Christina Tsolaki, Dimitrios Kokaridas, Sofia Batsiou, Maria Baxevani, Georgia Kofou


Children with intellectual disability (ID) and autism spectrum disorder (ASD) are participating more and more actively in exercise programs, with swimming being one of the most popular ways to improve motor and psychosocial skills for these children. The Sports for All program, led internationally under the central responsibility of each Ministry through the General Secretariat for Sport in cooperation with Local Authorities, promotes the global effort to adopt this model of sport for citizens with and without disabilities of all ages. However, research has not yet been conducted to investigate the effect of exercise on Sports for All environments for people with disabilities, even more so on therapeutic swimming programs in Sports for All settings. The purpose of this study was to examine the effect of a therapeutic swimming program within the Sport for All Program setting on the aquatic readiness and emotional satisfaction of children with ID and ASD. The sample consisted of 13 children with ID and ASD, participating in a therapeutic swimming program for a duration of 10 weeks at a frequency of 3 sessions per week, 60 minutes per session. Instruments included the use of pre- and post-measures of HAAR and WOTA1 for aquatic readiness and the SSI questionnaire completed at the end of the program to assess children’s satisfaction. Non-parametric analyses (Wilcoxon and Mann-Whitney) that were used, identified statistically significant differences in aquatic readiness for both children with ID and ASD, whereas satisfaction of all children from their participation in the program was completely positive. In conclusion, the therapeutic swimming program produced significant improvements in aquatic readiness and emotional satisfaction for children with ΙD and ASD within a Sport for All setting that provides important services to children with disabilities and low socio-economic status, as in this case.


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therapeutic swimming, autism spectrum disorders, intellectual disability, aquatic readiness, satisfaction, Sports for All

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American Psychiatric Association (APA). 2013. Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Publications (5th edition).

Ansari, S., Hosseinkhanzadeh, A. A., AdibSaber, F., Shojaei, M. & Daneshfar, A. (2021). The effects of aquatic versus kata techniques training on static and dynamic balance in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 51(9), 3180-3186.

Araujo, L. G., Souza, T. G. (2009). Natación para portadores de necesidades especiales. Revista EFDeportes, 14(137).

Bataglion, G. A., Zuchetto, A. T., Nasser, J. P. & Schmitt, B. D. (2018). Development of aquatic skills in a child with visual and intellectual disability. Revista Internacional de Medicina y Ciencias de la Actividad Fisica y del Deporte, 18(70), 395-411.

Battaglia, G., Agrò, G., Cataldo, P., Palma, A. & Alesi, M. (2019). Influence of a specific aquatic program on social and gross motor skills in adolescents with autism spectrum disorders: Three case reports. Journal of Functional Morphology and Kinesiology, 4(2), 27-30.

Becker, B. E. (2009). Aquatic therapy: Scientific foundations and clinical rehabilitation applications. Paper Presented at the PM&R.

Boer, P. H., & de Beer, Z. (2019). The effect of aquatic exercises on the physical and functional fitness of adults with down syndrome: A non‐randomised controlled trial. Journal of Intellectual Disability Research, 63(12), 1453-1463.

Bremer, E., Crozier, M., & Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20(8), 899-915.

Brody, L. T., & Geigle, P. R. (2009). Aquatic exercise for rehabilitation and training. Human Kinetics.

Caputo, G., Ippolito, G., Mazzotta, M., Sentenza, L., Muzio, M. R., Salzano, S., & Conson, M. (2018). Effectiveness of a multisystem aquatic therapy for children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 48(6), 1945-1956.

Casey, A. F., & Emes, C. (2011). The effects of swim training on respiratory aspects of speech production in adolescents with Down syndrome. Adapted Physical Activity Quarterly, 28(4), 326-341.

Chu, C. H., & Pan, C. Y. (2012). The effect of peer-and sibling-assisted aquatic program on interaction behaviors and aquatic skills of children with autism spectrum disorders and their peers/siblings. Research in Autism Spectrum Disorders, 6(3), 1211-1223.

