Date Presented 03/21/24

This presentation will detail the development, treatment fidelity, active ingredients, and effectiveness of AquOTic, an OT-based aquatic intervention for improving water competency for children on the autism spectrum.

Primary Author and Speaker: Erika Kemp

Additional Authors and Speakers: Mequeil L. Howard, Savanna Yates, Jewel Elias Crasta

PURPOSE: Examining treatment fidelity and active ingredients (key treatment components) of occupational therapy interventions is critical for developing evidence-based practice standards and interpreting effectiveness (Hand et al., 2020). This presentation will detail the development and effectiveness of AquOTic – an occupational therapy-based aquatic intervention for improving water competency for children on the autism spectrum (Kemp et al., 2023).

DESIGN: Children on the autism spectrum (N=37; ages 5–9) were randomized into a 10-week AquOTic intervention or control group using a waitlist randomized control design.

METHOD: Fidelity to the active ingredients of AquOTic was measured using a treatment fidelity checklist and completed by the interventionist after each weekly AquOTic session. AquOTic sessions were video-recorded to confirm the presence of active ingredients. Outcome measures included standardized performance-based and parent-report measures of water competency.

RESULTS: The AquOTic intervention was delivered with high treatment fidelity as measured by the treatment fidelity checklist and video analysis of active ingredients. Children in the AquOTic group showed significantly higher swim skills post-intervention compared to their baseline scores (p<.001). Caregivers of child participants reported high satisfaction with goals related to water competency post-AquOTic.

CONCLUSION: Establishing the treatment fidelity and efficacy of the AquOTic program will allow us to ensure that this intervention is client-centered, occupation-based, theory-driven, and manualized. With the growing prevalence of autism, it is imperative to develop innovative and evidence-based occupational therapy interventions that meet the needs of the autism community.

IMPACT STATEMENT: The AquOTic intervention has the potential to transform water competency and drowning prevention intervention in children on the autism spectrum, a group that is at high risk for drowning.

References

Hand, B. N., Darragh, A. R., & Persch, A. C. (2018). Thoroughness and psychometrics of fidelity measures in occupational and physical therapy: a systematic review. The American Journal of Occupational Therapy, 72(5), 7205205050p1–7205205050p10. https://doi.org/10.5014/ajot.2018.025510

Kemp, E., Woodson, R., & Baldino, M. (2023). Addressing swim safety in autistic children: a pilot feasibility study using aquatic occupational therapy. International Journal of Aquatic Research and Education, 14(1), 2. https://doi.org/10.25035/ijare.14.01.02

Walsh, K., Kemp, E., & Woodson, R. (2021). Effectiveness of aquatic OT for children with autism spectrum disorder. The American Journal of Occupational Therapy, 75(Supplement_2), 7512515318p1–7512515318p1. https://doi.org/10.5014/ajot.2021.75S2-PO318

Woodson, R., & Kemp, E. (2021). Parent perspective of OT-focused aquatic intervention for children with autism spectrum disorder. The American Journal of Occupational Therapy, 75(Supplement_2), 7512515365p1–7512515365p1. https://doi.org/10.5014/ajot.2021.75S2-RP365