Aquatic therapy is a world of its own. It is extremely relaxing and grounding! Performing exercises in the water is easier and more fun, due to buoyancy or feeling almost weightless and other hydrodynamic principles.

Aquatic therapy is beneficial for children with gross motor delays, decreased postural control, sensory issues, Autism, CP, and syndromes causing high or low tone. The water is kept at a warm temperature, at about 86 degrees, to help increase mobility of the muscles and joints.

Therapeutic aquatic techniques such as Bad Ragaz, Watsu, and Ai Chi involve passive and/or active stretching, allowing for increased range of motion and active movement.

Bad Ragaz is a handling technique that passively stretches the body, working with the therapeutic properties and principles of the water. Watsu is a powerful yet gentle handling technique that uses the currents created in the water to achieve deep stretching in a very gentle way. This technique is especially beneficial for children with CP and syndromes involving muscle tightness. Ai Chi uses slow, symmetrical exercises in the water to promote strengthening and relaxation. It is like Tai Chi, just in the water.

These techniques, along with the assistance of the therapist and floatation equipment, allow children with motor impairments to move more freely in the water, in ways that would not be possible on land.

More aggressive techniques, such as Burdenko, are great for muscle strengthening and increasing body awareness. Feldenkrais is yet another technique that can be used in the water, using gentle exercises to gain increased motor skills and control.

Motor Skills

The pool is a great place to work on strengthening, improving balance, and even learning to walk. Children who have difficulty learning to stand or walk have an easier time developing these skills in the water. The reason for that is because the water provides resistance around their bodies, providing them with increased balance and motor awareness. Children with muscle weakness or tightness, such as torticollis (tightness and decreased range of motion of the neck), can work to improve head and neck control while on their stomach, side, or back in the water. Since there is less gravity in water, the exercises are easier to perform, ensuring greater compliance from the child.


Aquatic therapy is great for children with tactile defensiveness and decreased body awareness. The hydrostatic pressure from the water decreases the sensitivity to touch input. Kids who dislike getting their hair or facewashed can work on increasing their tolerance through playful water activities in the pool. The pressure from the water also creates resistance for the body, increasing body awareness and muscle tone in low tone kids.


Aquatic therapy works wonders for children with Autism. The water has a very calming affect with these children. It helps decrease anxiety, improve sleep hygiene, coordination, and social skills. Some children may have a fear of water and may need to go into the pool very slowly.These children do well when allowed ample time to get acclimated to the pool.

Safety First

While there are so many benefits to the water, safety should never be compromised. Please make sure the pool is supervised at all times, and that your child wears a swim vest if he is not a strong swimmer.

There are some instances where aquatic therapy is not recommended or contraindicated. Please consult with your child’s health care provider to ensure that these activities are suitable for your child.

Aquatic Activities to Improve
Sensory Processing and Overall Strengthening

Pull and Go– Use a noodle topull your child around the pool, go fast, go slow, etc. This activity uses the resistance of the water to build strength and body awareness.

Zigzag Walking –This activity is super fun! You are basically creating turbulence in the water while walking three steps to the right and then one step to the left, multiple times. This is a wonderful strengthening activity, appropriate for an older child.

Rowing with a Noodle– Instruct your child to hold each end of the noodle in both hands and push down into thewater in circles. You can instruct your child to do squats as well, while rowing.

Hudi Schweky, OTR/L is an occupational therapist with extensive training in Sensory and Reflex Integration. She utilizes a child-centered, movement and play based approach to assist children with autism, learning challenges, developmental delays, and attention issues.She is also the founder of the Theraflex, LLC in Lakewood, NJ.