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Rett’s disorder, or Rett’s syndrome, is a severe degenerative condition, under the broad umbrella of Pervasive Developmental Delays, that affects only females. It is diagnosed by:

  • deceleration of head growth between ages 5 and 48 months,
  • loss of previously acquired hand skills between ages 5 and 30 months,
  • loss of interest in the social environment,
  • appearance of stereotyped hand-wringing movements,
  • gait and coordination problems,
  • subsequent development of severe impairment in language, and
  • subsequent development of severe impairment in psychomotor function.

To meet the unique needs of a swimmer with Rett’s Disorder in an aquatic environment, a very small teacher-student ratio is required; typically, a one-to-one ratio will be necessary.

A highly structured environment is required. Each lesson should begin and end with the same greeting.

The same organization strategy and equipment should be used each day.  The same one-word or two-word name for equipment should be used each time. The same one-word or two-word prompt for an activity should be used each time it is desired/performed.

Careful transitions between activities allow the swimmer to prepare to learn.

Eliminate unnecessary external stimuli and limit the amount of relevant stimuli presented at one time. The aquatic environment may heighten sensory input due to the dynamics of the medium such as temperature, light reflections and pressure sensations. Moving while under the surface of the water may actually reduce the stimulation due to constant hydrostatic pressure and muted auditory and visual stimuli.

Utilize sensory stimulation and, if possible, vigorous aerobic exercise to increase attention span and decrease self-stimulatory and off task behaviors.

If possible, the aquatics instructor should use the same behavior management plan the child’s classroom teacher and parents are using.

The swimmer’s full attention is required prior to instruction.  The swimmer must be making eye contact for learning to occur.

Teach safety often and be very specific.

The swimmer should have a "home base" or a place designated just for him/her to which they return after each activity.

Simplify the task.

Breathing dysfunction may prohibit the use of vigorous aerobic exercise or cardiovascular training. The swimmer with Rett’s Disorder may not be able to hold his/her breath for a long period of time so underwater swimming is contraindicated.

Music therapy has been shown to be very helpful when working with individuals with Rett’s Disorder. The same songs should be used daily. New songs may be added when others are mastered.


Auxter, D., Pyfer, J., & Huettig, C. (1997). Principles and methods of adapted physical education and recreation. (8th ed.). Saint Louis: McGraw-Hill.

Sherrill, C. (1998). Adapted physical activity, recreation and sport: Crossdisciplinary and lifespan. (5th ed,). St. Louis: McGraw-Hill.

This content was created by Tiffany Bowers,
Master's Student in Adapted Physical Education at Texas Woman's University,
as part of requirements for
"Aquatics for Special Populations", Huettig, Summer, 1999.

page last updated 1/3/2017 1:00 PM