1. sports
2. swimming

A Guide For Swimming
Teachers
The Centre for Cerebral Palsy
106 Bradford Street, Coolbinia, Western Australia, 6050
Correspondence: PO Box 61 MOUNT LAWLEY WA 6929
Ph: (08) 9443 0211 Fax: (08) 9444 7299
Website: www.tccpcom.au
Email:
[email protected]
This booklet was prepared by: Kate Sheard, Amelda Preston,
Matthew Brain. Updated by Natalie Georgeff and Jessica Morris.
©
Copyright 1999, 2003. This booklet may be reproduced in whole or part,
subject to the inclusion of the source and no commercial usage or sale.
Foreword
The Western Australian Department of Education and Training conducts an
extensive swimming and water safety programme that provides students
with the opportunity to learn and develop important life skills in a
structured environment. The Department recognises that each student is
an individual and that learning experiences should respect these differences
and start at the level of the student.
The updated version of ‘A Guide for Swimming Teachers’ provides a skills
framework, which incorporates the Foundation Levels of the Health and
Physical Education Outcomes and Standards Framework and Stages 1 to 3
of the Department’s Swimming and Water Safety Continuum.
This
information will assist teachers to modify activities and skills to better meet
the needs of students with cerebral palsy.
I would like to congratulate the Physiotherapists at the Cerebral Palsy
Association of Western Australia who were responsible for updating this
booklet.
Also Janet Boer-Draffin, who wrote the section ‘Hints and
Suggestions when Working with Students with Disabilities’, AUSTSWIM WA
and the Royal Life Saving Society WA Branch who participated in the initial
planning of the document and the Department’s Swimming and Water
Safety Section for its review of the final document.
I am pleased to endorse ‘A Guide for Swimming Teachers’ and commend it
as a valuable tool for any swimming teacher working not only with children
with cerebral palsy, but with any child who has a disability.
PAUL ALBERT
DIRECTOR GENERAL
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© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Table of Contents
Foreword
2
What is Cerebral Palsy?
4
Types of Cerebral Palsy
5
What Part of the Body is Affected?
6
Curriculum Framework and Inclusivity
7
General Principles of Teaching and Assessment
8
Hints and Suggestions when Working with Students with Disabilities
9
Water Safety and Pre-Swimming Skills
11
The Stages of Swimming
13
Foundation Skills - Mild/Moderate Disability
14
Stage 1 - Mild/Moderate Disability
16
Stage 2 - Mild/Moderate Disability
18
Stage 3 - Mild/Moderate Disability
21
Foundation Skills - Severe Disability
24
Stage 1 - Severe Disability
26
Stage 2 - Severe Disability
28
Stage 3 - Severe Disability
29
Equipment Available
32
List of Contacts
33
Acknowledgements
35
References
36
Bibliography
37
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
3
What is Cerebral Palsy?
The brain controls all that we do. Different parts of the brain control
the movement of every muscle of the body. In cerebral palsy there is
damage to, or lack of development in, one of these areas of the brain.
‘Cerebral’ refers to the brain.
‘Palsy’ can mean weakness or paralysis or lack of muscle control.
Cerebral palsy, therefore, is a disorder of muscle control which results
from some damage to part of the brain. The term cerebral palsy is
used when the problem has occurred to the developing brain either
before birth, around birth or early in life.
Control of
Movement
Sensation of
Touch
Thought
Processes
Sight
Speech
Figure 1
4
The Brain
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Types of Cerebral Palsy
There are several different types of cerebral palsy.
Spastic Cerebral Palsy
This is the most common type of cerebral palsy. Spasticity means
stiffness or tightness of muscles.
The muscles are stiff because
messages to the muscles are relayed incorrectly through the damaged
part of the brain. When people without cerebral palsy perform a
movement, some groups of muscles become tighter and some groups of
muscles relax. In children with spastic cerebral palsy, both groups of
muscles may become tighter. This makes the movement difficult.
Athetoid Cerebral Palsy
Athetosis is the word used for the uncontrolled movements that occur in
this type of cerebral palsy. This lack of control is often most noticeable
when the child starts to make a movement. In addition, children with
athetoid cerebral palsy often have very weak muscles or feel floppy when
carried.
Ataxic Cerebral Palsy
This is the least common type of cerebral palsy. Ataxia is the word used
for unsteady shaky movements or tremor. Children with ataxia also have
problems with balance.
Mixed Types
Many children do not have just one type, but a mixture of several of
these movement patterns.
Definitions of Ability Levels
•
Mild - Children in this category will be able to participate in
swimming lessons with little
modification of skills required.
•
Moderate - Children will
swimming lessons and may
•
Severe - Children will require equipment and assistance to
participate in swimming
lessons.
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
require some modifications during
need concessions to pass levels.
5
What Part of the Body is
Affected?
This varies greatly from one child to another, depending on the body parts
affected. This will alter the shape and density of the body and affect
movement in the water.
Hemiplegia
The leg and arm on one side of the body are affected.
