Adapted Aquatic Exercise and Behavioral Outcomes, Flexibility, and Handgrip Strength in Children With Autism Spectrum Disorder

Effects of Adapted Aquatic Exercise on Behavioral Outcomes, Flexibility, and Handgrip Strength in Male Children With Autism Spectrum Disorder: A Randomized Clinical Trial

This randomized clinical trial studied whether an adapted aquatic exercise program could improve behavior and physical abilities in children with autism spectrum disorder (ASD). Thirty-five boys aged 6 to 12 years with mild ASD participated in the study. Participants were randomly assigned to either an aquatic exercise group or a control group.

The aquatic exercise group took part in a structured, individualized swimming and water-based exercise program twice per week for 16 weeks, while the control group continued their regular academic education without additional exercise. The program focused on water safety, breathing control, and basic swimming movements.

Outcomes were measured before and after the 16-week period. Autism-related behaviors were evaluated using the Autism Behavior Checklist. Physical abilities were assessed using flexibility (sit-and-reach test) and handgrip strength measurements.

The study aimed to determine whether regular participation in adapted aquatic exercise could reduce autism-related behaviors and improve motor skills that are important for daily life activities in children with ASD.

Inclusion Criteria:

• Male children aged 6 to 12 years
• Clinical diagnosis of mild autism spectrum disorder confirmed by a licensed -child psychiatrist according to DSM-5 criteria
• Medical clearance for participation in aquatic exercise
• Ability to follow verbal and visual instructions
• Ability to imitate fine and gross motor movements
• Independent in toileting
• Not participating in structured sports or exercise programs other than standard academic instruction
• Written informed consent provided by a parent or legal guardian

Exclusion Criteria:

• Severe autism spectrum disorder
• Orthopedic, neurological, or medical conditions that contraindicate participation in aquatic exercise
• Current participation in structured physical training or sports programs outside of school
• Inability to safely participate in water-based activities