the aquatic therapist

Looking for practical ideas for treating sensory integration in the pool? Sign-up for our webcast

Tired of attending a seminar and going home with no immediately practical ideas for treating your pediatric clientele on Monday morning?

Well, our Aquatic Sensory Integration webinar is chock-full of practical treatment ideas generated from working with OTs, COTAs, PTs, PTAs, SLPs, adapted aquatic instructors and even a few hydrotherapists from Israel!

We have created a budget-conscious method for learning how to transform your therapeutic pool into a sensory integration "room".

To watch our 90 minute webcast, you only need a high-speed internet connection. If you know how to log onto a webpage, you can attend our webinar. And for $199, your entire office can watch along with you.

Shoot. Project it on a wall, order subs, and make our webcast into your in-house inservice!

Our live-streamed seminar will show you how to create 16 sensory stations in your home pool -- so that no matter what area your patient gravitates, you will always have a treatment plan.

With a few inexpensive toys (a flow-through mat, a child's plastic slide, a canvas hammock) your pool will become a joy to work in.

<more info on "Get Dressed Relay" under photo...>

Masterton Recreation Centre. A glimpse of the indoor children's pool. There is also an outside complex with a large pool, plus a diving pool. Also a water slide, children's pools and picnic tables.

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Here's one idea we'll be discussing on Tuesday, December 2, 2008 (1PM Eastern/12 noon Central).

Problem: Difficulty with body awareness.

Scenario: Your 6-year old patient has trouble donning his clothing correctly in the mornings.

Practice the “Get Dressed Relay” in the pool. Put various articles of clothing in two opposing corners of the deck.

Have your patient either swim or gutter crawl (hand-cruise along the edge of the pool) from the first location to the second and then climb up onto the side of the pool. He will pick a clothing item from the pile, put it on, swim (or crawl) to the second location (usually 14-20’ away), climb out of the pool and put on another piece of clothing. He will repeat this until fully dressed.

To make it even more challenging, require your patient to put on the clothes in an appropriate order (for instance, boxer shorts and tshirt first, socks second, pants and shirt third, belt and shoes last). This drill provides extensive amounts of proprioceptive input and problem-solving and kids love it.

[Idea courtesy Karen Reckamp, OTR/L, ATP, Wolfson Children’s Rehabilitation, Jacksonville, FL]

Watsu® for orphans: What better way to celebrate aquatic therapy worldwide?

What better way to celebrate World Watsu® Week (April 20-26, 2009) than to donate water therapy sessions for children living in orphanages and childcare institutions?

Watsu providers from all over the world (Brazil, Haiti, France, Great Britain, USA, Lithuania, Poland, Hungary, Thailand and Africa) are joining in.

Watsu for Orphans was initiated by Basia Szpak Borst, a Watsu practitioner and instructor from the Netherlands, and is supported by an Endowment Fund.

This project is an opportunity for orphanages to learn about this ground-breaking water therapy (Watsu) and to benefit from the installation of mobile pools donated by the Endowment Fund wherever technical possibilities allow their installation.

The long-term objective of the donation is to ensure continuous presence of Watsu practitioners and therefore enable participating institutions to integrate Watsu into their existing therapeutic and pedagogical programs.

But why water for these children?

As just one example, look to Bulgaria where the Ministry of Health is monitoring a 10-year follow-up of babies from an orphanage. They found that these children had a greater chance to be adopted because of a 20-minute a day medical water training.

Quick links for more info:

Watsu for Orphans newsletter update (newsletter is in English)

Website - Watsu for Orphans

Videoclips - Watsu sessions

Watsu for Children book chapter

Finding the perfect host location for aquatic therapy trainings in 2009: Are you THE ONE?

[First published 3/07]

We are looking for the perfect host locations for seminars in 2009. Are you THE ONE?

One of the major frustrations of my year is tracking down the perfect location to hold all of our aquatic therapy seminars.

You wouldn't think it could be such a headache. There are thousands of pools in the U.S. We know about almost all of them. And yet, I would give my first born child for a warm water (92-94 degree) pool with loads of water in the 3' to 4' depth.