Children with hemiplegia will have asymmetrical or uneven movements.
Swimming can emphasise movement of the affected side.
Diplegia
Both legs and both arms are affected but the legs are significantly more
affected than the arms. Children with diplegia usually have some clumsiness
with their hand movements.
Figure 2: The various forms of cerebral palsy and the regions of the brain affected.
From Children with Handicaps: A Medical Primer (p. 195) by M.L. Batshaw and Y.M. Perret, 1981, Baltimore:
Brookes. Drawing by Elaine Kasmer. Copyright 1981 by Mark L. Batshaw and Yvonne M. Perret.
6
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Curriculum Framework
and Inclusivity
Learning experiences
should respect and accommodate
differences between learners
The Curriculum Framework(1) was introduced into all Western Australian education systems
and sectors in 1999. The fundamental purpose of the Curriculum Framework is to provide
a structure around which schools can build educational programmes that ensure students
achieve agreed outcomes. The Department of Education and Training’s Swimming and
Water Safety Programme has established appropriate water safety outcomes for all
students through the implementation of an integrated teaching, assessment and reporting
document - The Swimming and Water Safety Continuum(2).
The Curriculum Framework’s Overarching Statement provides general advice about
learning, teaching and assessment based on understandings of how students learn best in
outcomes-focused education. The Department of Education and Training’s swimming
programmes clearly link with these key principles.
Inclusivity is providing all groups of students with access to the widest possible and most
empowering range of knowledge and skills. It means recognising and accommodating the
different starting points and previous experiences of individual students or groups of
students, and valuing and including the understandings, knowledge and ways of knowing
and being of all groups. It also requires the provision of opportunities for students to
critically analyse the social patterns and constructions associated with such concepts as
disability, race, class and gender.
Instructors should plan lessons that respect and accommodate differences between
learners. When planning and implementing learning and teaching activities for students, it
is important to acknowledge that each individual is different. Each student needs to be
challenged, but the nature of the challenge may vary from student to student. Students
with disabilities should be provided with appropriate, alternative avenues for achieving the
outcomes.
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
7
General Assessment Principles
ASSESSMENT
“Assessment practices have a powerful impact on learning and teaching.
Assessment information should enable judgements to be made about
students’ progress towards the desired outcomes in a way that is fair and
contributes to continued learning. Fair assessment is based on criteria
which are valid and transparent and applied with consistency and without
discrimination.” (2)
The Curriculum Framework
-
(1)
states that assessment should be:
Valid
Educative
Explicit
Fair
Comprehensive
“Students should have equal opportunities to demonstrate their
achievement of outcomes. Assessment should be sensitive and responsive
to differences amongst students, so that they are not inadvertently placed
in a better or worse position to demonstrate their achievement.” (2)
CONCEDED PASSES
There are strict guidelines for conceding a pass in any of the skills in the
Continuum. A supervisor may, on sighting appropriate evidence that a
swimmer has attempted the same skills on three previous occasions in
separate series of Department of Education classes, concede a pass in that
skill. In such cases the supervisor must write the following statement on
the swimmer’s report:
“After three separate attempts in Department of Education classes, and
despite additional attention and instruction,…(Name)...has been granted a
conceded pass in skill number __.”
The Centre Supervisor must countersign this statement and the swimmer
should be directed to take the report to their instructor when attending
their next series of classes. (2)
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© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Hints and Suggestions
when Working with
Students with Disabilities
© Janet Boer-Drattin
1.
(3)
Find out what is achievable for the student and what is not
The more information you can gather regarding the abilities of the
student in your class, the better prepared you will be for making
informed judgements regarding the programming and assessing of
these students. Physiotherapists involved with the student, parents,
teachers and teacher assistants can be excellent sources to gather
this information.
2.
Try to keep the student with his/her peers
Concentrate on what the student can do and work on this. Teaching
should start at the level that the student is currently achieving. Work
on the student’s strengths. For example, if it is not possible for the
student to swim strokes on his front and back, then ignore the one
that is not going to be achieved and strengthen the preferred stroke.
3.
If the distance is correct then the style is not the major concern
Look at the main goal of the stage/level as well as the distance. The
individual technique that a swimmer uses should be allowed if it is
effective. The swimmer may have a disability affecting arm rotation
or their kick but is still able to swim the distance required.
4.
Don’t hold the students back in stages they won’t be able to
achieve
There are strict guidelines for a Conceded Pass as outlined on Page 8.
If a skill is never going to be achieved due to their disability, it is fair
and reasonable to skip this particular skill and not hold the student
back in this stage. Tick the skills that have been achieved and leave
the others blank, stating why they were not achieved. For example,
‘due to physical limitations this skill could not be achieved’.
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
9
5.
Remember to treat each person with a disability as an individual and assess
in this way
‘Must sees’ are the non-negotiable indicators or standards of performance required
to pass the skill. Sometimes a flotation device is needed to assist the student to
achieve the desired skill or perform a particular stroke using the most effective way
of moving through water. The must see can be ignored in these cases if the
primary skill is achieved.
