Successful Group Speech Therapy at the Pool

“Aquatic therapy and children…is a medium… (in which) great things… (may) happen in the physical, cognitive and psycho-social realms…while providing a natural environment in which to practice ADL skills, communication skills, problem solving skills and motor skills…”

(From APT Newsletter, October, 1995, “Aquatic Therapy and Children—Welcome to the Water”, by Dori Maxon, PT, specializing in pediatric physical therapy for children with a variety of limitations including gross motor involvement.)

Natural Environments and Early Intervention

The idea of “Natural Environments” is a concept synonymous with Early Intervention.  As specialists, we provide our services most often in the naturally occurring setting, the family’s home. Early Intervention sites often recommend structured group settings for socialization and peer modeling. Finding a ‘natural’ space for group instruction among typical peers posed a challenge for therapists at Hasbro Hospital. A team of us put our heads together and identified an innovative therapy approach of group speech therapy at the pool, where fun meets effective communication enhancement in a unique setting.

And so it Begins

One day back in 2003, I was observing a toddler in his Gymboree class when somehow the topic of Early Intervention groups came up with another Speech Therapist from Meeting Street School in Rhode Island.  She had found a rental at the Jewish Community Center (JCC) in Providence and was co-treating a pool group with a physical therapist.  Shortly after, I found myself observing her group with my own “physical therapist partner –in-crime,” Kate Sparrow!  We watched, listened and took notes.

Clearance was easier than expected. A couple of phone calls to the Risk Management office at Rhode Island Hospital sufficed. Some would argue that the pool was not a “natural environment” since the families could not frequent the pool outside of our session and typically developing peers would not be participating.  However, it was a start and we were determined to help address a multitude of needs while showing families another option to enjoy time with their children.

Outreach

Finding people to participate was quick and easy.  Kate and I spread the word to our clients and asked co-workers to share the information on their home visits with children who might benefit from the group. We started with 6-10 families and asked caregivers to provide 1:1 assistance with their children.  Some families brought their babysitter/nannies/grandparents along to care for siblings who were watching on the sidelines!  Our attendance was nearly perfect and to this day, I’m not sure who had the most fun at those sessions, the therapists, kids, caregivers, or lifeguard (who often sang our songs with us while sitting in her chair!)

“Sing, Sing a Song”

Music was an essential element to our group.   We used songs paired with movements that promoted speech and movement in a fun, rhythmical manner.  Our sequence became predictable since we always started and finished with the same songs.   Before we started our first session, we distributed a “Pool Group Agenda” that explained the sequence of our session in a parent-friendly manner and it discussed the developmental goals that the group would encourage.

The agenda explained that we would open with a welcome song to promote name recognition, greeting, turn taking, gesturing/vocalization.  We then noted that music and singing would be encouraged throughout several activities.  Here is a complete description of Developmental targets for pool group.

What’s on the Agenda

Moving along on the agenda, we discussed that bubble play would entice children to use hand and eye coordination to “pop” bubbles with their hands and kick at them with their feet.  Bubbles were also a great motivator for children to request “more” through gestures, sounds, and words.  Following this description were summaries discussing target goals for slide and ball play.  Finally, the agenda noted that closing songs would not only promote following directions, but also closure for play activities.

Amidst all this structure, we also let families enjoy some “free time” in the water with their children using kick boards and noodles for much splashing opportunities!  The best part about a group in this medium was that it excluded no one and included everyone regardless of age, cognitive or physical ability levels.  Our clients included children with Cerebral Palsy, Down syndrome,   Apraxia, Autism, and Expressive language delays to name just a few.

Starting all over Again

Flash forward to March 2015:  Our family relocated to Illinois and I launched both this blog and my private practice:  Naperville Therapediatrics.  One spring, I transitioned to full-time work from my home office after completing a part-time contract at a Catholic school. Juggling administrative tasks and speech pathology, I’m committed to independent work and collaborating with a nearby OT/PT practice to enhance services for families, inspiring me to explore starting another pool group. For more information on how you can start your own pool group, then read my post about Playing with Water.

We Talk on Water

In June 2019, I launched  We Talk on Water, a guide book available on Amazon primarily for speech pathologists, but also useful for occupational/ physical therapists and parents/caregivers wanting to enhance overall communication with a pediatric population at the pool.

If you’re interested in learning more about stimulating your children in a water environment, take a peek at my guide book which is divided into four parts:

1. Background information on finding the right location and asking the right questions; documenting sessions; advertising; and billing/ insurance for speech and language pool groups.
2. Seventeen lesson plans for 2-5 years old.
3. Seven lesson plans for 6-9 years old.
4. Sample documentation (SOAP note, augmentative communication board, list of developmental targets addressed at the pool, registration paperwork)

For more details, you can follow this link to the Table of Contents.

References:
“Aquatic Therapy and Children—Welcome to the Water!” excerpt from APT aquatic therapy workshop by Dori Maxon, PT; APT Newsletter, 10/1995

Note: APT= Association of Pediatric Therapists; based in San Francisco Bay Area
For membership: APT, 1193 Clear Lake Court, Milpitas, CA 95035

Nanette Cote

Nanette Cote is an ASHA certified speech pathologist, published author, and private practice business owner with 30 years experience.