Reflections of and on a probably Asperger's parent parenting an Asperger's kid (or 2)!

dragon pups

dragon pups

Thursday, March 7, 2013

The Sensory Experience of Water...


I have been instructing swimming for 3 years now (formally) and have an American Red Cross (ARC) Water Safety Instructor (WSI) certification.  All that has combined with my previous teaching experience (classroom as well as challenge course) and parenting experience to bring me to a place where I see the process of learning & teaching swimming in a vocabulary I am not hearing elsewhere.

There are certain behaviors that are common to children (and adults) who struggle to swim.  They have trouble tolerating certain sensations - like water in the eyes, or floating on their backs, or jumping in...  these behaviors are COMMON, expected even.  Most of the strategies that are suggested in WSI training include offering the students visuals/ descriptions of what their body should look like/ do.

But I think it is MORE than that.  As the parent of a child on the Autism Spectrum, I have been gifted the opportunity to learn about Sensory Processing Disorder (SPD).  The idea is that individuals on the spectrum actually process the information from their senses in an extreme fashion – they either feel too much (avoid stimuli) or too little (seek stimuli) from every sensory input.  We seek treatment for our children with Sensory Integration Therapy (SI therapy) which is about incremental building of stimuli to create a habit of tolerance.  (We help them get “used” to the world around them VERY S-L-O-W-L-Y).  It's really very Montessori in philosophy - the "teacher" is creating an environment where the student teaches themselves through experience.  The learner has to conquer their own body…

Teaching swimming is EXACTLY that.  When you become a WSI they give you Performance Standards by which the instructor measures progress through levels.  The literature makes it clear that students will often "stall out" at a particular level and have to take it several times to "pass" it.  At first I thought "What a racket!", but then I realized it's really about that "Montessori" realization that the body and the mind must meet for us to observe "success" / mastery - and that happens at a different pace for EVERYONE.  

The Body and Mind must meet.... sounds like "sensory processing" process to me.

Water/ swimming/ submersion is an "alien" environment - it creates sensations for ALL people that are "alien" to our daily living - in particular it significantly impacts the tactile, vestibular and propioceptive sensations and processing.  

The strength of SPD, for me, is that it provides me a language, a vocabulary with which to identify and then address challenges.  And I don't just mean that it allows me to identify what's "wrong with you"..., I mean that it allows me to explore my own experiences, compare them to others, see and label minute facets, and then verbalize that understanding - it allows me (the teacher) to identify with you (the learner) so that we can put a name to those unknowns that are the starting point for fear.  

And fear WILL kill you in the water.  If you cannot relax and trust the water to support you, you WILL sink.  It is ONLY when the body is relaxed that we can float.

And once we identify with each other, we can find common ground - I can tell you what strategies helped me, and we can observe together if those strategies help you, or if they helped someone else, or compare them to what your instincts are leading you to do, and the natural physics that drives the physical reality that is coming to the senses...  We can work incrementally to create a series of successes that help the learner gain confidence in their ability to conquer their body.

Here are some of the ways my experience/ insights from autism shape my swim teaching:

Incremental Learning/ building physical tolerance
Much like Sensory Integration therapy (SI) - the student has to be exposed to the stimuli many, many times over a long period in small steps - in other words: GO GENTLY.  With swimming in particular, parents become VERY invested in seeing success, because it is a safety issue.  There is a cultural perception that swim lessons will "drown-proof" a child - and that is simply NOT true.  It is VERY, VERY frustrating to watch a child be so afraid or reluctant that they do not perform the "assigned task", but the point is that their body HAS to teach them.

Adults around the students have to remember that this learning experience is compounded by the novelty of being in the alien environment of water itself.  Maybe the parent's goal IS to teach or hone life-saving aquatic skills (make them better swimmers).  If that is the case, then watch - observe, and remember that teaching is most successful when it comes in digestible pieces. What skills ARE your child lacking? Which do they already exhibit?  Do they have the motor control to actually do that movement?  The hardest part of swimming is that the body is performing several tasks simultaneously, often alternately - so it's like patting your head, rubbing your tummy, chewing gum, and keeping a rhythm with your toes and then switching every 7 seconds. There is a LOT going on there! 

