Download - A Guide for Swimming Teachers 2009
The Centre for Cerebral Palsy
A Guide For Swimming Teachers
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]
© 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.
This booklet was prepared by: Kate Sheard, Amelda Preston, Matthew Brain. Updated by Natalie Georgeff and Jessica Morris.
2 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
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
3 © 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
4 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
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.
Figure 1 The Brain
Thought Processes
Control of Movement
Sensation of Touch
Sight
Speech
5 © 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 require some modifications during
swimming lessons and may need concessions to pass levels. • Severe - Children will require equipment and assistance to
participate in swimming lessons.
6 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
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.
7 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
Curriculum Framework and Inclusivity
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.
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.
8 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
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)
9 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
Hints and Suggestions when Working with
Students with Disabilities
1. 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’.
© Janet Boer-Drattin (3)
10 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
© Janet Boer-Draffin No 2002
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
11 © 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: T The ‘Humpty Dumpty’ song
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
T Hold child close initially. Gradually
lower your arms to progress child to falling forwards into water with hands on your shoulders
T Walking down steps/ramp with/
without rail 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
Exiting pool over side: T Exit pool onto stomach with hands
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 Use hoist or ramp with wheeled
chair T Use of ladder T Use of hoist
12 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Water Safety and Pre-Swimming Skills
BREATH CONTROL WATER CONFIDENCE
Blowing bubbles at surface on water 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 Practice turning head so ears are in
the water 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
T Splashing games and water on the face
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 Use of flotation devices - kicking
board, noodle
13 © 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
14 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
SKILL LIMITATION IDEAS FOR TEACHING
Demonstrates actions to ensure personal safety
Unable to float Poor breath control
T Promote head control to prevent mouth from entering water
T Uses flotation device eg. kickboard or noodle
T Wear goggles
T Grasp rail/side of pool independently
T Sit in shallow water
Displays an awareness of self and body parts
Poor coordination and body awareness 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
Mild/Moderate Disability
15 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
SKILL LIMITATION IDEAS FOR TEACHING
Control body movements Lift and turn head Make purposeful limb movements Bring hands to or across midline Change body position
Poor head control Poor coordination Limited strength and movement
T Breath control activities
T Activity songs T Kicking with floatation device in
upright position T Animal walks eg. frog, chicken,
monkey walks, kangaroo
Move in water with or without support
Unable to perform without some assistance Fear of water
T Entry to water and Exit from water techniques
T Water Confidence/Disengagement techniques
T Walking/running using dog paddle arms
T Games ‘What’s the Time Mr Wolf?’, water chasey
T Use flotation devices eg. kickboard, noodle, ring
T Practice moving from floating on back to standing
T Monkey walks
T Dog paddle on stomach with flotation device
Mild/Moderate Disability
16 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Submerge
Waist deep
Entire head under water
Poor balance and strength to move from under the water to a standing position
Grommets
Fear of water
Perceptual difficulties
T May require a wall/ledge to assist with recovery
T Teach in waist deep water T 1:1 assistance T Toys under water as incentive
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
Recovery to standing position
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
Poor trunk control
T Use flotation devices for the arms and waist
T Assist with push off for glide T Assist the child with bending
at the waist and standing back to upright position
T Recover to safe position eg. stand at side of pool
T Break into 2 steps of glide and recover
T Practice vertical and horizontal body positions
Float or glide backward on back and recover
Waist deep
Flotation aide acceptable
No set time/distance required
Near horizontal body position
Recovery to a standing position
Difficulty bending forward from lying on the back to standing
T Roll onto the stomach then stand
T Assist with bending at waist and to upright position
T Head brought upright/forward and hands pushed down in water to assist with recovery
T Practice floating on back and front
T Rockets T Float on back holding
kickboard and kicking
Survival Safety/Sequence No 1
Enter water safely
Hold flotation aid/float for 10-15 seconds
Exit safely from water
Lack of strength or coordination for exits
