OTS 124: School-Based Benefits of Aquatic Therapy
- Jayson Davies
- May 14, 2023
- 35 min read
Updated: Aug 19, 2024
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Welcome to the show notes for Episode 124 of the OT Schoolhouse Podcast.
In this podcast episode, Maggie Aschenbrener discusses how she applies her passions for water, children, and occupational therapy by utilizing aquatic therapy in a school-based setting. In addition, she shares valuable insights on the benefits of aquatic therapy, the types of individuals who can benefit from it, and how occupational therapy practitioners can incorporate it into their practice.
This podcast episode is a valuable resource for anyone interested in learning about aquatic therapy or incorporating it into their occupational therapy practice. It provides both inspiration and practical guidance on how to make the most of this modality.
Listen now to learn the following objectives:
Identify key benefits of aquatic therapy for individuals with a variety of conditions.
Identify specific populations that could benefit from aquatic therapy.
Identify potential opportunities to incorporate aquatic therapy into school-based occupational therapy services.
Guest Bio
Maggie Aschenbrener, OTR/L, graduated in 2006 with an undergraduate degree in Occupational Therapy. She earned her master's degree in OT in 2010. She practiced school-based OT from 2006-2021. In 2021, she began working for Concordia University as their Pediatric Clinical Coordinator in the OT department. She has also practiced at a therapeutic horse ranch doing hippotherapy. She loves sharing her passion for OT with others.
Quotes
“A student who has difficulty with transitions, difficulty with sensory processing, or difficulty with attention or focus, being in the water can really help them regulate their body so that they can then participate in other activities” - Maggie Aschenbrener, OTR/L
“We were working on that participation goal through water, and then generalizing it to the classroom” - Maggie Aschenbrener, OTR/L
“Think about that auditory deprivation. There are no sounds underwater, so a lot of our kids with autism just loved to go under the water and just be little fish… because it just cut out the rest of the world” - Maggie Aschenbrener, OTR/L
“If people didn't do what they love within the profession, then we wouldn't have things like hippotherapy and sensory integration may not even have come to play” - Jayson Davies, M.A. OTR/L
Resources
Episode Transcript
Expand to view the full episode transcript.
Jayson Davies
What is happening my fellow OTPs, so happy to have you here for Episode 124 today we are talking all about how we can use aquatic therapy to potentially supplement our traditional push in and or pull out services that we typically do within school based settings. So I think it's only fair to use the analogy that we are going to dive into this podcast head first and go for a swim as we talk with Maggie aschenbrenner to talk about how she has actually used aquatic therapy in her school based ot career to supplement the other types of therapy that she might also implement. Now I know some of you might be thinking to yourself, there's no way I could ever get access to a pool, and that's what Maggie, once upon a time, thought. So I want to just encourage you to have an open mind as we go through this episode, I could totally see during extended school year, or maybe even during the regular school year, some of you figuring out a way to work with your students in the pool. After hearing this episode, you'll know exactly how that could potentially look. So tune in. We're going to dive in right now with Maggie Aschenbrenner to talk about how aquatic therapy could augment your therapy services in school based OTS. Hang in there. Let's Cue the intro, and when we come back, we'll hear from Maggie Aschenbrenner.
Amazing Narrator
Hello and welcome to the otschoolhouse com podcast. Your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.
Jayson Davies
Hi Maggie. Welcome to the otschoolhouse podcast. How are you doing today?
Maggie Aschenbrener
I'm doing great. How are you?
Jayson Davies
Doing very well, you know, it's we're recording this at the end of March. It's almost ot month as we're recording this. And, yeah, I'm just looking forward to a fun conversation with you all about aquatic therapy. So to kick us off today, I love to just let you share a little bit about yourself and where you are in your ot career today.
Maggie Aschenbrener
Okay, okay, I have been practicing since 2006 the majority of my career has been in a school based setting. 13 and a half years of that was in a school for kids with pretty significant special needs, which is where I got into aquatic therapy. And then recently, in the last year and a half, I have moved to academia, and I am currently at Concordia University as an assistant professor and their pediatric clinical coordinator.