BE PATIENT.  

That is hard to do with your child under any circumstances, but especially when you are so concerned to see that progress that will make you feel confident about their safety.  Like the adage of special needs parents - celebrate the small successes.  Focus on just one skill at a time: submerging, flutter kicking, breast stroke pull.  Even at the competitive swimming level, this is what they are doing - concentrating on the minutia of a movement until it becomes MUSCLE MEMORY.

And that is where the length of the class is a problem.  Traditionally swim lessons are 8 1/2 hour sessions (that is what the Red Cross curriculum is set up for) - so 4 hours of instruction time.  Think carefully about that.  What skill did you learn in just 1/2 an hour?  Have you ever mastered a new skill in just 2 weeks?  Middle school classes are typically 45 - 55 minutes, and it takes kids 9 months to "master" a topic!  Having realistic expectations about what your child will take away from the class is VERY important, as well as understanding that it is just a starting point.  A 1/2 hour class is not really long enough to allow the kind of practice that builds muscle memory - it allows the kind of practice to explore.  And the hard truth is that while there are "correct" processes and movements to swimming, each and every body swims in a different fashion.  I can't tell you how many parents come to class concerned that their child can't float.  Well, if your kid is finishing a growth spurt and has no fat to float on, then you're right - that kid won't float - at least not flat.  The kid needs time to explore their own "center of bouyancy" - which is not the "center of gravity".  Your kid has been trying to coordinate their arms & legs to run and play for several years by the time you hit swim lessons - and now the water moves the center of their body!?! CRAZY!

The best way to support your child's ability to swim is to come to the pool often so they can practice on their own terms; That kind of learning is self-teaching - the brain and body will remember it longer - but: 

IT TAKES TIME.  

Language
I have often said that the strength of SPD discussion to me is that it provides me a language to describe what I see.  Being able to verbalize your fears always makes them more conquerable.   It also allows us to be specific.  And the seeking/ avoiding aspect of SPD lets people make correlations between their actions (or the actions they observe in others).

VESTIBULAR: This is that sense of balance in the inner ear. One of the most mentioned concerns with teaching swimming (by concerned parents and in training tips) is reluctance to float.  When I see that behavior in toddlers I immediately ask if the child has reluctance to tilt their head back for hair washing too (a textbook example of a vestibular avoider).  How about swings? Does that kid who is reluctant to float avoid swings too, or demonstrate a low tolerance for them?  Adults do that too - by avoiding roller coasters.  Or is your kid a vestibular seeker? Do they hang off the couch upside down often? (Yeah, I totally did that as a kid, and knew it made me "feel" better, but not why).  Are they having trouble floating because they are busy turning over/ feeling their body move?  Once we can identify associations outside the water, then we can "treat" them/ "practice" them outside the water.  My son definitely conquered being horizontal in the water (the major milestone of successful swimming) by conquering swings through the winter.  And talking about what they are feeling, gives them more control over what they are feeling.  

I did an interesting experiment on my husband - who is amazingly physically awkward (visually so).  At 40 years old, he had never floated, so I asked him to lay in the water while I supported him.  He did (BIG trust moment), but the insight is not that grown-ups have sensory issues too - it's that he is old enough to describe to me what he felt.  After floating for no more than 2 minutes, he stood up and weaved on his feet for nearly 4 minutes.  He did say that propioceptive input (hugging and submerging to the shoulders) helped him "re-center" and be able to walk straight again.  While this example may seem extreme, consider that he has gotten though his whole life without ever having to deal with this sensation.  If your kid doesn't like laying in the water, or swings, or vestibular input, they may be having this extreme reaction and can't verbalize it to you!  Help them build that vocabulary.... "Hmm, does laying in the water make your head feel like it is spinning?"  "Are there circles inside your head?"  "Does the swing make you feel like it is hard to stand up?"  "Does it feel good to hang upside down?"  Use your instincts - think about what YOU experience, verbalize YOUR sensations, and give them room to disagree with you!  Their body is theirs, and maybe they feel something different, but by opening the discussion, you give them the room to label their sensations, compare them, conquer them.

