Adapted Swimming

By Lisa Kruse and Kristen Clatos Riggins

The Cincinnati Recreation Commission’s (CRC) individualized, adapted swimming program is year-round and designed for swimmers of all ability levels. This program incorporates the American Red Cross swim progression for swimmers preschool-age to senior, with developmental and physical disabilities. Participants are taught water safety, learn-to-swim skills, and independence in the water with a 1:1 trained instructor.

Due to the group-lesson nature of most learn-to-swim programs, individuals with disabilities may have difficulty being successful. Through the adapted swimming program, lessons are structured to provide visual, auditory, and sensory stimulation based on the individual’s needs. Part of the CRC’s mission is to provide healthy lifestyles and opportunities for all community members. By doing this, the Therapeutic Recreation Division serves an often under-served population.

The Goal
From beginning to end, adapted swim lessons boost a person’s swimming skills and confidence in the water. The ultimate goal is to create lifelong swimmers who not only are water-safe but love the water. Often, children with disabilities—specifically autism—may be more prone to wander and/or be drawn to water. Safety is paramount to prevent water emergencies and drownings in this population. Water has tremendous normalization qualities, and by being offered age-appropriate swim-lesson opportunities, individuals with disabilities are the same as their peers in water-splashing, floating, and having fun.

Among the objectives of the program:

• Adapted swim-lesson participants will gain water-safety skills. Children with disabilities may often need cueing, prompting, and modeling to demonstrate appropriate behavior in the aquatic setting.
• Participants will improve and gain swimming skills and stroke development. We use the Red Cross learn-to-swim progression and trained Water Safety Instructors, with additional training specific to working with individuals with disabilities.
• Participation in adapted swimming will increase the number of socially appropriate interactions with peers and staff, as well as increase the likelihood of future positive, inclusive participation. In this way, children with disabilities can enjoy swimming with their peers and hopefully create meaningful friendships through shared leisure participation.

How We Evaluate
During adapted swim lessons, participants are observed in pre-tests and post-tests to determine whether objectives have been met. In the six-week session, the aquatic therapist uses a variety of standardized assessments to gauge not only swim skills, but also cognitive, social, sensory, physical, and behavioral needs and abilities. By using standardized assessments, CRC is able to show the progress that affects the child holistically. The goal of Therapeutic Recreation is to mask therapy with fun, and we have found the water is the best medium.

Parents observe and evaluate the success and improvement in their child’s swimming ability and social-skill functioning. Longitudinal data are kept on swimmers, including how many have gained skills and how many have become water-safe. Data are collected from each lesson and compared week to week and session to session. Families are provided feedback at the end of each session regarding skills learned as well as skills needed for improvement. Statistics show that, during the last eight years, more than 250 children and adults with disabilities have become water-safe, and more than 105 have participated in swimming competitively.

Involving The Community
CRC has partnered with Cincinnati Public Schools and local charter school Mt. Auburn International Academy to offer adapted aquatics to children and teens with disabilities as part of the school day. Over 40 swimmers a week participate in this program, and special educators see the benefits in the classroom. Teachers report that students display more appropriate behavior, social skills, motor coordination, focusing, and self-regulation on the days after swimming. Most of these students had never been in a pool previously, and their progress is encouraging, showing that anyone can learn to swim.

Parents of children with disabilities enrolled in the adapted aquatic programs may also take swim lessons for free. CRC believes that it is never too late to learn to swim and that swimmers will be safer when their parents feel comfortable and safe in the water. Often the nervous energy of the parents is transferred to the child. Teaching parents in turn teaches children that the water can be a fun place to spend time. Parents who are water-safe are more likely to spend time in the pool with their child and more likely to continue the skill-development work we provide during adapted aquatics.

In order to successfully implement adapted swim lessons, CRC partners, along with the public schools, the Autism Society, Spina Bifida Coalition, Down Syndrome Association of Greater Cincinnati, and the Hamilton County Special Olympics for referrals and recruitment. Another source of referrals is the Perlman’s Center, an arm of Children’s Hospital Medical Center. When children are discharged from Children’s, they are referred to CRC for outpatient recreational-therapy and aquatic-therapy services.

Local volunteers from Xavier University’s Occupational Therapy Program and University of Cincinnati’s Special Education Program have assisted with lessons. They have worked with individual swimmers in the pool and have assisted in the adaptation of teaching materials and supports. Having the ability to mimic teaching strategies used in the classroom and at home has proven to be the most successful way to facilitate true learning in the water.

Challenges And Creative Solutions
A recent challenge in the adapted swim-lesson program is the language barrier presented with the increased number of Hispanic swimmers. In order to overcome this barrier, CRC has adapted the Picture Exchange Communication System (PECS), consisting of pictures and words on cards that provide detailed instructions and translated into Spanish.

Instructors are constantly finding creative solutions to combat boredom. For example, adapted swim-lesson instructors have searched high and low for mirrors that could be placed at the bottom of the pool to encourage swimmers to put their faces in the water.

In The End
From 2009 through 2011, the National Autism Association reported that “accidental drowning accounted for 91 percent of the total U.S. deaths reported in children with autism ages 14 and younger, subsequent to wandering/elopemont.” By offering adapted swim lessons, CRC is decreasing this statistic. Creating safe swimmers in Cincinnati is imperative to creating safe communities. While swimmers with disabilities can be more challenging to teach, the feeling of accomplishment and autonomy the swimmer develops, the sense of safety the parents feel, and the enhanced leisure lifestyle of the family unit make this program unique and rewarding for all involved.

Lisa Kruse and Kristen Clatos Riggins, MA, CTRS, ATRIC, specialize in quality recreation at the Cincinnati Recreation Commission. They can be reached at Lisa.Kruse@cincinnati-oh.gov or Kristen.Clatos@cincinnati-oh.gov. CRC enriches the lives of Cincinnati citizens through the operation and programming of 23 recreation centers, 34 aquatic facilities, 6 golf courses, and hundreds of playgrounds and sports fields. Find out more about CRC at www.cincyrec.org or the CRC InfoLine at 513-352-4000.