Background and Purpose: Autism Spectrum Disorder (ASD) is a developmental disorder in which children can present with multi-system delays. These delays include, but are not limited to, communication, behavior, and motor function. Children diagnosed with ASD also tend to be repetitive in their actions. Due to water's increased sensory contributions, and buoyancy, research has proven aquatics has a greater impact on those diagnosed with ASD rather than conventional therapy alone. In addition, aquatic therapy (AT) has provided positive correlations on behavioral, communication, and sleep disturbances in those diagnosed with ASD Stand Up Paddle Boarding Aquatic Therapy (SUPAT) is an innovative AT technique that might provide an opportunity for children with ASD to participate in a recreational sport that has been shown to improve balance and strength. The purpose of this case study was to explore the effects of SUPAT on balance, motor function, and attention span in a child with ASD.
Case Description: The participant has a diagnosis of ASD. He has sensory processing disorder and difficulty processing auditory stimulation making following commands challenging for him as well as decreased ability to sustain attention to tasks longer than 1-3 minutes. In addition, he has significantly decreased balance and strength compared to age-related peers. The patient attended seven 60-minute SUPAT sessions at the lake. The sessions included a 10-minute warm up, a trial run, standing dual tasks while paddling with therapist on/off the board, transitions on/off board and motor planning activities throughout the session with swim breaks integrated throughout the session. Assessments at each session included pre/post testing of Bruininks-Oseretsky Test of Motor Proficiency Ed. 2 (BOT-2and trial runs (length of time a child can paddle in standing before sustaining loss of balance, loss of attention to the task, or complains of being too tired).
Outcomes: At the first session, the child's trial run duration was 1 minute 49 seconds and at the 7th session, the child was able to paddle for 7 minutes 42 seconds improving by over 5 minutes. The therapist also observed independent standing while paddling on the board with maximum verbal cueing and improvement in form/duration. The balance and strength sections on the BOT-2 were completed pre- and post- SUPAT intervention and he scored 14, incomplete (unable to maintain attention long enough to complete the test) on the pre-test and 12, 2 on the post-test. In terms of his attention span, the child was able to complete both subsections of the BOT-2 after the SUPAT intervention.
Discussion: The participant demonstrated improved attention to task, when the trial run and 7th session are compared. The therapist observed improved command understanding, requiring decreased verbal cueing and increased participation throughout the session with SUPAT compared to land sessions. SUPAT may be a fun alternative to traditional pediatric aquatic therapy that can improve balance, strength, participation in therapy, and attention to task.