PROPIOCEPTION:  This is that idea that the joints register pressure in the nerves to define where they are in space.  This theory explains why kids trip over their own feet, or hit too hard, or don't like being hugged.  As adults, this is often at the heart of a couple's cuddling debate.  In therapeutic use, we use it to "center" the body, to calm the "hyperactivity".  It is the exact same "technology" that the "Thunder Shirts" for dogs uses - and that swaddling babies uses.  It comes into play with water because - water is heavy.  I have read in one occupational therapist's Facebook [Raising Sensory Smart Kids - a book too] that many propioceptive seekers submerge to feel the water "hugging" them.  I would imagine that propiocetive avoiders (I don't have one, so I have to extrapolate here) are bothered by the weight of the water on their body, much like a weighted blanket would feel like it entraps them.  Validating these sensations with vocabulary, with labeling them, creates a skill to build instead of a vague fear to avoid.  The body will still need to be dosed in small increments so as not to overwhelm, but the process (and oration of that process) of creating small goals, and meeting them, will empower the learner.  "Does the water feel like it is hugging you?"  "Can you feel your hand pushing the water against your legs?"  "Do you feel your feet coming out of the water when you kick?  Try keeping them in the water..."  "Let's try submerging just to our belly button... just to our elbows... just to our shoulders..." 

TACTILE:  There are 2 aspects to this that need to be explored.  One is the sensation of water on the skin.  I kind of think that one might be linked to propioception - like the difference between being brushed up against and banged.  Water tends to be gentle - so maybe the movement of water on the skin really does "tickle" people?  I don't know that I have ever heard someone say that in those terms, but I think it is a strong possibility.  Again, incremental exposure is the best "treatment".  People learn to not be ticklish - or at least control their reaction.

The second has to do with water in the face.   I am not sure that "tactile" is the best category for this, but I am not sure where else to categorize it.  This is a complicated discussion.  It is absolutely normal to react with anxiety when the face is covered in water (like submerging the head) - I would argue that it is an instinctive life preserving reaction.  In fact, we take advantage of that when we teach the Mommy & Me swimming.  Infant's bodies automatically hold their breath when their face is wet or blown into.  We reinforce that instinctive response by counting down to submersion and praising its accomplishment - moving the unconscious act into conscious control.  I think it is a similar thing as you get older - about controlling your body and environment, about creating consciousness of what the body does without our thought.  This is a pretty deep thing.... 

Interestingly what most kids and adults I have worked with do orate is that they are uncomfortable with the sensation of "water in their eyes."  You can totally practice getting water in your eyes in the shower! I find that I tend to spend most of the time in the shower with my face out of the water, but you can actually practice the looking down thing in the shower by putting your head squarely in the spray - gain control of what is happening/ start with the familiar and slowly add new sensations [EXACTLY what SI therapy is about].  Once you're OK with it, you can even play with/ adjust the angle of your face and test new sensations...  If water in the eyes is the problem, then address it, in a place where you feel comfortable/ strong - in a manner that gives you a sense of control - appreciating each small success as you build it - and it will lead to you being confident that you can control your environment in general - and you will control your reactions.

And THAT is my point!  It is ALL about breaking down the steps and building up the experiences so that confidence is gained - because CONFIDENCE will create a safe swimmer - fear ALWAYS leads to sinking.  Two of the primary safety rules the Red Cross teaches are:

Think, so you don't sink!

Never swim alone.

And the SPD conversations give us a new perspective to think from, because the answers do NOT always lie in the pool!

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