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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether a specialized swimming program called Sensory Enhanced Aquatics or standard swim lessons more effectively improve swimming and water safety skills in autistic children. Researchers seek to identify the factors that best facilitate skill acquisition. The trial is ideal for children aged 5-9 who have an autism diagnosis, can follow instructions, and are new to swimming. Participants will engage in swimming lessons and undergo tests before and after to measure progress. As an unphased trial, this study provides a unique opportunity for children to enhance their swimming skills in a supportive environment.

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 prior data suggests that these swimming programs are safe for autistic children?

Research has shown that Sensory Enhanced Aquatics is well-received by autistic children. Studies have found that these lessons significantly improve both motor and social skills. Parents report feeling that their children are safer around water after participating. Notably, over 90% of parents felt more confident in their child's safety after just eight lessons. No reports of negative effects have emerged, indicating that this program is safe for children.

The standard swim lessons used for comparison are also generally safe, as they are available to the public. The data shows no specific safety concerns for either program. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Sensory Enhanced Aquatics because it tailors swimming lessons specifically for autistic children, incorporating sensory integration techniques that are not typically part of standard swim lessons. This approach recognizes the unique sensory processing needs often experienced by autistic individuals, aiming to create a more comfortable and effective learning environment. Unlike standard swim lessons, which follow a more generalized curriculum, Sensory Enhanced Aquatics adapts to the sensory sensitivities and preferences of each child, potentially leading to better engagement and improved water safety skills.

What evidence suggests that this trial's treatments could be effective for improving swimming and water-safety skills in autistic children?

Research has shown that Sensory Enhanced Aquatics, a treatment in this trial, can help autistic children improve their swimming skills and feel safer in the water. One study found that both Sensory Enhanced Aquatics and regular swim lessons, also tested in this trial, improved important behaviors and swimming abilities. All parents reported that their children felt more secure around water after participating in Sensory Enhanced Aquatics. Another study found that swimming programs greatly improved movement and social skills in children with autism. These results suggest that both types of swimming lessons can be helpful, with Sensory Enhanced Aquatics possibly offering additional safety benefits. ^{1 3 6 7 8}

Are You a Good Fit for This Trial?

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

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

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

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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 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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9138228/

Effects of Aquatic Training in Children with Autism ... Our results showed the effectiveness of both training programs in enhancing several functional behaviors as well as swimming skills of children ...

2. research.aota.org research.aota.org/ajot/article/78/6/7806205050/25973/Water-Competency-and-Sensory-Processing-Among

Water Competency and Sensory Processing Among Children ... This study examined water competency, including swim safety skills, among children on the autism spectrum.

3. kumc.edu kumc.edu/school-of-health-professions/academics/departments/occupational-therapy-education/outreach/ku-sensory-enhanced-aquatics.html

Sensory Enhanced Aquatics (formerly Sensory Supported ... The impact has been significant: research shows 100% of parents feel their children are safer around water after eight lessons in our program, and more than 90% ...

4. frontiersin.org frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1473328/full

Improving water competency among children on the autism ... A recent meta-analysis showed that aquatic programs significantly improved motor and social skills among children on the autism spectrum (14).

5. researchgate.net researchgate.net/publication/354261643_Effects_of_Sensory-Enhanced_Aquatics_on_Body_Measures_and_Function_of_Children_With_Autism_Spectrum_Disorder

Effects of Sensory-Enhanced Aquatics on Body Measures ... Effects of Sensory-Enhanced Aquatics on Body Measures and Function of Children With Autism Spectrum Disorder ... To read the full-text of this ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11491375/

Improving water competency among children on the autism ... A recent meta-analysis showed that aquatic programs significantly improved motor and social skills among children on the autism spectrum (14).

7. trial.medpath.com trial.medpath.com/clinical-trial/5e242e8be33c5409/nct02747459-sensory-supported-swimming

Sensory Supported Swimming for Children With ASD | MedPath 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 ...

8. kumc.trialstoday.org kumc.trialstoday.org/trial/NCT06216613

Testing Swim Instruction for Autistic Children 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 ...