6.
Modify the skills to suit the student
If the continuum is way out of reach for the student with a disability then use either
the Department’s Special Needs Certificate where you can write the successfully
completed skills and activities on the form or the Department’s Participation
Certificate which has further simplified the basic swimming skills.
7.
Be the best swimming teacher you can be
Be creative with challenges, use problem solving to assist the student with a
disability. It may mean thinking of different flotation devices to use, activities to
accommodate the swimmer or a better understanding of the progressions and
movement patterns of the student with a disability.
8.
The assistance the student needs may not be the ‘flotation device’ alone
A smaller class size to assist the student with a disability. Physical assistance from
another person can keep your swimming lesson running smoothly and safely.
Discuss these issues with the supervisor, teachers or principal of the school for
further options. You can also contact the student’s physiotherapist, if they have
one.
REMEMBER:
Look at the students’ abilities
and work on their strengths
© Janet Boer-Draffin No 2002
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© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Water Safety and
Pre-Swimming Skills
ENTRY TO WATER
EXIT FROM WATER
Entry from sitting on side of pool:
Exiting pool over side:
T The ‘Humpty Dumpty’ song
T Exit pool onto stomach with hands
encourages leaning forwards and
blowing on entry into the water
T Sitting on edge of pool with child’s
hands outstretched and leaning
forwards to enter pool in upright
position
on pool side. Lift body and legs
together encouraging child to
assist. Take arm to rotate and sit
on edge of pool
T Walking up steps/ramp with/
without rail. Bottom shuffle
(backwards) up steps
T Hold child close initially. Gradually
lower your arms to progress child
to falling forwards into water with
hands on your shoulders
T Use hoist or ramp with wheeled
chair
T Use of ladder
T Walking down steps/ramp with/
without rail
T Use of hoist
T Use of ladder
T Bottom shuffle (forwards) down
steps
T Use ramp with wheeled chair
T Slide in from pool side
T Use of hoist
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
11
Water Safety and
Pre-Swimming Skills
BREATH CONTROL
Blowing bubbles at surface on water
WATER CONFIDENCE
T Splashing games and water on the
face
T Blow on child’s open hand to help
give them the idea
T Encourage ‘blowing out’ as the
child approaches the water
T Practise blowing balls over a
distance and ‘flipping eggs’
Exhale with face in water
T Eyes open under water with
counting fingers, colours, animals.
Try goggles
T Disengagement: encourage
increased independence in
complete safety providing minimal
support
T ‘Ring O Rosie’ or ‘Here We Go
Round the Mulberry Bush’ songs
encourage disengagement while
holding hands
T Games sitting astride knee ‘Wheels on the Bus’, ‘Hokey Pokey’,
‘Grand Old Duke of York’, gradually
withdrawing support
T Practice turning head so ears are in
the water
T Use of flotation devices - kicking
board, noodle
T Submerge: “1,2,3 under”.
Encourage mouth and lip closure to
hold breath or exhale if able.
‘Kangaroo Bobbing’ to chin _
bottom lip _ mouth _ nose _ head
submerged
12
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
The Stages of Swimming
(Department of Education and Training, Outcomes and Standards Framework for Physical Education)
(4)
TEACHING TOOLS:
This section outlines an approach to teaching children with varying levels of
disability and provides an alternative skills framework which incorporates
the Foundation Levels of the Health and Physical Education Outcomes and
Standards Framework and Stages 1 to 3 of the Swimming and Water Safety
Continuum.
These skills have been selected as a basis for teaching swimming and water
safety to all children and are sequenced for children with mild/moderate
disability and severe disability.
Key:
Bold = primary skill
Regular = skill
Italics = must see
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
13
FOUNDATION SKILLS
Mild/Moderate Disability
SKILL
14
LIMITATION
IDEAS FOR TEACHING
Demonstrates
actions to
ensure personal
safety
Unable to float
T Promote head control to prevent
Poor breath control
T Uses flotation device eg.
Displays an
awareness of
self and body
parts
Poor coordination
and body awareness
mouth from entering water
kickboard or noodle
T Wear goggles
T Grasp rail/side of pool
independently
T Sit in shallow water
Decreased use of
upper and lower
limbs
T Breath control activities
T Disengagement activities
T Action songs ‘Heads and
Shoulders’, ‘Open Shut Them’,
‘Hokey Pokey’, ‘Simon Says’
T Rockets by curling up at wall,
count down and push off to glide
on back
T Monkey walks around edge of
pool, going to left and right.