Most of the work that happens in aquatic therapy happens at chest- to waist-level water. So, we need a pool that will fit between 25 and 30 people in the same depth at the same time.

Argghh.

Laurie, our office manager, bless her soul, just wants to cry sometimes. It starts with an innocent comment on my part, say something like "Let's hold Peggy's next seminar in South Carolina."

She smiles (a bit tightly I must say) in my general direction and proceeds to the phone lines. Days later, she calls me with an update. It goes something like this.

"I found a pool in Greenville."

"Great," I exclaim (excitement evident in my voice. I like to be supportive to Laurie so she doesn't make my work world fall apart).

"It's almost functional."

"Umm..."

"The hurricane, you know."

"Ahhh."

"Three sides of the pool are operational. They plan on having the fourth up and running by the time we want to host."

"Uh. Do you think it's smart to plan a seminar in a pool that doesn't -- now, I realize I'm being picky here -- have the capacity to hold water?"

This is the point where Laurie starts getting uppity. Silence ensues until one of us (read: me) caves.

"Sure, sure. Sounds perfect." And voila! We've found our next host site.

Then we bite our nails until the pool is actually up and running.

So take a moment, have mercy on us, and let us know about that perfect pool at your place.

Leave a comment here on the blog about your pool -- or email us at ARN.

Laurie will thank you.

Warm water regards, Andrea Salzman

Ask ARN: Bowel and bladder incontinence issues in aquatic therapy

The Aquatic Resources Network gets questions from clinicians each day. We think everyone should learn from the answers!

Question: We have an interest and need to work with our residents in our therapy pool.  However, several of these residents have incontinence issues (bladder and/or bowel).  What products can you recommend that have been tried, tested and proven?

Answer: Incontinence often stands in the way for patients to experience the joys and triumphs associated with aquatic therapy. And although bowel incontinence can be a strong precaution -- or even a contraindication - for water therapy, bladder incontinence should not be.

Fecal contamination of pool water can cause serious illnesses. Ingestion of contaminated water while swimming, inhalation of water vapor above the pool surface, and body contact with pathogenic organisms and absorption through the skin, body orifices or open wounds while swimming can result in transmission of a variety of diseases.

To lessen the probability of fecal contamination, ask clients to use the toilet. Do not permit diaper changing at poolside. Request that patrons not use the pool if they are suffering from an illness that causes diarrhea or have had diarrhea in the past two weeks. Require the wearing of "swimsuit diapers" or tight fitting rubber/plastic pants by children who are not yet toilet trained or individuals who do not have bowel control. Request that patrons remove their street shoes when walking on the pool deck.

Read more ...including sample bowel and bladder incontinence policy and procedure.

Link to Kiefer incontinence pants

Link to Sprint Aquatics incontinence pants:
Disposable retainers
Youth sized disposable retainers
Swim diapers

New therapy pool especially for children with autism

From MetroWest Daily News release.

At the New England Center for Children (NECC), a handful of students leaped, paddled and splashed in the center's new pool, oblivious to the who's who of Massachusetts politicians watching through the large glass windows.

NECC, a residential and day-school center for children with autism, held a ceremony June 20, 08 to dedicate the "Michael S. Dukakis Aquatic Center," named for the former governor who co-chaired the aquatic center's capital campaign and serves on the school's board of directors.

Before the ceremony, Dukakis and his wife, Kitty, lingered in the aquatic center to watch the swim lessons. U.S. Sen. John Kerry, Lt. Gov. Timothy P. Murray and state Rep. James Eldridge toured the $5.5 million facility as well.

"It was touching to see the expressions on their faces," said Kerry. "It's wonderful to see how the pool opens their character, confidence and identity."

read more about this pool built especially for children with autism.

Aquatic therapy seminar for the pediatric therapist

At the Aquatic Resources Network we are constantly being asked to put on aquatic therapy seminars for the pediatric therapist. Well, we aren't doing it ourself in 2008, so we thought we'd pass along a link for someone who is.

More info on the Sept 19-20, 08 aquatic pediatric therapy course (held in Norwalk, CT).