Jayson Davies
Awesome. That is great. And we're talking about aquatic therapy today, and I'm excited to dive into that, but you know, you shared some slides with me, and you actually labeled your presentation as augmentative therapy. And so I just want to tease out what's the similarity with those words. The difference, why is it augmentative? Why did it aquatic?
Maggie Aschenbrener
Yeah, so generally, you know, you think about traditional therapy, and I use aquatic therapy to support traditional therapeutic outcomes and therapeutic goals. So we're looking at, you know, using ot but using that water as the medium for the therapy in addition to traditional ot services.
Jayson Davies
Fantastic. That's a great way to explain it. Hence the word augmentative, because you're augmented in the traditional therapy session. Awesome. And diving now a little bit deeper into the aquatic part. How is aquatic therapy different from maybe a student who is going to private swimming lessons or maybe even getting that sometimes. PE curriculum includes some swimming. How is aquatic therapy different from that?
Maggie Aschenbrener
So, yeah, there's adapted swim lessons for kids who have special needs. And those are amazing, because swimming is such a great skill, and as you know, it's leisure is such a great occupation for kids. So we the difference, though, is that we're working on those traditional otschoolhouse com do with dressing, which may have to do with any kind of functional activity, whereas an adapted swim lesson is looking at the goal of swimming.
Jayson Davies
Gotcha. You know, I have worked in a high school setting before, and we had some kids who, for PE they would go and mostly during summer school, but I think also kind of at the end of the school year, they would get some swimming in. And me not being a very strong swimmer. I never got into that. I know our adaptive physical education teacher every now and then she would actually work with those students in the pool a little bit, and she loved it. But I never got into that. And I'm excited to hear more in this conversation about what that looks like, and we're going to dive into what you know a session might look like, but first, I want to talk about some of the benefits that you have seen when using aquatic therapy. And so just to kind of, I don't know, a quick synopsis. I know you could go on and on about this for days, but what are some of those skills that you do tend to try and work on within aquatic therapy?
Maggie Aschenbrener
Yeah, so there's so many things like you said. I could go on and on, but I think we have an hour and a half. But when you look at water as a tool, especially warm water, think about an individual who may have something such as cerebral palsy that causes high tone. Well, think about go back to all of our basics, and the things that facilitate lowering that tone, warmth is one of the first things. So just getting the kids out of their chair into that warm water, and just letting their tone loosen up and doing some really great range of motion is amazing. The ability to get those same kids in different positions, is amazing. In water, you weigh about 1/10 of what you weigh on land. So when we have those kids, you know, you talked about being in working with high school kids, and when you do have bigger kids who have high tone, as you know, it really is harder to move them, and it's, you know, not like when you're working with the little three and four year olds, where it's just really easy to do that kind of stuff. And as you know, tone gets worse with age, if you know, you don't do things such as normal ranging. So that's been great respiration. I live in Wisconsin, and one thing that we see with individuals with special needs is that it's really hard to get rid of those normal viruses and colds that typical children might have an easier time because of low tone within their core. So just being able to stretch those intercostal muscles out is great, as we know, digestion some of our kids who have autism, some of our kids even who have high tone sensory issues, constipation is a huge issue for kids with special needs. And so we can look at just moving that core in certain ways to help get that digestion going. So it's really the whole body that it works. And it's pretty amazing.
Jayson Davies
Wow. You know, the way that I host this podcast, I host it as though you know someone who's listening today would ask questions and follow up. And so I actually want to follow up with this a little bit, because I'm sure there are OTS out there listening and they're kind of thinking the line here might be blurred between educational model and that medical model. And so I want to dive into that, but first, I want to let you explain kind of in what capacity and what kind of setting you were actually providing most of this aquatic therapy.
