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Sensory Integration is a term that is becoming more and more commonplace in discussions regarding differently abled and typical children alike.  Although most professionals in adapted aquatics do not purport to directly utilize sensory integration techniques as a treatment method, it is important that experience within the aquatic environment may contribute to a child's overall sensory experience.  In coordination with Project INSPIRE, this web page provides information that will be helpful in investigating some benefits of aquatic programming.  Below is information that may provide a starting point for exploring the topic of sensory integration as it relates to adapted aquatics.

Sensory Integration is "a term for a process in the normal brain which pulls together all of the various sensory messages in order to form coherent information on which we can act," (King interview, 1996).  In terms of therapeutic treatment, the approach was developed by Dr. A. Jean Ayres, an occupational therapist and neurophysiologist.   Treatment using specific Sensory Integration techniques are aimed at invoking an improved nervous system response and should, therefore, be professionally guided as it involves "a complex selection of interventions." (Wharger, 1991) and should only be utilized by trained professionals. 

However, it is important for all those involved with a child or person experiencing sensory dysfunction to understand that all activity involves a level of sensory integration. This is precisely where a discussion on adapted aquatics is appropriate.  A person who has sensory integration difficulties may have particular difficulty coordinating all of the sensory signals that received from the environment and this should be considered during adapted aquatics program planning. Below are various facets of this concept put to use within the realm of adapted aquatics.

Auditory Processing

"Auditory processing is the perception and ability to understand all that is heard in the environment". (Bissell, 1988).  Adapted aquatics may offer a challenge to persons with auditory processing problems because the pool environment may distort sound (such as in a large natatorium). Aquatics programming in a group setting tends to involve higher levels of sound. And, finally, certain techniques such as underwater immersion will, again, distort the quality and clarity of sounds and language heard.  Earplugs can be worn if an individual is becoming too over stimulated by the various sounds/sound levels in the aquatic environment. Underwater activities may provide a "muting" break when an individual appears to be getting over stimulated.  Underwater name or object guessing games can be used to foster the development of auditory processing.

Body Awareness

Body awareness is the perception of one's body dimensions and positions which comes from receptors that are located within one's muscles and joints. (Bissell, 1988).  An individual with decreased body awareness may frequently be the type of swimmer who bumps into objects or other swimmers or who may be fearful of activities such as the backstroke which involve a judgment about the navigation of one's body through a limited linear space. The aquatic environment is an excellent forum for developing body awareness. Swimming through floatation obstacle courses or underwater hoops assist an individual in determining how her or his body fits in to the schema of the external environment. Additionally such activities as floating on one's back can assist with heightened awareness of body dimension and position.  

Bilateral Coordination

The ability to integrate, cross over and coordinate movement from both sides of the body is a function of both sides of one's brain working smoothly together to integrate information  (Bissell, 1988).  An individual with decreased coordination of limbs on each side of the body may have difficulty with certain swimming strokes such as the front and back crawl which involve crossing the midline and coordinating movement on both sides of the body. A gradual introduction to the movements of these strokes to include visual and tactile cues (i.e., shallow water practice of reciprocal arm movements while touching a hand or marker) as well as games such "underwater escape hatch" in which an individual uses a hand over hand approach to pull themselves among an underwater line to "safety" can assist with facilitating bilateral coordination during aquatic activity.

Fine Motor Control

The ability to precisely coordinate ones fingers and hands for skilled manipulation and activity is referred to as fine motor control or coordination. (Bissell, 1988).  An individual with decreased fine motor coordination may demonstrate difficulty dressing before and after an aquatics activity as snaps, buttons, zippers and even fasteners for floatation devices require a good bit of fine motor coordination.  Activities such as diving for small objects and making "squirting one hand fountains" fountains in the water may be ways of increasing participation in fine motor activities during aquatics.

Motor Planning

Motor planning involves the brain's ability to conceptualize and carry out a sequence of actions, particularly those that are unfamiliar. (Bissell, 1988.).  Aquatics often poses a challenge for someone with motor planning difficulty because a new set of movements and movement patterns must be experienced and mastered in the aquatic environment.  Activities such as a swimming an obstacle course, or a floating "fun noodle maze" are just a few activities that can assist in the development of motor planning skills.  Obviously one of the greatest activities in aquatics that requires motor planning is the mastery of stroke patterns themselves.  Breaking down patterns into 1 to 2 step tasks as well as using rhythms and visual reinforcement are ways to increase success for persons with motor planning difficulty.

Perception of Movement or Vestibular Awareness

Perception of movement involves the brain's interpretation of vestibular information about movements in a gravity-based environment (Bissell, 1988).   Individuals with vestibular dysfunction may have difficulty judging the effects of their movements in relation to space and gravity. This may coexist with or create a lack of appropriate protective reactions and can cause a person to become quite fearful of large and quick movement.  Gradually introducing new movements and sensations such as floating and the use of firm, reassuring hand placement may assist the swimmer. Emphasizing touch and vision to assist with movement awareness may also be helpful. 