A toddler slips out of the house and heads for the family swimming pool. The boy falls in the water, and sinks, but something amazing happens next. Instead of drowning, he flips on his back, floats to the top and cries for help.

Too good to be true? You decide! Watch the video making the rounds on the Internet.

An organization called Infant Swimming Resource is teaching baby aquatic survival skills and drowning prevention classes to infants as young as 6 months old.

Harvey Barnett Ph.D. and his wife JoAnn have developed Infant Swimming Resource (ISR) into a nationally recognized program with a specific mission: prevent childhood drowning through specialized survival training. According to their statistics, since ISR’s inception in 1967 there have been more than 1700 aquatic survivals witnessed and 783 survivals unwitnessed.

Read more on becoming an instructor.

Goals for treating children in the water

At the ARN office, we are often asked about goals for treating children in the water so, we decided to give you some examples. Here are some goals for Speech, look for past postings for PT and OT goals.

 

Aquatic-based SLP goals

1. Attend to an aquatic activity for eight to 10 minutes or until completion twice per session. (Attending to a task is a foundation for building strong language skills).

2. Play with a novel aquatic toy for five minutes without upset once per session.

3. Produce "K," "G," "W," "F" and "T" in the initial position of words at phrase level with 80 percent accuracy.

4. Produce three-syllable words with 80 percent accuracy while being given multisensory aquatic cues.

5. Produce three- to four-word utterances with 80 percent accuracy with given cues.

6. Perform successful repetitions of shaker head raises (while lying supine in water) to promote strengthening of swallowing muscles.

7. Tolerate hydrostatic pressure against the rib cage while producing sounds and vocalizations without shortness of breath.

8. Perform lip and mouth closure and hold breath to perform immersion for 10 seconds without aspiration.

9. Share an aquatic task with a peer (expanding descriptive language by teaching a game to the peer).

10. Perform forced expiration necessary to project voice over loud atmospheric noises.

11. Perform sustained exhalation necessary to blow pool toy across surface of water for 10 seconds.

12. Articulate names of pool toys without sputtering.

13. Decrease facial sensitivity enough to allow splashing of water around face and neck without avoidance.

Goals for treating children in the water

At the ARN office, we are often asked about goals for treating children in the water so, we decided to give you some examples. Here are some goals for OT, look for other postings for PT and Speech goals.
 

Aquatic-based OT goals

 

1. Improve eye-hand coordination by throwing and catching a medium-sized ball with less than 30 degrees deviation to the target while standing in water up to the waist, for three out of four throws.

2. Improve bilateral coordination by paddling in a kayak position on a raft for 10 feet, two out of three times.

3. Independently propel through the water 10 feet without support or assistance from therapist, three out of four attempts.  

4. Maintain balance while seated on an unstable bolster in the water for one minute with minimal challenge, three out of four trials.  

5. Play fishing game which requires casting, reeling, and unhooking “fish” with fine motor skills.  

6. Cross midline while sitting on aquatic mat to retrieve aquatic toy  

7. Sustain interactive play with peer for 3 minutes while sitting on aquatic mat.  

8. Perform head-righting while “kneeling” on therapist’s thighs while immersed in water.

 

 

Goals for treating children in the water

At the ARN office, we are often asked about goals for treating children in the water so, we decided to give you some examples. Here are some goals for PT, look for future postings for OT and Speech goals.

 

 Aquatic-based PT goals

1. Perform unilateral stance on right and left leg for five seconds without trunk compensation and without assistance in 1 to 2 feet of water.

2. Successfully walk up and down one step in 1 to 2 feet of water without trunk compensation and without assistance two out of three times.

3. Successfully jump off a step or ledge 6 inches high into water with only standby assistance for safety two out of three tries.

4. Perform developmental transitions on floating mat (sit, kneel, supine, prone, quadruped, bridge, crawl, stand, etc.)

6. Perform symmetrical kicking motion to propel across water.

7. Crawl down ramp to enter pool independently.

8. Perform sit to stand in gravity-offset environment

9. Perform 5 minutes of sustained exercise at appropriate level of exertion.

10. Sustain scullying motion to keep body afloat for 10 seconds