Maggie Aschenbrener
Sure. So I was at a school called Lakeland school. It's a school for kids with pretty significant special needs. And so some of these kids, their function in school is to be able to tell they have to be able to tolerate sitting in a wheelchair throughout the day. They have to, you know, their goals might be transferring goals, so it's easy to work on that in the water. Additionally, though I did a lot of groups work with speech, with early childhood education, with PTS, where we would take a group into the water and really work on those school based schools. So maybe take foam puzzles into the water. Maybe take instead of, obviously, you can't bring a pen and paper, but you can bring a Magna doodle into water. So working on those shape drawings. So getting their body ready, innervating those gross motor muscles by swimming across the pool with their circle puzzle piece and then having to draw that circle. So really, getting that brain and body working together. Additionally, you can do things with you know, a lot of our early childhood kids had academic goals of one to one correspondence and counting. So okay, we're going to bring three pieces or three manipulatives across the pool, or we're going to sort them by colors. So really activating that movement and activating that brain through the movement. So yes, there were in the one on one sessions, we did work with some of the kids who had really significant physical issues, but we're also able to really work in those academic goals as well as really look at that interdisciplinary model, bringing everybody in together and looking at the child as a whole, which was very progressive. And I love to hear the Early Childhood Education teachers say, oh my gosh, oh my gosh. And she would bring in the iPad for the parents and say, Oh my gosh. Look at okay. They can do this. And now we're going to generalize this to the classroom again. That's where that augmentative comes in. Okay, wow. We got that brain and body working together. So let's get that motor memory going where they can do this puzzle, and they can do this. And then let's generalize that back to the classroom. Wow, yeah, you just answered both questions all in one. I love how you brought that back into the classroom, right? Like we're always as OTs, especially as a new school based ot you know, one of the first things they have to figure out is, is what I'm doing something that I would do in a clinic, or is what I'm doing, something I would do in a school, and that's always hard to mesh together. It a little bit, and it sounds like you kind of have figured that out. And I'm sure it wasn't easy at the beginning, actually, you know what follow up with that, like that first few times that you jumped into a pool with this student? I mean, did you have any training? Or how did you kind of get started with it? Yeah, I mean, the first time I jumped into the pool with a student as an OT I was actually like, chomping at the bit to get there, because my background was I was a lifeguard in college. I taught swimming lessons. I worked for Milwaukee Public Schools recreation department in their adapted aquatics program. So I already had this idea of like, wow, I am going to school for OT and I'm seeing, like, all of these things that water can do for kids, and now I'm going to apply it to that ot background and just watch the kids flourish. So once I got there, I was so ready to do it and so excited, and I was really lucky when I started at my previous job, a whole new building was being built. So we had a therapeutic pool with in the second year I was there, and because my boss was really supportive and she wanted to see we built this beautiful building. We have all these facilities. Let's use them. So I was one of those people who was so fortunate to have full support of my supervisors. Like, yes, we've got these tools and we've got these resources, and so let's use this. And so it was great.
Jayson Davies
That's awesome. And so as you were getting started, then, you know, you've already talked about working with maybe some kids who have high tone cerebral palsy. But how did you determine, you know, maybe what students this was for versus what students this may not be for? Did you have some set of criteria, or it sounds like you felt very comfortable in the water? I can imagine, if you feel very comfortable in the water, maybe you're going to try it with everyone. But how did that with everyone. But how did that work out for you? How did you decide maybe who this was and wasn't for
Maggie Aschenbrener
Well, you know, just based on basic contraindications. So there are students who have, you know, basic contraindications are students who have or individuals who may have different rashes, different skin conditions, trachs or stomas, we brought in a lot of people, and we just really worked with what they had. So like, for example, even though working in the water is obviously a contraindication for traches and stomas, we are OTs, so we modify and adapt. And so what I did with a small child, obviously, with parental permission, and she was one to one, so this is very safely doing it, though, was we put a puddle jumper on her, and then we put one of those things. She was a smaller early childhood student. So one of those things that you can use for kind of more toddler sized kids, where you can put both legs in and they kind of float around the pool, and then we also put another floatation device in between, so she was sitting up, and she could do things in the water with the top half of her body out of the water. So really, when we were looking at when we were going in with a early childhood group. I wanted her to be included in it, because that's the point of being at the school that those kids were at, that they could do things with other kids. And so I didn't want to leave her out. So she was able to do things throughout the water being in a seated position with one to one support and protection over stoma. It was pretty amazing.
Jayson Davies
Wow, wow. That is really cool. You also gave me, like an idea. I can just see a student sitting in one of those things you're talking about, but then it almost has like a floating desk so that they could do a lot of, like, fine motor stuff.
