Overview

AquOTic is an evidence-based, occupational therapy-led intervention designed to enhance water competency and swim safety skills in children on the autism spectrum. The 10-week program consists of weekly 60-minute group sessions, each including six children paired in a 1:1 ratio with an interventionist. Sessions follow a structured routine involving six rotating stations, targeting various swim and safety skills, with the flexibility for individualized support by the interventionist.

Overall, this study has 3 major aims. The first aim evaluates the effectiveness of the AquOTic intervention in improving water competency and swim skills, while comparing outcomes between two implementation models: professional student interventionists (occupational and physical therapy students) and trained community-based interventionists. A total of 108 autistic children will be enrolled and randomly assigned to one of three groups: (1) AquOTic with professional student interventionists, (2) AquOTic with community interventionists, or (3) a control group receiving no AquOTic intervention. The second aim explores the mediators and moderators of the intervention outcomes to assess fidelity and efficacy. The third aim identifies the cost and resources associated with AquOTic. A cost analysis will be conducted to evaluate the resources required for implementation and to inform the development of a scalable, cost-effective drowning prevention strategy for autistic populations.

Eligibility

Children Participants (n=108)

Inclusion Criteria

• Educational or medical diagnosis of autism
• Age between 5 - 9 years
• Having vision and hearing within normal limits with or without corrective modifications

Exclusion Criteria

• Children who demonstrate swim proficiency, as defined by the ability to tread water for 1 minute or move the body through the water without flotation
• Open wounds or infectious skin diseases
• Allergy to chlorine
• Severe co-occurring motor impairments or neurological conditions such as uncontrolled seizures, Rett's or Angelman's syndrome
• The family is unable to commit to the sessions or evaluations

Interventionists (n=64)

Inclusion Criteria

• Aged 18 or over
• Demonstrate swim proficiency, as defined by the ability to tread water for 1 minute and move the body through the water without flotation for 25 yards

Exclusion Criteria

• Open wounds or infectious diseases
• Failed background check
• Unable to commit to Basic Swim Instructor and AquOTic training (\~40 hours) and 10 AquOTic sessions (20 hours)