T Use a rail/ramp/stairs T Allow more time T Mat at edge of pool
STAGE 1
Mild/Moderate Disability (2)
17 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
STAGE 1
SKILL LIMITATION IDEAS FOR TEACHING
Enter water safely
Shallow Slide in entry Waist deep water
Confident and safe entry and exit
Unable to use both arms/legs, due to muscle weakness/incoordination
Fear of water
Poor head and trunk control
Sensitive skin
Poor safety awareness
Poor balance uses walker/assistive device
T Entry to water techniques
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
Poor head control
T Additional practice of bubble blowing activities
T Blow up a balloon and let air out under water
T ‘Kangaroo Bobbing’ up and down to variable levels
T Use goggles/mask to assist with gaining confidence by being able to see under water
T Demonstrate
Open eyes in water
Identify an object under water
Confidence
Ability to identify an object clearly
Visual impairment
Sensitive eyes
Grommets
T Goggles T Splashing games at face T Silicon ear plugs
Mild/Moderate Disability (2)
18 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 2
SKILL LIMITATION IDEAS FOR TEACHING
Glide forward on stomach and kick 3 metres Horizontal body position, face in Waist deep (minimum) Near horizontal body position Face in water, exhaling Continuous kick
The face down position may increase involuntary movement patterns Cycling kick is common Body rotation is common to compensate for an ineffective asymmetrical kick Unable to achieve horizontal position
T Use a flotation device, eg. noodle, kickboard
T Check ability to kick from hips or knees
T Check ankle flexibility. Forward propulsion is difficult if ankles are restricted
T Flippers assist in a stronger kick
T Physical guidance at hips for body position
T Bent arm position is acceptable
T Kickboard held out in front to practise patter kicking and reduce rotation. Use counting and timing
T Kicking positions upright, on stomach with flotation device
T Kicking progressions cycling _ kick with bent leg _ patter kick
Mild/Moderate Disability (2)
19 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
STAGE 2
SKILL LIMITATION IDEAS FOR TEACHING
Glide backward, kick and recover Waist deep (minimum) No set distance Arms by side Near horizontal body position Continuous kick without excessive knee bend
The face up position may increase involuntary movement patterns, for example, the head and back may arch backwards Cycling kick is common Body rotation is common to compensate for an asymmetrical or ineffective kick Unable to achieve horizontal position
T Use a flotation device, eg. kickboard, noodle
T 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
T Try a personal flotation device with a head support to encourage the head to bend forward
T A kickboard or noodle under the pelvis will keep the body horizontally aligned
T A kickboard held by the child at the chest will reduce the body rotations and keep them more buoyant
T Physical guidance for body position and kick
T Begin with child’s head on assistant’s shoulder
T Kicking positions upright moving towards lying on back
Mild/Moderate Disability (2)
20 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Swim 5 metres freestyle Face submerged Catch up acceptable Effective kick Arm recovery clear of water Face in water, exhaling
The face down position may increase involuntary movement patterns
Cycling kick is common
Body rotation is common to compensate for an asymmetrical kick
Smooth arm movements may be difficult
May not be able to use arms above water or kick symmetrically
Compensate style
T Flotation devices T Practice catch-up drills with the
kickboard T Swim action into pool wall T Accept dog paddle with modified
breathing T Physical guidance for sequencing of
arm movements T Use a kickboard to prevent arms
pulling back into the body T 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
T A kickboard held out in front to practise patter kicking. Flippers assist in keeping legs straighter
T Kicking positions inclined forwards towards lying on stomach
T A kickboard held out in front will assist with reducing rotation tendency
T Allow unilateral breathing
Scull/tread water
Using hands and legs to support body weight in water
Outward and inward scull
Ability to gain some support
Alternating leg action
Coordination skills T Non-symmetrical action is acceptable T Encourage large shoulder movements T Floating acceptable T Use flotation device eg. noodle, milk
container
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
Grasp an object and be pulled to safety
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
T 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
STAGE 2
Mild/Moderate Disability (2)
21 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
STAGE 3
SKILL LIMITATION IDEAS FOR TEACHING
Swim 10 metres freestyle Breathing Near horizontal body position Effective leg action Regular breathing pattern
Free arm movements may be difficult Muscle tightness on one side caus-ing arm to not exit the water, or only complete a short stroke Control of the volume of breathing may be difficult
Asymmetrical kick on one side
Excessive body roll-ing due to muscle tightness on one side of body
T Practice catch-up drills with the kickboard. Use bar if unable to hold
T Swim action into pool wall T Practise standing in water waist
deep T Physical guidance for
sequencing of arm movements T A kickboard in front to
encourage straight arms T 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
T Catch-up may assist breathing by ensuring an adequate arm stroke during freestyle
T Encourage use of large shoulder movements
T Encourage the child to blow air out into the water between breaths.