Make sure both feet are flat on
the wall
T Obstacle courses over, under,
through, on
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
Mild/Moderate Disability
SKILL
Control body
movements
LIMITATION
Poor head control
Poor coordination
Lift and turn
head
IDEAS FOR TEACHING
T Breath control activities
T Activity songs
T Kicking with floatation device in
upright position
Limited strength and
movement
T Animal walks eg. frog, chicken,
Unable to perform
without some
assistance
T Entry to water and Exit from
Fear of water
T Walking/running using dog
monkey walks, kangaroo
Make purposeful
limb movements
Bring hands to or
across midline
Change body
position
Move in water
with or without
support
water techniques
T Water Confidence/
Disengagement techniques
T
T
T
T
T
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
paddle arms
Games ‘What’s the Time Mr
Wolf?’, water chasey
Use flotation devices eg.
kickboard, noodle, ring
Practice moving from floating on
back to standing
Monkey walks
Dog paddle on stomach with
flotation device
15
STAGE 1
Mild/Moderate Disability
SKILL
Submerge
Waist deep
Entire head under water
LIMITATION
Poor balance and strength
to move from under the
water to a standing
position
Grommets
(2)
IDEAS FOR TEACHING
T
T
T
T
May require a wall/ledge to
assist with recovery
Teach in waist deep water
1:1 assistance
Toys under water as incentive
Fear of water
Perceptual difficulties
Glide forward and
recover
Waist deep
No set distance required
Glide
Face in water - exhaling
Near horizontal body
position
Arms extended in front of
head
Problem bending at waist
due to increased body
extension, stiffness or
limited movement
Poor coordination/body
awareness
Unable to hold both arms
above head
May roll to one side if has
hemiplegia
Recovery to standing
position
Poor trunk control
Float or glide backward
on back and recover
Difficulty bending forward
from lying on the back to
standing
Waist deep
Flotation aide acceptable
T
T
T
T
T
T
T
T
T
No set time/distance
required
T
Near horizontal body
position
T
T
Recovery to a standing
position
Survival Safety/
Sequence No 1
Enter water safely
Lack of strength or
coordination for exits
T
T
T
Use flotation devices for the
arms and waist
Assist with push off for glide
Assist the child with bending
at the waist and standing back
to upright position
Recover to safe position eg.
stand at side of pool
Break into 2 steps of glide and
recover
Practice vertical and horizontal
body positions
Roll onto the stomach then
stand
Assist with bending at waist
and to upright position
Head brought upright/forward
and hands pushed down in
water to assist with recovery
Practice floating on back and
front
Rockets
Float on back holding
kickboard and kicking
Use a rail/ramp/stairs
Allow more time
Mat at edge of pool
Hold flotation aid/float
for 10-15 seconds
Exit safely from water
16
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 1
Mild/Moderate Disability
SKILL
Enter water
safely
Shallow
LIMITATION
Unable to use both
arms/legs, due to
muscle weakness/
incoordination
Slide in entry
Fear of water
Waist deep water
Poor head and trunk
control
Confident and
safe entry and
exit
(2)
IDEAS FOR TEACHING
T
Entry to water techniques
T
T
Additional practice of bubble
blowing activities
Blow up a balloon and let air out
under water
‘Kangaroo Bobbing’ up and
down to variable levels
Use goggles/mask to assist with
gaining confidence by being able
to see under water
Demonstrate
T
T
T
Goggles
Splashing games at face
Silicon ear plugs
Sensitive skin
Poor safety
awareness
Poor balance uses
walker/assistive
device
Exhale in water
Face in
Relaxed and
confident
exhalation
Poor strength with
exhaling
No lip closure - not
necessary to have lip
closure for exhaling
Poor coordination
T
T
T
Poor head control
Open eyes in
water
Identify an object
under water
Visual impairment
Sensitive eyes
Grommets
Confidence
Ability to identify
an object clearly
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
17
STAGE 2
Mild/Moderate Disability
SKILL
Glide forward on
stomach and kick 3
metres
Horizontal body
position, face in
Waist deep
(minimum)
Near horizontal body
position
Face in water,
exhaling
LIMITATION
The face down position
may increase
involuntary movement
patterns
IDEAS FOR TEACHING
T
T
T
Cycling kick is common
Body rotation is
common to compensate
for an ineffective
asymmetrical kick
Unable to achieve
horizontal position
(2)
T
T
T
T
Continuous kick
T
T
Use a flotation device, eg.
noodle, kickboard
Check ability to kick from
hips or knees
Check ankle flexibility.
Forward propulsion is
difficult if ankles are
restricted
Flippers assist in a
stronger kick
Physical guidance at hips
for body position
Bent arm position is
acceptable
Kickboard held out in
front to practise patter
kicking and reduce
rotation. Use counting
and timing
Kicking positions
upright, on stomach with
flotation device
Kicking progressions
cycling _ kick with bent
leg
_ patter kick
18
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 2
Mild/Moderate Disability
SKILL
Glide backward,
kick and recover
LIMITATION
Waist deep
(minimum)
The face up position may
increase involuntary
movement patterns, for
example, the head and
back may arch backwards
No set distance
Cycling kick is common
Arms by side
Body rotation is common
to compensate for an
asymmetrical or
ineffective kick
Near horizontal
body position
IDEAS FOR TEACHING
T
T
T
T
Continuous kick
without excessive
knee bend
Unable to achieve
horizontal position
T
T
T
T
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
(2)
Use a flotation device, eg.