Maggie Aschenbrener
Yeah, absolutely. It has something in front of them. So you can do things like you can put a puzzle on there, or you can put, you know, any kind of Magna doodle, or you can put manipulatives on there, you know. And similarly, we use a lot of foam. They have big foam mats that you can put in the pool and different thicknesses. So some give you a lot of movement, and some give you a little bit of movement. So if you think about it, look at that. We've got a dynamic surface to work on right there. So I can do stuff in four point and move it a little bit. So we're working on children writing themselves, and really working on balance things like that. So really just thinking about, that's where the OT comes in. We're just thinking about, how is this? And how are these tools? How do they help with those therapeutic outcomes?
Jayson Davies
That's amazing. You know, I'm going to ask you more about that in a little bit, but you've already alluded to, kind of this brain body connection that that occurs within water. But I want to let you kind of more specifically talk about that, that brain body connection and how that water facilitates it.
Maggie Aschenbrener
Yeah. So well, one of the most amazing things about swimming is you're using when you're actually doing the strokes, is you're using all four quadrants of your body together. And so if you think about your Corvus collosum and midline crossing, which is huge, especially for school based OTS who are working on writing and visual tracking and visual perception when you get all four quadrants of the body working together. So even if you have a student who's not a swimmer, per se, but they have, you know, for our younger students, having a puddle jump around and doing that, paddling, one arm, one arm, and then those feet, one foot, one foot, what are you doing? You're sending those messages across that corpus callosum the whole time and just really activating both sides of their brain, which, as we know as OTs, is exactly what our exercises, when we think about doing exercises before working on that functional skill, lead us to. So just, it's just this natural, amazing place where we can work on different things. Also think about the vestibular system, how easy it is to get a child to flip over and to roll and to try different positions that you might that might be a little bit more difficult on land to do with kids. So
Jayson Davies
Wow. First of all, we're gonna jump into the next question. But for everyone listening, I know you can't see Maggie's face right now, but you can hear it in her voice. She is so excited about this.
Maggie Aschenbrener
I love aquatic therapy, and I also love the fact that as OTs, we can carve our own niche. And so I really one thing I like to at Concordia, like to tell my students is, you know, if you think it and if it's working towards function and therapeutic outcomes, you can do it. And you know, when I started and I had my interest in aquatic therapy, a lot of people told me, Well, isn't that more PT than OT? Isn't that more PT than OT? And it can be, but it also can very much be OT. And I think I found a way to really make meaningful therapeutic sessions and really get some great therapeutic outcomes using the water. So
Jayson Davies
Absolutely,That's awesome, you know. And if people didn't do what they love within the profession, that we wouldn't have things like hippotherapy and sensory integration may not even even have come to play, you know. So, yeah, totally agree. When I was in college, we had to write like an OT program, and I use film. I was a I loved film, and so I wanted to, I haven't implemented it yet, but I wanted to incorporate special education students with general education students using film as the medium to promote social participation and so many other skills. And so you're right, you know, using what we love and bringing that to the table for therapy. Awesome.
Maggie Aschenbrener
Yeah, that's so cool. Yeah, that's a great example, too.
Jayson Davies
Yeah, thanks. So you already talked about, you know, when you're in the water, you a student, anyone is 1/10 the weight, I think is what you said. Was that correct?
Maggie Aschenbrener
Yeah, it's around 1/10 of the weight. I'd have to look up specifics. It's right, it's right around there. I mean, if you, you know, just think about just picking up your kid, like I my 12 year old boy, who I could never lift on land. I could pop him right up, you know. So,
Jayson Davies
Yeah, and so I wanted to lead into that, because, you know, there is a quote, a very common quote, being that water is a great equalizer. And I think that kind of alludes to that. So when you think of that term, water being a great equalizer, what is? What comes to mind for you?