T Re-explore bubble blowing games
T Use flippers to assist the child to focus attention on arms with-out struggling with legs as well
T Arm position progressions below _ at _ above water level
Mild/Moderate Disability (2)
22 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Glide backward and kick 5 metres
Waist deep (minimum)
Arms by side
Near horizontal body position
Effective kick
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
Cycling kick is common.
Body rotation is common to compensate for an ineffective kick
Recovery is hard for children with balance difficulties
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.
T Try a flotation device with a head support to encourage the head to bend forward
T A kickboard or noodle under the child’s pelvis will keep the body horizontally aligned.
T A kickboard held by the child at the chest will reduce body rotation
T Consider propulsion rather than style
T Use flippers to assist kick
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)
T 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
T Use a kickboard held at the chest to assist flotation
T Use hands-on facilitation T Modified stroke or kick action
may be considered acceptable provided required distance is completed
T Consider propulsion rather than style
Demonstrate survival sculling
On back
Sculling hand action
Flat, relaxed hands
Effective support
Some children are unable to rotate their hand (from their elbow) so the palm faces upwards
T Encourage movement to come more from the shoulders than the elbows
T Encourage any movement of the arms parallel to water surface
T Consider propulsion rather than style
T Use flotation devices
STAGE 3
Mild/Moderate Disability (2)
23 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR
Demonstrate a forward roll Extension Deeper than waist deep
Getting into a ball position may be difficult Pushing off from the floor and maintaining a rotatory motion with the arms may be difficult Body symmetry may not be achieved and roll will not be straight
T 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
T Practice in chest deep rather than waist deep water
T Practice forward rolls on the grass
T Practice forming a ball in water
T Practice duck dives T Hands on assistance or
guidance
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
The face down position may increase involuntary movement patterns Cycling kick is common Body rotation is common to compensate for an ineffective kick Child may have difficulty maintaining grasp while being pulled to safety Recovery to standing may be difficult
T Use a rail T Allow more time T Hands-on physical
guidance for body position is acceptable
T Consider recovery to side of pool and then to upright position
T 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
T Loop a rope to hold onto or put arm through loop and hold with bent elbow
T Attach flotation device to student
STAGE 3
Mild/Moderate Disability (2)
24 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
SKILL LIMITATION IDEAS FOR TEACHING
Demonstrates actions to ensure personal safety
Poor head control Unable to keep head above water, float or remain buoyant Fear of water
T Use of flotation device
T 1:1 assistance
T Use of goggles
T Breath control activities
T Promote head control to prevent mouth from entering water
Demonstrates an awareness of self and body parts
Poor head and trunk control Involuntary movements
T Action songs with physical assistance
T Relaxation using flotation devices
Severe Disability
25 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
FOUNDATION SKILLS
SKILL LIMITATION IDEAS FOR TEACHING
Control body movement Lift and turn head Make purposeful limb movements Bring hands to or across midline Change body position
Poor balance and strength Poor coordination Involuntary movements
T Making splashes
T Verbal prompts eg. activity songs
T Circles with child on back, hold 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
Move in water with or without support
Unable to perform independently
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
Severe Disability
26 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
STAGE 1
SKILL POSSIBLE LIMITATION
IDEAS FOR TEACHING
Enter water safely
Shallow
Slide in entry
Waist deep water
Confident and safe entry and exit
Poor trunk and head control
Involuntary movements
Unable to stand independently
T Use hoist T Use ramp with wheeled
chair T 1:1 assistance T Do not submerge head
Exhale in water
Face in
Relaxed and confident exhalation
Poor strength with exhaling
Poor head control
Aspiration
G-tube (= nil by mouth)
No lip closure - tongue and jaw thrust
