Peer-reviewed article
AquOTic: protocol for a type 1 hybrid effectiveness-implementation trial of an occupational therapy-based water competency intervention for children on the autism spectrum.
Kemp E, Juckett L, Sansone IO, Walton KM, Palettas M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a protocol for a research trial testing an occupational therapy-based water competency intervention for autistic children aged 5-9 years. Drowning is a leading cause of death for autistic children, partly because of autism-related factors like wandering, sensory differences, and limited danger awareness. The trial will compare the intervention delivered by professional and community swim buddies against a control group, measuring water safety skills and implementation outcomes. The study aims to understand both whether the intervention works and how well it can be delivered in real community settings.
Key points
- Drowning is a leading cause of unintentional death among children on the autism spectrum
- Autism-related factors including wandering, sensory differences and limited danger awareness increase drowning risk
- The trial randomises 108 children into three arms: AquOTic with professional swim buddies, AquOTic with community swim buddies, and usual water exposure control
- Primary outcomes measure water competency and swim skills using standardised performance-based and caregiver-report measures
- Secondary aims assess implementation fidelity, engagement, and attitudes using mixed methods
Limitations
This is a protocol document only, not yet reporting results; therefore, it cannot tell us whether the intervention is effective or how it performs in practice. The study is limited to children aged 5-9 years in what appears to be a US setting, so findings may not generalise to other age groups or contexts.
Abstract
Introduction Drowning is a leading cause of unintentional death among children on the autism spectrum, emphasising the need for tailored water competency interventions. Autism-related factors such as wandering, sensory differences and limited danger awareness increase drowning risk. Evidence suggests structured aquatic programmes improve water safety, yet guidance on effective components and implementation fidelity in community settings remains limited. Methods and analysis This type 1 hybrid effectiveness-implementation randomised controlled trial will evaluate AquOTic, an occupational therapy-based water competency intervention for children on the autism spectrum aged 5-9 years. A total of 108 participants will be randomised into three arms: (1) AquOTic delivered by professional student swim buddies, (2) AquOTic delivered by community swim buddies and (3) usual water exposure control. Primary outcomes include water competency and swim skills measured by standardised performance-based and caregiver-report measures. Secondary aims assess implementation determinants (fidelity, engagement, attitudes) using mixed methods, while exploratory analyses calculate costs and resources. Ethics and dissemination Ethical approval has been obtained from The Ohio State University Institutional Review Board (protocol number: STUDY20250101). Written informed consent will be obtained from parents or legal guardians and assent from children when appropriate. Findings will be disseminated through peer-reviewed publications, conference presentations and partnerships with community organisations involved in autism and water safety. Trial registration number NCT07076264.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- AquOTic: an occupational therapy-based water competency intervention delivered either by professional student swim buddies or community swim buddies
- Population
- Children on the autism spectrum aged 5-9 years (planned n=108)
E et al. · Europe PMC · 4 Aug 2026