It’s officially the silly season and families are making their way back to the beach, pool, or rivers for the first time in far too long.

While spending time by the water can be a chance to relax and reflect on the year that has passed, it can also present new challenges and dangers for our loved ones. Children and adolescents (0-19 years) on the autism spectrum are 3x more likely to drown than their peers (Peden & Willcox-Pidgeon, 2020). Well-established prevention strategies such as pool-fencing and active adult supervision continue to be front-line defences in the prevention of drowning for children on the autism spectrum. However, recent research has identified specific risk factors for people on the autism spectrum that require further consideration.

These safety challenges can include

Wandering and attraction to the water

Wandering is the tendency for an individual to try to leave the safety of a responsible person’s care or a safe area, which has the potential to result in potential harm or injury. It is often referred to as absconding, elopement or fleeing. Almost 50% of children on the autism spectrum will attempt to wander, which is a rate nearly four times higher than their peers.

It is not uncommon for individuals on the autism spectrum to become overstimulated with crowds, noises and a range of other stimuli, and wandering can be an attempt to escape this by retreating to another environment. Outside the water, sensory rich environments provide visual (e.g., light reflecting from the water, splashing of water), auditory (e.g., water gushing, children playing, loud music and whistles) and olfactory (e.g., chlorine and mangroves can have strong smells) input.

For some people, this can be overstimulating and make the environment feel uncomfortable or unsafe. Some individuals gravitate toward bodies of water and find that being immersed in water can alleviate overwhelming sensory input. For others, it could meet a need for more sensory input (e.g., the way the light glistens when the water moves, or the deep pressure feeling of moving underwater) making the environment feel enticing. Understanding individual responses to sensory input can help to identify wandering risks and potential adjustments when visiting novel and unfamiliar environments.  

Difficulties with communication

Communication relates to the ability to convey and understand messages with others. Some children may have diverse communication needs which means they are not able to express themselves, respond to others or ask questions without assistive technology or assistance. Difficulties with communication have significant impacts on safety behaviours. For example, if a child does not understand instructions or rules in an environment, then they are not able to follow them. Similarly, if the child is not able to communicate their needs, they are more likely to wander or engage in risky behaviours in order to have their needs met. Understanding and having the resources to support individuals with diverse communication needs is integral for ensuring safe aquatic environments this summer.  

Difficulties with generalisation of skills

Even though an individual has had swimming lessons and developed swimming and water safety skills, they may experience difficulties using these skills in novel and unfamiliar environments. Generalisation or transfer of skills relates to the ability to retrieve and use skills in a variety of contexts. This is developed through consistent and variable practice opportunities. Practicing safety skills in different pools, with or without goggles, and wearing clothes instead of swimwear are examples of ways to promote skill transfer or generalisation. Safe, structured exposure to new aquatic environments can also play a key role in building a strong foundation of water safety awareness and skills.

Difficulties perceiving danger

Early cognitive skills such as social imagination, impulse control, and cognitive flexibility impact on an individual’s ability to perceive danger and judge risk. Social imagination allows us to anticipate risks and consequences of our actions, impulse control allows us to stop and think before doing (i.e., looking at pool depth before jumping in), and cognitive flexibility allows us to consider alternative outcomes to our plan. We can create safer behaviours in aquatic environments through developing routines and using visual supports such as a social story, positive pool rules poster or through modelling (e.g., pointing out signs in the pool area or saying “I’m walking around the pool so that I don’t fall”).

What can you do to create a safer summer around the water?

Download Autism Swim’s World First Water Safety App!

Available on Google Play and the Apple App Store for iPhone and iPad devices, your child can interact with interactive social stories which target key safety skills for bodies of water. Help your child to prepare for swimming at the pool, the beach or the lake with new storyboards being launched this summer!

Use resources and strategies at home

Autism Swim has a range of resources, including visual aids and social stories, to support autistic people, their parents/carers and their educators to prioritise water safety. You can explore these resources here.

Enrol in an Autism Swim approved program

Swimming and water safety lessons with a focus on survival skills, if undertaken with appropriate instruction, has also been proposed as a drowning prevention strategy suitable for children and adolescents on the autism spectrum. You can find instructors who have accessed comprehensive training, mentoring and have access to resources to ensure your child is set up for success in their program. Find a local provider here. 

Has your child already attended learn to swim programs and looking for their next aquatic activity? Surfing instructors can now access Autism Swim Certifications, so surfing could be something worth trying!

By Jessica Thackeray, Clinical Lead & Occupational Therapist at Autism Swim.‍

‍References

Guan, J., & Li, G. (2017). Characteristics of unintentional drowning deaths in children with autism spectrum disorder. Injury epidemiology, 4(32). https://doi.org/10.1186/s40621-017-0129-4

Hwang, J., Srasuebkul, P., Foley, K., Arnold, S., Trollor, J. (2019). Mortality and cause of death of Autsralians on the autism spectrum. Autism Research, 12(5). https://doi-org.ezproxy.library.uq.edu.au/10.1002/aur.2086 

Peden, AE., Willcox-Pidgeon, S. (2020). Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Archives of Disease in Childhood 105(9). DOI:10.1136/archdischild-2019-318658