kickboard, noodle
If the child’s neck is
arched back do not push it
forward from the back of
the head. Guide it forward
gently from the top of the
head or chin
Try a personal flotation
device with a head support
to encourage the head to
bend forward
A kickboard or noodle
under the pelvis will keep
the body horizontally
aligned
A kickboard held by the
child at the chest will
reduce the body rotations
and keep them more
buoyant
Physical guidance for body
position and kick
Begin with child’s head on
assistant’s shoulder
Kicking positions upright
moving towards lying on
back
19
STAGE 2
Mild/Moderate Disability
SKILL
Swim 5 metres freestyle
Face submerged
Catch up acceptable
Effective kick
Arm recovery clear of water
Face in water, exhaling
LIMITATION
The face down
position may
increase involuntary
movement patterns
Cycling kick is
common
IDEAS FOR TEACHING
T
T
T
T
T
Body rotation is
common to
compensate for an
asymmetrical kick
T
T
Smooth arm
movements may be
difficult
May not be able to
use arms above
water or kick
symmetrically
T
Compensate style
T
T
T
Scull/tread water
(2)
Flotation devices
Practice catch-up drills with the
kickboard
Swim action into pool wall
Accept dog paddle with modified
breathing
Physical guidance for sequencing of
arm movements
Use a kickboard to prevent arms
pulling back into the body
Accept a modified stroke. For
example, one where one arm does not
complete a full stroke, it can be
considered acceptable providing the
distance is completed
A kickboard held out in front to
practise patter kicking. Flippers
assist in keeping legs straighter
Kicking positions inclined forwards
towards lying on stomach
A kickboard held out in front will
assist with reducing rotation tendency
Allow unilateral breathing
Coordination skills
T
T
T
T
Non-symmetrical action is acceptable
Encourage large shoulder movements
Floating acceptable
Use flotation device eg. noodle, milk
container
Child may have
difficulty
maintaining grasp
on a rope while
being pulled to
safety
T
Use a large object that the child could
hold with one or two arms, for
example, a two litre plastic bottle on
the end of a rope
Loop a rope to hold onto. The child
may put an arm through the loop and
hold the rope with a bent elbow
rather than using a hand
Using hands and legs to support
body weight in water
Outward and inward scull
Ability to gain some support
Alternating leg action
Safety/Survival Sequence No 2
Enter water safely
Glide forward and kick 3 metres,
recover to standing position
Holding floatation aid/float for
30 seconds
Exit safely from water
T
Grasp an object and be pulled to
safety
20
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 3
Mild/Moderate Disability
SKILL
Swim 10 metres
freestyle
LIMITATION
Free arm
movements may be
difficult
Breathing
Near horizontal
body position
Effective leg action
Regular breathing
pattern
Muscle tightness
on one side causing arm to not exit
the water, or only
complete a short
stroke
IDEAS FOR TEACHING
T
T
T
T
T
T
Control of the
volume of
breathing may be
difficult
Asymmetrical kick
on one side
Excessive body rolling due to muscle
tightness on one
side of body
T
T
T
T
T
T
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
(2)
Practice catch-up drills with the
kickboard. Use bar if unable to
hold
Swim action into pool wall
Practise standing in water waist
deep
Physical guidance for
sequencing of arm movements
A kickboard in front to
encourage straight arms
Accept a modified stroke. For
example, where one arm does
not completely exit the water or
one leg does not complete a full
kick, it may be considered
acceptable providing the
requisite distance is completed
Catch-up may assist breathing
by ensuring an adequate arm
stroke during freestyle
Encourage use of large shoulder
movements
Encourage the child to blow air
out into the water between
breaths.
Re-explore bubble blowing
games
Use flippers to assist the child
to focus attention on arms without struggling with legs as well
Arm position progressions
below _ at _ above water level
21
STAGE 3
Mild/Moderate Disability
SKILL
Glide backward and
kick 5 metres
Waist deep (minimum)
Arms by side
Near horizontal body
position
Effective kick
LIMITATION
IDEAS FOR TEACHING
The face up position may
increase involuntary
movement patterns, for
example, head and back
arched backwards
Stroke may not be text book
but may be able to achieve
distance using ‘freestyle’
stroke
T
T
T
Cycling kick is common.
Body rotation is common to
compensate for an ineffective
kick
Recovery is hard for children
with balance difficulties
Demonstrate breast
stroke leg action
On back (with board)
No set distance
Circular movement of
feet
Flexed feet
Bending the knees while
keeping the hips straight
might be difficult
Turning the feet outwards
may be difficult, if not
impossible
Do not expect the kick to be
symmetrical if there are body
asymmetries eg. hemiplegia
Unable to turn feet out and up
(very common)
Demonstrate survival
sculling
On back
Some children are unable to
rotate their hand (from their
elbow) so the palm faces
upwards
T
T
T
T
T
T
T
T
T
T
Sculling hand action
Flat, relaxed hands
Effective support
22
(2)
T
T
If the child’s head is arched back
do not push it forward from the
back of the head. Guide it
forward gently from the top of
the head or chin.