Cole, A. J., & Becker, B. E. (Eds.). (2004). Comprehensive aquatic therapy. Butterworth-Heinemann.

Cousineau, C. (1998). Leisure and recreation and the 'sport for all' policy in developing countries: critical analysis. Leisure and recreation and the 'sport for all' policy in Developing Countries: Critical Analysis, 29-48.

Duda, J. L., y Nicholls, J. G. (1992). Dimensions of achievement motivation in schoolwork and sport. Journal of Educational Psychology, 84(3), 290-299.

Fragala‐Pinkham, M., Haley, S. M., & O’Neil, M. E. (2008). Group aquatic aerobic exercise for children with disabilities. Developmental Medicine & Child Neurology, 50(11), 822-827.

Fragala-Pinkham, M. A., Haley, S. M., & O’Neil, M. E. (2011). Group swimming and aquatic exercise programme for children with autism spectrum disorders: a pilot study. Developmental Neurorehabilitation, 14(4), 230-241.

Hakim, R. M., Ross, M. D., Runco, W., & Kane, M. T. (2017). A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability. Journal of Exercise Rehabilitation, 13(1), 89–94. doi: 10.12965/jer.1732838.419

Hartlage, A., Nicholson, C., Silvius, A., & Ennis, B. (2021). The Effect of Aquatic Physical Therapy on Children with Down Syndrome. The Journal of Aquatic Physical Therapy, 29(3), 73-77.

Huettig, C., & Darden-Melton, B. (2004). Acquisition of aquatic skills by children with autism. Palaestra-Macomb Illinois, 20(2), 20-25.

Humphries, K. M. (2008). “Humphries‟ Assessment of Aquatic Readiness”, unpublished master’s thesis. Texas Women’s University, Denton, TX.

Hutzler, Y., Chacham, A., Bergman, U., & Szeinberg, A. (1998). Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy. Developmental Medicine & Child Neurology, 40(3), 176-181

Kim, E. S. (2004). Effects of aqua exercise program on the improvement of static balance in child with mental retardation. The Journal of Korean Physical Therapy, 16(1), 208-246.

Kokaridas, D., Aggelopoulou-Sakadami, N., & Walters, B. (2000). An intervention in the Halliwick method procedures (swimming) for a group of individuals with Downs syndrome. European Journal of Special Needs Education, 15(2), 218-231.

Kokaridas & Lambeck, J. (2015). The Halliwick Concept: Toward A Collaborative Aquatic Approach. Inquiries in Sport & Physical Education, 13(2), 65-76.

Langendorfer, S. J., Quan, L., Pia, F. A., Fielding, R., Wernicki, P. G., & Markenson, D. (2009). Scientific review: Minimum age for swim lessons. International Journal of Aquatic Research and Education, 3(4), 451-469.

Langendorfer, S., & Bruya, L. D. (1995). Aquatic readiness: developing water competence in young children. Champaign, IL, Human Kinetics Publishers.

Langendorfer, S., Harrod, D. K., & Bruya, L. D. (1991). Prescriptive aquatic instruction: a developmental approach. The National Aquatics Journal, 7(1), 14-15.

Lee, J., & Poreta, D. L. (2013, January). Enhancing motor skills of children with autism spectrum disorder: A pool- based approach. Journal of Physical Education, Recreation and Dance, 84(1) 41-45.

Lincoln, Y.S. & Guba, E.G. (1985). Naturalistic inquiry. Sage.

McNiff, J. (2006). Teaching as learning: An action research approach. Routledge.

Mehrholz, J., Kugler, J., & Pohl, M. (2011). Water-based exercises for improving activities of daily living after stroke. Cochrane Database of Systematic Reviews. 42(4), 358-358.

