The Effects of Halliwick Aquatic Therapy on Social Interactions in Children With Autism Spectrum Disorder Hospitalized in Boarding Wards

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition, characterized by deficits in social interaction and the presence of restricted interests and repetitive behaviors. ASD is not progressive, and over time, the relevant neurological impairments neither eliminate nor aggravate. One of the newest methods to enhance social interactions is hydrotherapy. Using water at different temperatures can present different effects on various systems of the human body. Hydrotherapy is based on buoyancy, hydrostatic pressure, turbulence, and flow. Accordingly, this approach provides multiple sensory stimuli through water temperature, it helps the circulatory system, as well as muscle relaxation. The current research aimed to investigate the effects of Halliwick aquatic therapy on social interactions in males with ASD hospitalized in the boarding ward.

This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of this research included all children with ASD in Karaj City, Iran. The sample size was determined by the G*Power software. Among the boys hospitalized at the boarding ward of the Kahrizak Alborz sanatorium, 24 were selected by convenience and targeting sampling methods concerning the inclusion and exclusion criteria of the study. The inclusion criteria of the study were the diagnosis of ASD by psychiatrists and psychologists, the age range of 4–11 years, and the ability to understand oral instructions. The exclusion criteria included the presence of physical–motor disabilities, audiovisual impairments, epilepsy, and infectious diseases. The research tool employed in the pretest, posttest, and follow–up phase included Gilliam Autism Rating Scale–Second edition (GARS–2) (Gilliam, 2006). The experimental and control groups were tested before the intervention. The treatment sessions were performed according to the Halliwick program (Grosse, 2001), which consisted of 24 sessions and 3 sessions a week. Next, a posttest was performed in the groups; subsequently, after one month, the follow–up test was performed in the research groups. The obtained data were analyzed using descriptive statistics (mean & SD) and inferential statistics, including repeated–measures Analysis of Variance (ANOVA) and the Least Significant Difference (LSD) posthoc test. Data analysis was performed in SPSS at a significance level of 0.05.

The ANOVA data were significant for the intragroup factor (time) (p<0.001) and the intergroup factor (p<0.001). Additionally, the interaction between group and time was significant (p<0.001) with an effect of 0.56. In social interactions, there was a significant difference between pretest, posttest, and follow–up stages (p=0.001). However, there was no significant difference between the posttest and follow–up stages, indicating the persistence of the effects of the intervention in the follow–up stage (p=0.571).

The present research results revealed that hydrotherapy significantly increased the quality of social interactions in children with ASD. Thus, this method can be used as a complementary approach in rehabilitating children with ASD.