Try a flotation device with a head
support to encourage the head
to bend forward
A kickboard or noodle under the
child’s pelvis will keep the body
horizontally aligned.
A kickboard held by the child at
the chest will reduce body
rotation
Consider propulsion rather than
style
Use flippers to assist kick
Once the child has mastered this
stroke while sitting, get them to
lie down on their back, legs
dangling over the edge. Repeat
in pool
Use a kickboard held at the chest
to assist flotation
Use hands-on facilitation
Modified stroke or kick action
may be considered acceptable
provided required distance is
completed
Consider propulsion rather than
style
Encourage movement to come
more from the shoulders than
the elbows
Encourage any movement of the
arms parallel to water surface
Consider propulsion rather than
style
Use flotation devices
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 3
Mild/Moderate Disability
SKILL
Demonstrate a forward
roll
LIMITATION
Getting into a ball
position may be
difficult
IDEAS FOR
T
Extension
Deeper than waist deep
Pushing off from the
floor and maintaining
a rotatory motion
with the arms may be
difficult
T
T
Body symmetry may
not be achieved and
roll will not be
straight
Water safety sequence
No 3
Enter water safely
Glide and swim 10
metres
before recovering to
upright position
Grasp a flotation aid
thrown for support
Float 60 seconds and
kick to safety
Support body in upright
position and signal
distress
T
T
T
The face down
position may increase
involuntary
movement patterns
T
T
T
Cycling kick is
common
T
Body rotation is
common to
compensate for an
ineffective kick
T
Child may have
difficulty maintaining
grasp while being
pulled to safety
T
T
Recovery to standing
may be difficult
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
(2)
Encourage the child to
keep chin on chest.
Assist this by holding the
top of the child’s head
rather than the back of
the head
Practice in chest deep
rather than waist deep
water
Practice forward rolls on
the grass
Practice forming a ball in
water
Practice duck dives
Hands on assistance or
guidance
Use a rail
Allow more time
Hands-on physical
guidance for body
position is acceptable
Consider recovery to side
of pool and then to
upright position
Consider using a large
object that the child
could hold with one or
two arms. For example, a
two litre plastic bottle on
the end of the rope
Loop a rope to hold onto
or put arm through loop
and hold with bent elbow
Attach flotation device to
student
23
FOUNDATION SKILLS
Severe Disability
SKILL
Demonstrates
actions to
ensure personal
safety
LIMITATION
Poor head control
Unable to keep head
above water, float or
remain buoyant
Fear of water
Demonstrates
an awareness of
self and body
parts
24
Poor head and trunk
control
IDEAS FOR TEACHING
T
T
T
T
T
Use of flotation device
1:1 assistance
Use of goggles
Breath control activities
Promote head control to prevent
mouth from entering water
T Action songs with physical
assistance
T Relaxation using flotation
Involuntary
movements
devices
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
Severe Disability
SKILL
LIMITATION
IDEAS FOR TEACHING
Control body
movement
Poor balance and
strength
T Making splashes
T Verbal prompts eg. activity
Lift and turn
head
Poor coordination
T Circles with child on back, hold
songs
Make purposeful
limb movements
Involuntary
movements
Bring hands to or
across midline
Change body
position
Move in water
with or without
support
Unable to perform
independently
under arms and spin around in a
circle
T Seaweeds with child on back
with head on shoulder, sway side
to side
T Starfish float with child on back
with legs around your hips and
spin in circle
T Entry to water and exit from
water techniques
T Use of ramp with wheeled chair
in water
T Use hoist/hydraulic lifts
T Use of flotation device with
propulsion on back or stomach
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
25
STAGE 1
Severe Disability
SKILL
Enter water safely
Shallow
Slide in entry
Waist deep water
POSSIBLE
LIMITATION
Poor trunk and head
control
Involuntary movements
Unable to stand
independently
(2)
IDEAS FOR
TEACHING
T
T
T
T
Use hoist
Use ramp with wheeled
chair
1:1 assistance
Do not submerge head
Confident and safe
entry and exit
Exhale in water
Face in
Relaxed and
confident exhalation
Poor strength with
exhaling
T
Additional practice of
bubble blowing
activities
Do not submerge head
T
T
T
Goggles
Splashing games at face
Silicon ear plugs
T
Poor head control
Aspiration
G-tube (= nil by mouth)
No lip closure - tongue
and jaw thrust
Open eyes under
water
Non verbal
Confidence
Grommets
Visual impairments
Sensitive eyes
Ability to identify an
object clearly
26
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 1
Severe Disability
SKILL
Submerge
Waist deep
Entire head under water
(2)
POSSIBLE
LIMITATIONS
Poor balance and strength
to move from under the
water to a standing
position
IDEAS FOR
TEACHING
T
T
Use hoist