Some individuals require a great deal of movement to experience and process vestibular sensations. They may jump, bob or circle seeking out such input.  Many swimmers do this naturally to give their central nervous system the input it needs. 

Perception of Touch or Tactile Processing

"Tactile perception refers to the sense of touch on the skin." (Bissell, 1988) An individual with difficulty in tactile processing may be either over-sensitive or under-sensitive to touch. Often children who are hypersensitive may appear aggressive simply because they are startled by touch that is perceived as noxious or irritating.  Individuals may resist touching a variety of textures, and, in some instances they can be defensive to the feel of various textures in their mouth.  One advantage of aquatics is the neutral warm environment that most pools offer. The warmer temperature and consistent pressure of the water against the skin can serve as a source of constant, easily discernable, and, therefore, calming sensation. The use of snug lycra swimwear can also provide such a calming effect and one may even want to consider the use of a unitard or bicycle shorts to enhance this effect.   

Individuals with tactile hypersensitivity may be adverse to splashing or water trickling on their face and body.  Also, a gradual introduction of textured pool toys can assist with increasing awareness of tactile processing.  

Ocular Control

Ocular control involves the smooth coordination of the muscles of the eyes used when attending to or following objects (Bissell, 1988).  A child or individual having difficulty with ocular control may appear distractible in that they can only visually attend to objects for brief periods of time.  The use of this skill in aquatics comes in to play in staying aware of  the usually dynamic surroundings of the pool environment.  Activities such as in-pool "I Spy" games as well as scanning the pool bottom for "sunken treasure" may help the child develop ocular control. 

Visual-Spatial Perception

"Visual-spatial perception is how a person perceives the relationship of external space to his body as well as how he perceives objects in space relative to other objects" (Bissell, 1988).  A child or individual having difficulty with visual-spatial perception, much like a person with body awareness difficulty, may bump into other swimmers in the pool. Jumping, diving, and judging the distance to the wall during lap swimming may also be difficult for such individuals.  Activities that may be helpful include water volleyball with a beach ball, target practice with sponge balls, underwater retrieval of submerging objects thrown for long distances and even jumping or swimming out to touch targets in the water.

Resources and Bibliography

Below are a list of books and resources that may be helpful in learning more about sensory integration and individuals with disabilities.

  • Anderson, E. & Emmons, P. (1996). Unlocking the Mysteries of Sensory Dysfunction. Future Horizons, Inc, 422 E. Lamar, #106, Arlington, TX 76011.

  • Ayers, A. Jean. Interrelations among perceptual-motor functions in children. American Journal of Occupational Therapy, 20, 68-71.

  • Ayers, A. J.. (1994) Sensory Integration and the Child. Los Angeles: Western Psychological Services. 1994.

  • Ayers, A. J. Tactile functions: their relation to hyperactive and perceptual motor behavior. American Journal of Occupational Therapy, 18, 6-11.

  • Bissell, J, et al (1988). Sensory Motor Handbook: A Guide for Implementing and Modifying Activities in the Classroom, Torrance, CA:  Sensory Integration International.

  • Cheatum, B. & Hammond, A. (2000) Physical Activities for Improving Children's Learning and Behavior. Champaign, IL: Human Kinetics.

  • DeGangi, G.A. (1995) Infant/Toddler Symptom Checklist: A Screening Tool for Parents. Tucson, AR: Therapy Skill Builders. (1-800-0763-2306)

  • Fink, Barbara E. (1989) Sensory Integration Activities. Therapy Skill Builders. 3830 E Bellevue, Tucson, AZ 42050

  • Huettig, C., Pyfer, J. & Auxter, D. (2001) Gross Motor Activities for Young Children with Special Needs.  St. Louis: McGraw-Hill.

  • Kranowitz, C. (1998) The Out-of-Sync Child: Recognizing and Coping with Sensory Integrative Dysfunction.

  • Trott, Maryann Colby et al. (1993)  SenseAbilities: Understanding Sensory Integration. Tucson, AR: Therapy Skill Builders.

  • Wilbarger, P. & Wilbarger, J. (1991). Introduction to Sensory Defensiveness in Children Aged 2-12: An Intervention Guide for Parents and Other Caregivers. Santa Barbara, CA: Avanti Educational Programs.


  • American Alliance of Health, Physical Education, Recreation and Dance (AAPHERD), 1900 Association Drive, Reston, VA, 22091

  • Sensory Integration International, 1602 Cabrillo Avenue, Torrance, CA 90501, (310) 320-9986. (A non-profit organization dedicated to networking and providing information about sensory integration.)

  • Sensory Integration Network: c/o The KID Foundation, 1901 West Littleton Blvd. Littleton, CO 80120

This content was created by Amy McBride, OTR,

a doctoral student in Adapted Physical Education

Texas Woman's University

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