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Hydrotherapy and Swimming for Children with Autism

Autism is a developmental neurological problem and not the result of psychological factors. Brain studies show that people with autism appear to have structural brain abnormalities with some areas being underdeveloped while others overdeveloped.

Other studies have shown that low-functioning autistic people have slow neural transmission and defects in brain stem development which are related to early stages in the beginning of pregnancy.

Signs of autism:

1. Difficulties with speech and language comprehension.

2. Difficulties with communication, exhibited by a display of superficial expressions, non-initiating communication, difficulty in imitating/mirroring others’ verbal and nonverbal communication, nonstandard tone, and more.

3. Poor social skills: with some or all of the following on display: no eye contact, no social interactions, no playing with friends or seeking adults for support.

4. Attitude to the environment: repetition, resisting changes.

5. Sensory deficiencies: hearing, vision, touch, movement.

Researchers have found that the above difficulties and impairments affect mental development.

Individuals with autism have lots of challenges, with limited access to alternative solutions and sometimes are left with unresolved issues.

According to some international studies, people with autism need understanding and professional therapists who know how to interact in a way that balances demands and instruction with friendly empathy.

People with autism usually (but not always) think visually.

Below are some tips and principals that can be implemented in a swim/hydrotherapy session with a person identified with Autism:


Define the space you are going to use and maintain consistency so that your student/s will come back to the same familiar space. Borders are created by objects, skin tape, and other visual aids.


Have a plan that has integrity and consistency and start with 1-2 items. Then repeat activities with the familiar items for a few sessions before introducing the next part of your plan. Keep the same routine and always start and finish with the items that your student mastered. Routines help create order and provide understanding and confidence. The schedule should be checked after completing a task.

Routines help to establish behaviors that are necessary for success in daily life experiences.


Long sequences of verbal instructions should be avoided as remembering a long sequence is not possible. One or two simple tasks can be either written if the person knows how to read, otherwise visual representations of the task should be utilized.

Keep it simple

Do not offer a visual and auditory message at the same time as they cannot operate on two channels at the same time. Instructions should be visual and concrete.

Use their strengths

Use what they like to give instructions as they are extremely good in being focused on one thing that they find interesting.

The environment

Try to protect them from an hectic environment as loud noises and bright flashes or rattles (for example: direct sun or a neon light) can overwhelm them. Find the quietest corner in the pool.


People with autism who "swing" all the time need help to regulate their nervous system so they can relax. Some relax if you let them wear a "sensory vest", be hugged gently (as touch is usually the most reliable sense), or float using a head pillow and floats around the knees.


Some children with autism sing better than talk and will respond better if you sing the instructions words to them.


Give them positive feedback and say NO when it is required.

Firm and friendly

As the teacher you should maintain a positive firm, authoritative yet friendly manner.

(Written by © Anat Juran)


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