-Brown v. Board of Education, 347 U.S. 483 (1954)
Autism is a lifelong neurological and biological developmental disability that begins at birth or during the first three years of life. Current prevalence rates indicate an incidence of about 2 in 1000. Although the cause is still unknown, Autism appears to be associated with some hereditary factors. The risk of Autism is three times more likely in males and is not isolated to any one race, culture or socioeconomic group.
The Diagnostic Statistical Manual of Mental Disorders (DSM IV, l994) places Autistic Disorder under the broader category of Pervasive Developmental Disorders, which includes Autistic Disorder, but also Rett's Disorder, Childhood Disintegrative Disorder, Asperger's Disorder, and PDD not otherwise specified.
Autism has numerous treatment implications for recreational therapy because of the significant impact on an individual’s lifestyle. The main features of Autism include severe delays in language development, inconsistent pattern of sensory responses, uneven patterns of intellectual functioning with peak skills in some areas and significant deficits in others, and marked restriction of activity and interests. Beyond the public perception of Dustin Hoffman’s performance in the movie Rain man, most people understand very little about this complex disorder that affects every aspect of an individual’s life.
Socially, children with Autism may lack awareness of others, have severe anxiety around others, experience difficulties with reciprocity, and significant difficulties with socialization. A child with Autism will usually lack any kind of a social smile or eye contact. They lack ‘normal’ responses to people, they may laugh and giggle inappropriately or cry and tantrum easily. The usually have poor play skills, and spend time alone rather than with others. They show little interest in making friends and usually lack the ability to form personal attachments. Often children with Autism lack spontaneous or imaginative play. They do not imitate others' actions and they don't initiate pretend games like other children.
Autism involves many cognitive consequences including; problems with verbal commands, problems with verbal concepts and explanations, literal and concrete understanding, delayed processing, and problems with communicating. Children with Autism often focus on detail and have trouble with choices. They are unable to distinguish relevant from irrelevant information, which results in significant difficulty making decisions. They have trouble understanding cause and effect relationships and are usually not able to understand the concept of time.
Children with Autism have a strong need for sameness and they usually have a very hard time with any changes or transitions. These children have a strong need for rituals and routine and free time is very difficult for them to manage.
Children with Autism often have low muscle tone, self-injurious behavior, and unusual sleeping patterns. Autism is associated with various kinds of neurobiological symptoms, which may include unusual reflexes and high rates of seizure disorder. Children with Autism have significant sensory and perceptual problems, including inconsistent response to sounds. They are very distractible and will over or under react to stimuli. They usually dislike certain textures. They may have a strong sensory need to smell or lick and they have a great deal of trouble screening sounds and processing words.
The lifestyle of children with Autism includes many challenges due to their organizational and sequencing problems. These children don’t know where to start, what comes next, or when a task is finished. This creates significant difficulties with organizing their day or their activity involvements.
Recreational therapy interventions can help address many of these affected life areas. Recreational therapy can play a primary role in enhancing the quality of life and productivity of a child with Autism. According to the American Therapeutic Recreation Association, Recreational therapists offer individuals with disabilities the opportunity to resume normal life activities and to establish/re-establish skills for successful social integration.
Among the range of interventions that a recreational therapist might choose, one unique and very successful alternative for individuals with autism is aquatic therapy. Water activities provide autistic children with proprioceptive and tactile input. Children with Autism have significant sensory difficulties, and are very distractible. These children over or under react to stimuli in their environment and have very strong reactions to certain textures. The warm water provides a safe and supported environment, which not only supports the children, but also provides them with hydrostatic pressure that surrounds their body in the water. This pressure actually soothes and calms the children, providing the necessary sensory input they crave.
Aquatics activities are a fun and enjoyable experience that have many physical, psycho social, cognitive, and recreational benefits. Research continues to support the concept that water is the ideal medium in which to exercise or rehabilitate the body. Water provides an environment, which reduces body weight by 90%, decreasing stress or impact on the body. Warm water also reduces spasticity and relaxes muscles.
For children with Autism aquatic therapy can focus on therapeutic play-based functional movement, improving range of motion, helping to facilitate neurodevelopmental growth, improved body awareness, increased balance, sensory integration, mobility skills and most importantly, having fun. The Aquatic Therapy and Rehabilitation Institute defines Aquatic Therapy as "The use of water and specifically designed activity by qualified personnel to aid in the restoration, extension, maintenance and quality of function for persons with acute, transient, or chronic disabilities, syndromes or diseases". Clients with Autism present an interesting opportunity for recreational therapists to use aquatic therapy interventions as part of their overall treatment plan.