T Additional practice of bubble blowing activities
T Do not submerge head
Open eyes under water Confidence Ability to identify an object clearly
Non verbal
Visual impairments
Grommets
Sensitive eyes
T Goggles T Splashing games at face T Silicon ear plugs
Severe Disability (2)
27 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
SKILL POSSIBLE LIMITATIONS
IDEAS FOR TEACHING
Submerge
Waist deep
Entire head under water
Poor balance and strength to move from under the water to a standing position G-tube (nil by mouth) Aspiration
T Use hoist T Use ramp with wheeled
chair
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
Recovery to standing position
Fixed range of motion Excessive movement
T Use flotation device T 1:1 assistance
Float or glide backward on back and recover
Waist deep
Floatation aide acceptable
No set time/distance required
Near horizontal body position
Recovery to a standing position
Involuntary movements Poor head and trunk control
T Assist with bending at waist to upright position
T Head brought upright and forward with hands pushed down in water to assist with recovery
T 1:1 assistance T Flotation devices with
chair
Survival Safety/Sequence No 1
Enter water safely
Hold flotation aid/float 10-15 seconds
Exit safely from water
Unable to enter/exit/independently
T Use ramp with wheeled chair
T Hydraulic lift/hoist T Use flotation device T 1:1 assistance
STAGE 1
Severe Disability (2)
28 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Glide forward on stomach and kick 3 metres
Horizontal body position, face in
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
Will need 1:1 assistance to achieve all skills
T 1:1 assistance T Extensive use of flotation device
and hands-on physical guidance for body position
STAGE 2
Severe Disability (2)
29 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Swim 10 metres freestyle
Breathing
Near horizontal body position
Effective leg action
Regular breathing pattern
Glide backward and kick five metres
Waist deep (minimum)
Free arm movements will be difficult Muscle tightness on one side may make it difficult to complete a stroke 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
T 1:1 assistance is necessary
T Encourage use of large shoulder movements
T Encourage the child to blow air out into the water between breaths.
T Bubble blowing games T Use of flotation device
will be necessary T Consider propulsion
rather than style T Use flippers to assist
propulsion
STAGE 3
Severe Disability (2)
30 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Glide backward and kick 5 metres Waist deep (minimum) Arms by side Near horizontal body position
The face up position may increase involuntary movement patterns, for example, head and back arched backwards
T 1:1 assistance T Use of a flotation device,
positioning at chest, head, knees or pelvis to address individual child’s needs
T Use flippers to assist propulsion
Demonstrate breaststroke leg action Sculling hand action Flat relaxed hands
Child will not be able to coordinate this stroke
T Consider relaxation instead with 1:1 assistance
T Flotation device T Use flippers to assist
propulsion
Demonstrate survival sculling On back Sculling hand action Flat relaxed hands Effective support
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 Encourage any movement of arms parallel to water surface
T Use flotation device T 1:1 assist T Do log roll from front _
back T 1:1 assist T Use of flippers
STAGE 3
Severe Disability (2)
31 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
SKILL LIMITATION IDEAS FOR TEACHING
Demonstrate a forward roll 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
Will be extremely difficult primarily due to lack of breathing control
T Do log roll from front � back T 1:1 assist
STAGE 3
Severe Disability (2)
32 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Equipment Available
SUGGESTED EQUIPMENT TO USE IN THE WATER Supervision is essential for swimmers when using equipment 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
33 © 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]
34 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
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
35 © 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.
36 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
References
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.
37 © 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.
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38 © 2003 - The Centre for Cerebral palsy - A Guide for Swimming Teachers
Notes
39 © 2003 - The Centre for Cerebral Palsy - A Guide for Swimming Teachers
Notes