Maggie Aschenbrener
Yeah, I think about that. It allows children who may have different needs to participate with their peers, amongst their peers, and adults, for that matter, as well, to participate amongst their peers and feel a little bit more equal. So for example, for our young adult group, I did a water aerobics class, and so kids who are in wheelchairs and have decreased balance might be able with support. Well, they were able to, I shouldn't say might be. They were able to get out and with some support from an adult, either hold on to the edge and do some of the different like moves, or have support like at the waist of an adult. Whereas, if they were doing something on land, maybe a yoga class on land, or a Fayette class on land. Their wheelchair is obviously a physical barrier which keeps them physically away from their peers, but they also have, you know, they're strapped in with a belt and at their feet too, so they're not able to get that movement in. So that's one example. Also just if you're thinking about walking and you think about the Viscosity of water. Think about how it helps you with balance. So if you fall in the water, you're not going to fall to the ground. You're going to have this slow movement, and you're going to have this pushback, of which really helps with proprioception. Thinking about like, Okay, where is my body in space? I'm falling this way, or I'm tipping this way a little bit, but I can really feel that. So I'm going to write myself. And so it really helped us with balance. So if you think about walking and any kind of participation, even I would have kids, we had a bench in our pool, which was pretty amazing. And so those kids with lower body awareness, if you had them do something where their elbows and arms were supported a little bit by the water, floating on the water and doing a bilateral task, it really assisted with that as well.
Jayson Davies
Wow. You know, you every time I'm about to ask you a question, you just kind of alluded to it, but I wanted to talk about sensory supports, and you talked about that proprioception. You know, you do get so much more feedback when you're in the water. You weigh less, and you also get more feedback, apparently. But I want to give you the opportunity to dive even more into a little bit of that sensory support you've already alluded to a lot, but feel free to add more.
Maggie Aschenbrener
Yeah, and I mean, think about as OTs, how often we try to simulate deep pressure, whether it's wearing a, you know, a tight Under Armor shirt, or whether it's putting a compression vest on when you go into the water, you've got that automatic compression. It really is that calming feeling. Also, for those students who could go underwater independently, think about that auditory deprivation. There are not sounds underwater. So a lot of our kids with autism just loved to go under the water and just be little fish under the water because it just cut out the rest of the world. Another great thing, it was for our Crashers, those kids who just like to crash and jump in, jump in, jump in. I had students that I in order to prepare them for the afternoon, and being able to sit still during the afternoon just can be really hard for some of our kids, who've been holding it together all morning long in class, just do some crashing. And I would incorporate academics as well. So I did a lot of my my items come from the dollar store because, you know, we're school based, OTs, we don't have huge budgets. So I would get I one thing I remember specifically was, I took a foam sheet, which are great in the water, because they don't, you know, they don't get ruined like a regular pizza, and I wrote the alphabet, uppercase alphabet, on it, and then wrote with Sharpie on those glass stones that you can get at the dollar store, the uppercase alphabet. So he'd have to crash in, go to the bottom of the pool, the letter, bring it back. And I, of course, you know, we do that tender loving sabotage, where we pull it a little bit out of the water. So then he also has to use his whole body to pull himself out of the water. That's a lot of work, as we know as adults who maybe aren't as in as good of shape as we used to be, so pulling himself all the way out of the water, matching that letter, and then jumping back in. And you really, what I really found through time is you can ask teachers what they're working on. You can ask like, what sight words are you working on? What math problems are you working on? What things so when you have these sensory breaks, quote, unquote, they're still getting academic pieces in it.
Jayson Davies
Wow. You know, as I listen to you, a lot of memories are coming back to me from from therapists who provide sensory integration therapy. And you know, we haven't talked about swinging, but we've talked about crashing, we've talked about proprioception, we've talked a lot about just understanding your body in space. And so I see a lot of similarities. So thank you so much for sharing that.
Maggie Aschenbrener
Yeah, and you know, it's funny that you bring up swinging, because linear movement can be so calming. And so instead of swinging in the water, I call it swishing and just taking a child back and forth, side to side, back and forth. And it's again, with that, you know, reduced body weight. It's really easy to do that linear movement in the water as well. So just, you know, and a lot of times to make it more child centered, just adding music to it. So, you know, like, what was the song about? The mouse going up the clock and the clock striking one? So having, yeah, be the clock going across and dinging at the you know, so just using, you know, what we know as Pete's therapist, and bringing it to the water.
Jayson Davies
Yeah, and, I mean, there's so many other opportunities for for vestibular input. I mean, it sounds like you've had kids that just want to jump in. I mean, that's a ton of vestibular input, running, jumping in, or whatever that. And then you also talked earlier about that floating mat and trying to balance with a floating mat. I mean, that's very similar to, like a platform swing, trying to remain on a platform swing while it's going back and forth or whatnot. So so many similarities.
