Water Competency Intervention for Children on the Autism Spectrum: The AquOTic Hybrid Effectiveness Implementation Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Ohio State University
- Enrollment
- 108
- Locations
- 1
- Primary Endpoint
- Water Orientation Test-Alyn (WOTA) 2
Study Overview
Brief Summary
AquOTic is an evidence-based, occupational therapy-led intervention designed to enhance water competency and swim safety skills in children on the autism spectrum. The 10-week program consists of weekly 60-minute group sessions, each including six children paired in a 1:1 ratio with an interventionist. Sessions follow a structured routine involving six rotating stations, targeting various swim and safety skills, with the flexibility for individualized support by the interventionist.
Overall, this study has 3 major aims. The first aim evaluates the effectiveness of the AquOTic intervention in improving water competency and swim skills, while comparing outcomes between two implementation models: professional student interventionists (occupational and physical therapy students) and trained community-based interventionists. A total of 108 autistic children will be enrolled and randomly assigned to one of three groups: (1) AquOTic with professional student interventionists, (2) AquOTic with community interventionists, or (3) a control group receiving no AquOTic intervention. The second aim explores the mediators and moderators of the intervention outcomes to assess fidelity and efficacy. The third aim identifies the cost and resources associated with AquOTic. A cost analysis will be conducted to evaluate the resources required for implementation and to inform the development of a scalable, cost-effective drowning prevention strategy for autistic populations.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 5 Years to 9 Years (Child)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Children Participants (n=108)
- •Inclusion Criteria
- •Educational or medical diagnosis of autism
- •Age between 5 - 9 years
- •Having vision and hearing within normal limits with or without corrective modifications
Exclusion Criteria
- •Children who demonstrate swim proficiency, as defined by the ability to tread water for 1 minute or move the body through the water without flotation
- •Open wounds or infectious skin diseases
- •Allergy to chlorine
- •Severe co-occurring motor impairments or neurological conditions such as uncontrolled seizures, Rett's or Angelman's syndrome
- •The family is unable to commit to the sessions or evaluations
- •Interventionists (n=64)
- •Inclusion Criteria
- •Aged 18 or over
- •Demonstrate swim proficiency, as defined by the ability to tread water for 1 minute and move the body through the water without flotation for 25 yards
- •Exclusion Criteria
- •Open wounds or infectious diseases
- •Failed background check
- •Unable to commit to Basic Swim Instructor and AquOTic training (~40 hours) and 10 AquOTic sessions (20 hours)
Arms & Interventions
AquOTic with Professional Student Interventionist
Participants in this arm will participate in the 10-week AquOTic intervention with their one to one interventionists being professional students (OT/PT students currently enrolled at OSU).
Intervention: AquOTic (Other)
AquOTic with Community Interventionists
Participants in this arm will participate in the 10-week AquOTic intervention with their one to one interventionists being community interventionists (high school or undergraduate students in the community).
Intervention: AquOTic (Other)
Control Group
Participants will NOT receive AquOTic intervention and will engage in usual and customary water exposure.
Outcomes
Primary Outcomes
Water Orientation Test-Alyn (WOTA) 2
Time Frame: At baseline, immediately post-AquOTic, 6 months after termination of AquOTic, and 12 months after termination of AquOTic
The WOTA2 measures a child's mental adaptation, adjustment to the pool, postural balance, and the ability to move and change position in the water, based on the Halliwick concept. WOTA2 assesses 27 swim skills scored on a 0-3 scale with a minimal detectable change score of 11.5. Higher scores indicate better skills. WOTA2 has high test-retest reliability (ICC=.97) and is validated for children with autism-like characteristics.
Secondary Outcomes
- Water Orientation Test-Alyn (WOTA) 1(At baseline, immediately post-AquOTic, 6 months after termination of AquOTic, and 12 months after termination of AquOTic)
- Water Competency Checklist (WCC)(At baseline, immediately post-AquOTic, 6 months after termination of AquOTic, and 12 months after termination of AquOTic)
- Canadian Occupational Performance Measure (COPM)(At baseline, immediately post-AquOTic, 6 months after termination of AquOTic, and 12 months after termination of AquOTic)
Investigators
Jewel Crasta
Assistant Professor
Ohio State University