment

Participants complete a swim test and an interview after the intervention

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Sensory Enhanced Aquatics
• Standard Swim Lessons

Trial Overview The study compares Sensory Enhanced Aquatics—a special swimming program—with regular swimming lessons. It checks which improves autistic children's swimming skills and safety in water better, considering different characteristics of the participants.

Participant Groups

Group I: Sensory Enhanced Aquatics Experimental Treatment 1 Intervention

Sensory Enhanced Aquatics is a specialized swimming and water safety program for autistic children.

Group II: Standard Swim Lessons Active Control 1 Intervention

Standard swim lessons which are provided to the general public will be used as the comparison group.

Sensory Enhanced Aquatics is already approved in United States for the following indications:

Approved in United States as Sensory Enhanced Aquatics for:

• Swimming and water-safety skills for autistic children

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

Findings from Research

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]

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]

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]

An 8-12 session aquatics program was found to be a potentially beneficial form of physical activity for individuals with severe to profound intellectual disabilities (SPIDs), suggesting its suitability for this population.

Despite the positive effects observed, barriers to participation were identified, indicating the need for tailored programs to enhance accessibility and engagement in aquatics for people with SPIDs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A preliminary investigation of the suitability of aquatics for people with severe and profound intellectual disabilities. Aherne, C., Coughlan, B.[2018]

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]

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]

References

1. 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]

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

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

6. England pubmed.ncbi.nlm.nih.gov

A preliminary investigation of the suitability of aquatics for people with severe and profound intellectual disabilities. [2018]

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. 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]