Milligan, H., Glanzman, A., Waasdorp, I., Kinslow, T., Hagenbaugh, M., Pipan, M. & Palombaro, K. (2022). The Benefits of Group Aquatic Therapy for Young Children with Down syndrome. The Journal of Aquatic Physical Therapy, 30(1), 12-21. doi:10.1097/PXT.0000000000000011

Ministry of Education & Culture (2013). Organization and Operation of Sports for All programs, article 11, par. b, Law 2527/08-10-2013

Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American journal of medical sciences, 6(5), 199. doi: 10.4103/1947-2714.132935

Moreno-Murcia, J. A.; Huéscar Hernández, E.; Polo, R.; López, E.; Carbonell, B.; Meseguer, S. (2016). Efecto de los cuentos en la competencia acuática real y percibida en infantes. Revista internacional de Medicina y Ciencias de la Actividad Física y el Deporte, 16(61), 127-138.

Mortimer, R., Privopoulos, M., & Kumar, S. (2014). The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: A systematic review. Journal of Multidisciplinary Healthcare, 7, 93–103.

Pan, C. Y. (2010). Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders. Autism, 14(1), 9-28.

Pan, C. Y. (2011). The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 657-665.

Prupas, A., Harvey, W. J., & Benjamin, J. (2006). Early intervention aquatics a program for children with autism and their families. Journal of Physical Education, Recreation & Dance, 77(2), 46-51.

Rodrigues, M. N.& Lima, S. R. (2014). Actividades motoras acuáticas en la coordinación corporal de adolescentes con deficiencia intelectual. Revista Brasileira de Ciências do Esporte, 36(2), 369-381.

Schalock, R. L., Borthwick-Duffy, S. A., Bradley, V. J., Buntinx, W. H., Coulter, D. L., Craig, E. M. & Yeager, M. H. (2010). Intellectual disability: Definition, classification, and systems of supports. American Association on Intellectual and Developmental Disabilities. 444 North Capitol Street NW Suite 846, Washington, DC 20001.

Thomas, J. R., Martin, P., Etnier, J. & Silverman, S. J. (2022). Research methods in physical activity. Human Kinetics.

Tirosh, R., Getz, M., & Katz-Leurer, M. (2008). Halliwick-based aquatic assessments: reliability and validity. International Journal of Aquatic Research and Education, 2, 224 – 236.

Tough, H., Siegrist, J., & Fekete, C. (2017). Social relationships, mental health and wellbeing in physical disability: A systematic review. BMC Public Health, 17(1), 414.

Vodakova, E., Chatziioannou, D., Jesina, O., & Kudlacek, M. (2022). The Effect of Halliwick Method on Aquatic Skills of Children with Autism Spectrum Disorder. International Journal of Environmental Research and Public Health, 19(23), 16250.

Vonder-Hulls, D. S., Walker, L. K., & Powell, J. M. (2006). Clinicians' perceptions of the benefits of aquatic therapy for young children with autism: A preliminary study. Physical & Occupational Therapy in Pediatrics, 26(1-2), 13-22.

Wardle, J. (2013). Hydrotherapy: a forgotten Australian therapeutic modality. Australian Journal of Herbal Medicine, 25(1), 12-17.

Yanardag, M., Akmanoglu, N., & Yilmaz, I. (2013). The effectiveness of video prompting on teaching aquatic play skills for children with autism. Disability and Rehabilitation, 35(1), 47-56.

Yilmaz, I., Yanardağ, M., Birkan, B., & Bumin, G. (2004). Effects of swimming training on physical fitness and water orientation in autism. Pediatrics International, 46(5), 624-626.

Yılmaz I., Ergu N., Konukman F., Agbuğa B., Zorba E. & Cimen Z. (2009). The effects of water exercises and swimming on physical fitness of children with mental retardation. Journal of Human Kinetics, 21, 105–11.

Zanobini, M., & Solari, S. (2019). Effectiveness of the program “Acqua mediatrice di comunicazione” (Water as a mediator of communication) on social skills, autistic behaviors and aquatic skills in ASD children. Journal of Autism and Developmental Disorders, 49(10), 4134-4146.



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