Use ramp with wheeled
chair
T
T
Use flotation device
1:1 assistance
Assist with bending at
waist to upright position
Head brought upright
and forward with hands
pushed down in water to
assist with recovery
1:1 assistance
Flotation devices with
chair
G-tube (nil by mouth)
Aspiration
Glide forward and recover
Waist deep
No set distance required
Fixed range of motion
Excessive movement
Glide
Face in water - exhaling
Near horizontal body position
Arms extended in front of head
Recovery to standing position
Float or glide backward on
back and recover
Involuntary movements
T
Waist deep
Poor head and trunk
control
T
Floatation aide acceptable
No set time/distance required
T
T
Near horizontal body position
Recovery to a standing position
Survival Safety/Sequence
No 1
Unable to enter/exit/
independently
Enter water safely
Hold flotation aid/float 10-15
seconds
T
T
T
T
Use ramp with wheeled
chair
Hydraulic lift/hoist
Use flotation device
1:1 assistance
Exit safely from water
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
27
STAGE 2
Severe Disability
SKILL
Glide forward on stomach
and kick 3 metres
Horizontal body position,
face in
LIMITATION
Will need 1:1 assistance
to achieve all skills
(2)
IDEAS FOR TEACHING
T
T
1:1 assistance
Extensive use of flotation device
and hands-on physical guidance
for body position
Waist deep (minimum)
Near horizontal body
position
Face in water, exhaling,
continuous kick
Glide backward
Waist deep (minimum)
No set distance
Arms by side
Near horizontal body
position
Continuous kick without
excessive knee bend
Swim 5 metres freestyle
Face submerged
Catch up acceptable
Effective kick
Arm recovery clear of water
Face in water, exhaling
Scull/tread water
Use hands and legs to
support body weight in
water
Outward and inward scull
Ability to gain some support
Alternating leg action
Safety/Survival Sequence
No 2
28
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 3
Severe Disability
SKILL
Swim 10 metres freestyle
Breathing
Near horizontal body
position
Effective leg action
Regular breathing pattern
Glide backward and kick
five metres
Waist deep (minimum)
LIMITATION
IDEAS FOR TEACHING
Free arm
movements will be
difficult
T
Muscle tightness
on one side may
make it difficult to
complete a stroke
T
Control of the
volume of
breathing may be
a difficulty, eg. the
child may not take
a large enough
breath or may hold
in air
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
(2)
T
T
T
T
T
1:1 assistance is
necessary
Encourage use of large
shoulder movements
Encourage the child to
blow air out into the
water between breaths.
Bubble blowing games
Use of flotation device
will be necessary
Consider propulsion
rather than style
Use flippers to assist
propulsion
29
STAGE 3
Severe Disability
SKILL
LIMITATION
Glide backward
and kick 5 metres
The face up position may
increase involuntary
movement patterns, for
example, head and back
arched backwards
Waist deep
(minimum)
(2)
IDEAS FOR TEACHING
T
T
T
Arms by side
1:1 assistance
Use of a flotation device,
positioning at chest, head,
knees or pelvis to address
individual child’s needs
Use flippers to assist
propulsion
Near horizontal
body position
Demonstrate
breaststroke leg
action
Child will not be able to
coordinate this stroke
T
T
T
Sculling hand
action
Consider relaxation instead
with 1:1 assistance
Flotation device
Use flippers to assist
propulsion
Flat relaxed hands
Demonstrate
survival sculling
On back
Sculling hand
action
Flat relaxed hands
Will be unable to rotate
their hand (from their
elbow) so the palm faces
upwards
Will be extremely difficult
primarily due to lack of
breathing control
T
T
T
T
T
T
Encourage any movement
of arms parallel to water
surface
Use flotation device
1:1 assist
Do log roll from front _
back
1:1 assist
Use of flippers
Effective support
30
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 3
Severe Disability (2)
SKILL
Demonstrate a forward
roll
LIMITATION
Will be extremely difficult
primarily due to lack of
breathing control
IDEAS FOR TEACHING
T
T
Do log roll from front back
1:1 assist
Extension
Deeper than waist deep
Water Safety Sequence
No 3
Enter water safely
Glide and swim 10 metres
before recovering to upright
position
Grasp a flotation device
thrown for support
Float 60 seconds and kick
to safety
Support body in upright
position and signal distress
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
31
Equipment Available
SUGGESTED EQUIPMENT TO USE IN THE WATER
Supervision is essential for swimmers when using equipment
32
T
Flotation toys to reach for and blow
T
Swim rings or car tubes, with the valve taped down for the larger swimmer
T
Noodles bound together in a loop for greater variety, using noodle connectors
T
Flotation mats
T
Back bubbles and arm floats can also be used on the legs to encourage greater movement
T
Hip floats and neck floats
T
Milk or juice bottles may be easier to hold
T
Leg and arm floats can be used for smaller children
T
Kickboards
T
