Adapted swimming, aquatic skill development and emotional regulation in children with Autism Spectrum Disorder (ASD) and Intellectual Disability (ID)

Abstract

Emotional regulation is a fundamental psychological process that enables individuals to manage and adapt their emotional responses in ways that support well-being and social functioning. Children with Autism Spectrum Disorder (ASD) and Intellectual Disability (ID) frequently experience difficulties in emotional regulation, which may contribute to emotional, behavioral, and social challenges. Despite growing evidence supporting the benefits of adapted swimming, limited research has simultaneously examined improvements in aquatic skills and emotional regulation in these populations. This study investigated the efficacy of an adapted swimming program with visual prompts in improving both aquatic skills and emotional regulation in children with ASD and ID. Thirty children (20 with ASD and 10 with ID) were randomly assigned to an experimental group (EG; n = 17) or control group (CG; n = 13). The EG participated in a 14-week adapted swimming program with visual prompts. Participants were assessed before and after the intervention to examine changes in aquatic skills and emotional regulation outcomes, including within-group improvements and between-group differences. Significant pre- to post-intervention improvements were observed exclusively in the EG across measures of aquatic skills and emotional regulation. Furthermore, post-intervention comparisons revealed significantly better outcomes for the EG than the CG, supporting the effectiveness of an adapted swimming program with visual prompts for children with ASD and ID. Significant positive associations were observed between aquatic skills measures (WOTA-1 and A-SEAS) and between A-SEAS (Emotional Adjustment) and ERC scores. Overall, an adapted swimming intervention with structured visual supports appears to be an effective approach for enhancing both functional aquatic abilities and emotional regulation, providing new evidence for the role of aquatic environments in promoting holistic developmental outcomes.