Technique

Short entry

[Verified]

Full entry coming in 2027

Encyclopedia definition

AquOTic: a 10-week occupational therapy program, delivered from a written manual, that builds water competency in children on the autism spectrum, developed and studied by researchers at The Ohio State University. Each child works one-to-one with the same trained interventionist (a “swim buddy”) in a small group supervised by a lead therapist, to build water safety and swim skills.

Evidence label: [Verified] that the statements below match the published studies, the two trial registrations and The Ohio State University’s own AquOTic pages, read on October 19, 2026.^1–9 Descriptions of the program are the developers’ own statements. All published results so far come from the developers’ research group and have not been repeated by an independent team; a PubMed search for “AquOTic” on October 19, 2026 found four papers, all from that group.¹⁰ Whether the name is a registered trademark is [Needs verification]. Numbers refer to the reference list below.

Credit and origin: Developed at The Ohio State University’s Division of Occupational Therapy (School of Health and Rehabilitation Sciences), where the AquOTic research lab is led by Erika Kemp, OTD, OTR/L, and Jewel E. Crasta, PhD, OTR/L.^1,7,8 The lab describes AquOTic as an occupational therapy aquatic program it created for children with intellectual and developmental disabilities; the published trials have studied children on the autism spectrum.^1,7 [Verified]

Also called: AquOTic intervention; AquOTic program; Aquatic Occupational Therapy (the name the lab’s website and the first trial registration pair with AquOTic^5,7)

Scope note: this entry describes one named, manualized program as its developers publish it. It is not a general term for occupational therapy in water (see Aquatic occupational therapy, coming soon), and it is not a credential.

Usage note: the developers write the name with a capital “OT” in the middle: AquOTic. The lab’s website is titled “AquOTic: Aquatic Occupational Therapy.”⁷ The developers use “water competency” for water safety and swim skills together.²

Cite this entry

How to cite

Salzman, A. (Ed.). (2026). AquOTic (Aquatic Occupational Therapy). In Aquatic Therapy Encyclopedia™. ATU Educational Services, LLC; published by the Aquatic Therapy Foundation. https://aquatictherapyfoundation.org/encyclopedia/aquotic/

Permissions: You may quote and cite this entry with attribution. Reproducing or adapting full entries requires written permission from ATU Educational Services, LLC. Quoted material, trademarks and linked documents belong to their respective owners and are not covered by this permission.

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Longer definition

• What it is. A 10-week occupational therapy program, delivered from a written manual, that builds water competency in children on the autism spectrum. It embeds individualized, one-to-one therapy in a group setting.^2,3 [Verified]
• Session format. One 60-minute session a week for 10 weeks in a warm-water therapy pool. Six child–interventionist pairs per group, supervised by a lead therapist; each child keeps the same interventionist for the whole program. A session runs through pool-deck rules, water adjustment at the pool edge, skill introduction, about 35 minutes of rotating stations (such as submerging, floating, kicking, jumping and treading), a closing game or song, and feedback to caregivers.^1,6 [Verified]
• Methods it uses. The developers list play-based and child-led activities, task-specific training, positive reinforcement, sensory supports and a modified Halliwick approach to swim instruction.¹ The lab describes combining sensory, behavioral and motor-learning approaches with occupational therapy techniques such as grading activities, visual schedules, routines, shaping and individualized goals.^7,8 [Verified, issuer statement]
• Who delivers it. In the published trials the one-to-one interventionists were graduate therapy students, supervised by a lead therapist.^1,3 The lab states that its student swim buddies complete Red Cross BSI training (25 hours) and AquOTic training on land and in the water (16 hours).⁷ A current trial is testing delivery by trained community interventionists (high school or undergraduate students) as well as by occupational and physical therapy students.^4,6 [Verified]
• Who it has been studied in. Children on the autism spectrum aged 5 to 9 years in the randomized trial, and 3 to 7 years in an earlier pilot. The randomized trial excluded children who could already float for 5 to 10 seconds or move through the water without flotation.^1,9 [Verified]
• What the studies found. In a pilot of 8 children, all improved their total score on the Water Orientation Test Alyn-2 (WOTA 2), and 81% of individual goals were met or exceeded.⁹ In a single-blind randomized trial with a waitlist control (37 children), average WOTA 1, WOTA 2 and swim-skills scores rose significantly after AquOTic.¹ Reports from the same trial found better caregiver- and therapist-set goal scores (Canadian Occupational Performance Measure and Goal Attainment Scaling) after the program,² and high treatment fidelity (mean swim-buddy adherence 95.93%).³ [Verified]
• Research under way. A three-arm hybrid effectiveness-implementation randomized trial (108 children planned; NCT07076264) started in September 2025 and is listed as recruiting, with completion estimated for April 2029.^4,6 Ohio State reports a $2.9 million grant from the U.S. Department of Defense Autism Research Program for this work.⁸ The grant is U.S. Department of Defense award HT9425-25-1-0205 (proposal AR240048), a fiscal year 2024 Autism Research Program Clinical Trial Award of $2,873,200 made through the Congressionally Directed Medical Research Programs (CDMRP) to principal investigator Jewel E. Crasta, PhD, OTR/L, at The Ohio State University, for April 1, 2025, to March 31, 2029.^4,11 It funds a test of whether AquOTic delivered by trained community interventionists is as effective as (non-inferior to) AquOTic delivered by professional therapy students for children on the autism spectrum aged 5 to 9 years, along with a study of what affects delivery fidelity and an analysis of program costs.¹¹ [Verified]
• How strong the evidence is. One small randomized trial with a waitlist control, a pilot, a fidelity analysis and a published protocol, all from one research group. The trial authors call for research on long-term effects and on the dose needed to reach water competency.^1,10 [Verified]
• Not the same as. Aquatic occupational therapy in general, of which AquOTic is one named program; the Halliwick Concept, which AquOTic draws on in modified form;¹ or traditional group swim lessons, which the developers describe as designed for neurotypical children.¹ [Verified]

The evidence label after each statement shows how well it is sourced; it is not a grade of clinical effectiveness.

Search the Hot List™

The Evidence Library (our Hot List) is the searchable list of published studies and reviews on aquatic therapy.

The Hot List covers papers published from 2024 to 2026, so the 2024 trial is in it but the 2023 pilot is not. The three 2026 AquOTic papers are filed under drowning prevention: after the search opens, tap the Drowning prevention quick start to see them.

Resource links

Pages kept by the program’s developers and the trial registry. More links will be added as this entry is developed.

• AquOTic: Aquatic Occupational Therapy (The Ohio State University lab website)
• NCT07076264: Water Competency Intervention in Autism (ClinicalTrials.gov)
• NCT05524753: Active Ingredients & Efficacy of AquOTic (ClinicalTrials.gov)

References

Reference numbers match the evidence labels above.

Related entries

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