Reef walkers to protect feet whilst swimming and walking
T
Wet suit vest to help protect against the cold and for extra buoyancy
T
Goggles
T
Flippers
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
List of Contacts
AUSTSWIM WA (Inc)
The Australian Council for the Teaching of Swimming and Water Safety
Telephone:
(08) 9227 1530
Fax:
(08) 9227 6089
Email:
[email protected]
Royal Life Saving Society WA (Inc)
Telephone:
(08) 9383 9988
Fax:
(08) 9383 9922
Email:
[email protected]
Surf Life Saving WA (Inc)
Telephone:
(08) 9244 1222
Fax:
(08) 9244 1225
Email:
[email protected]
WA Swimming Association (Inc)
Telephone:
(08) 9328 4599
Fax:
(08) 9227 6089
Email:
[email protected]
WADSA
‘Be Active’ Learn to Swim
Western Australia Disabled Sports Association
Telephone:
(08) 9470 1442
Fax:
(08) 9470 3878
Email:
[email protected]
TCCP
The Centre for Cerebral Palsy
Telephone:
(08) 9443 0211
Fax:
(08) 9444 7299
Website:
www.tccp.com.au
Email:
[email protected]
Janet Boer-Draffin
Developing Skills
Telephone:
(08) 9310 2746
Email:
[email protected]
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
33
List of Contacts
IPC Swimming
International Paralympic Committee
Telephone:
(08) 9355 5517
Website:
www.ipcswimming.org
Email:
[email protected]
Peppertown Therapeutic Aquatics Equipment
PO Box 136 Albion QLD 4010
Telephone:
(07) 3265 5666
Fax:
(07) 3265 5770
Website:
www.peppertown.com.au
Email:
[email protected]
Protramp Australia Aquatics Equipment
PO Box 264 Quinns Rock WA 6030
Telephone:
(08) 9305 8919
Fax:
(08) 9305 8919
Superfins Swimming Club
Challenge Stadium
Stephenson Avenue Mount Claremont WA 6010
Coach: Phil Jose
Telephone:
(08) 9341 2644
Wanneroo Aquamotion Swimming Club
Civic Drive Wanneroo WA 6065
Telephone:
(08) 9306 2882
Joondalup Arena Swimming Club
Contact: Rob Bonsack
Kennedya Way Joondalup WA 6027
Telephone:
(08) 9300 3355
34
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Acknowledgements
The Centre for Cerebral Palsy would like to sincerely acknowledge the contribution
and advice of the following people:
T
All members of the Inglewood Aussi Masters Swimming Club for their continued
support of the Jantzen Sorrento Supa Swim. Proceeds of the 1998 Supa Swim
were used to fund the development of this resource. Sincere thanks to Jantzen for
their generous sponsorship of this event.
T
Phil Jose and Trevor Goddard (Coaches of the Superfins Swimming Club of the
Cerebral Palsy Sport and Recreation Association of WA) for their valuable
contributions and ideas.
T
Janet Boer-Draffin (Developing Skills) for her vast knowledge about swimming
with people with disabilities and permission to use her materials.
T
Mr Gary Shaw (Manager, Swimming and Water Safety Section, Department of
Education and Training) for permission to use material from the Swimming
Teacher Handbook and constructive advice in the preparation of this manuscript.
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
35
References
36
1)
Curriculum Framework for Kindergarten to Year Twelve. Curriculum Council of
WA, 1998.
2)
Swimming Teacher Handbook and Guidelines. Department of Education and
Training, Swimming and Water Safety Section, WA, 1993
3)
Janet Boer-Draffin. Swim-Ability Workshop, Assisting People with Disabilities in
Water and Teaching Swimmers with Disabilities (Course Notes) 2000 and 2001.
4)
Outcomes and Standards Framework for Health and Physical Education.
Department of Education and Training of WA, 1998.
5)
Children with Handicaps: A Medical Primer, by M.L. Batshaw and Y.M. Perret,
Baltimore, 1981.
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Bibliography
Amateur Swimming Association, edited by Joan A. Harrison. Anyone Can Swim understanding and coping with special needs.
Austswim (1998). Teaching Infant and Preschool Aquatics.
Black A and Black C (1984). Swimming for People with Disabilities Association of
Swimming Therapy Ltd. A & C Black (Publishers), London.
Blanksby BA (1986). Austswim: the teaching of swimming and water safety.
Melbourne, Wilke and Company.
Boer-Draffin Janet. Swim-Ability Workshop, Assisting People with Disabilities in
Water and Teaching Swimmers with Disabilities (Course Notes) 2000 and 2001.
CPAWA Ltd (1996). Cerebral Palsy: An information guide for parents. Perth,
CPAWA.
Lepore Monica, Gayle G William, Stevens Shawn F. Adapted Aquatics Programming:
A Professional Guide
Meaney PH (1996). Teaching swimming and water safety. Maryborough, McPherson’s
Printing.
Royal Life Saving Society (1987). Swimming and lifesaving: the manual. Melbourne,
Wilke and Company.
Royal Life Saving Society (1996). Aquapak: water safety, survival and swimming
skills. Antarman
Reid-Campion, Margaret, Heinmann, William (1985). Hydrotherapy in Paediatrics;
London.
S:\Dept\Childsrv\Pt\Hydro\Swimdoc.
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
37
Notes
38
© 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Notes
© 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
39