Maggie Aschenbrener
Yeah, and even like thinking about like in the water when you, I don't know if you and your little guy have done swimming lessons yet, but when you start with those, parent, child, swim class, swim lessons, a lot of things. One of the first things they have you do is you kind of crunch them up on the wall, and then you do these blast offs where they shoot themselves back. So think about those integrated reflexes and those movements where you go from going all the way in and then all the way out. So it's just really, there's a lot of things that you're like, oh, this happens so naturally in the pool, and it relates so much to OT. So just applying that, like, Huh? I did this with my kids at their scoring lessons. But guess what I'm gonna do? I'm gonna bring this because I know what else it's doing because of my ot background.
Jayson Davies
Absolutely, absolutely. All right, I've got one more question for you, and then we're going to take a quick break. But I think we've actually talked about this on the podcast before, that one of the leading causes of children with autism is drowning, and I know there has been some research about that. Obviously, at school based OTs, we do work with a lot of kids who have autism, and we also work with a lot of kids who have other disabilities. So how do you just provide and monitor that safety awareness throughout the sessions? And I'm actually going to add to this just a little bit. Do you have non OTS working with you in these sessions, and what role do they play also in this safety?
Maggie Aschenbrener
Sure, one thing that I am really strict about, especially when I'm doing my group sessions, is, if I don't feel safe with the staff to student ratio, which was usually one to one or two to one, we would have to do something like breaking the group in half and doing it in two sessions. Because, you know, I know when you're maybe doing a handwriting session or a yoga session, sometimes they're like, oh, this group is a little big. And, you know, I don't know if they're gonna get the best outcome from the size of this group, but in the water, it's an absolute NO. If it feels like it's too much, then it's it's just not happening. And so another thing that I do is routine, routine, routine. With my early childhood kids, we had them line up right outside of the door. They put their proper flotation devices on, and then they walked hand in hand to the side of the pool. And then we had this very strong routine where we would do body awareness things with sponges, and then they would stand up and be a tree. So just really training them through routine, which all kids crave so much, and then also thinking about the using the proper flotation devices, as well as knowing, you know what we're using those flotation devices for. So for example, water wings aren't the safest safety device. That's redundant, but they're not the safest flotation device.
Jayson Davies
There we go.
Maggie Aschenbrener
Because if you think about it, a kid without core strength can drown with two water wings on. But think about that head going down and those arms being up, right?
Jayson Davies
Yep.
Maggie Aschenbrener
But what we do use is we do use one to one therapist to child with water wings, because they do provide a little bit of flotation. There's that one to one to keep them up. And think about that shoulder stability and shoulder strengthening that you need to use water wings. So we're using those as a therapeutic device. So really having proper flotation devices, knowing what they should be using, used for routine and having that adult proper ratio is, was really the way that I kept things safe.
Jayson Davies
Absolutely and, you know, just just like everything we do, trying to find that just right challenge, right? You know, we don't want to give them too much support, make it too easy, and we don't want them to drown. So finding that just right support, where they're activating their core, whatever it might be, whatever we're working on and giving them that support that they need, but not too much. So, right?
Maggie Aschenbrener
Exactly.
Jayson Davies
Awesome. Well, Maggie, I am loving this conversation thus far, if you can't tell already, but we're going to take a quick break, and when we come back, we're going to dive into the assessment process and then also maybe a little bit about what a typical session might look like. So stay tuned. All right. Well, let's continue on, and let's kind of go about this in a case study, I want you to think of a student that's memorable for you, and we're going to dive through kind of that assessment process. What you kind of did, you know what those sessions look like, and maybe talk about some outcomes. So starting at the top, an assessment. What did an assessment look like for a kid that maybe you remember? How did you decide yes, aquatic therapy, based upon your assessment, is the right way to go?
Maggie Aschenbrener
Well, like I said, it's an augmentative therapy. So I'd already done the traditional evaluations and the traditional goal writing, so really looking at their function. And then I would think about the student as a whole and what their deficits were, and then think about, okay, can water help support this? So again, really thinking about water as the medium to get to those therapeutic outcomes. Specifically, I think of a kid, a little buddy. He was an early childhood student, and he Had just really low body awareness. He did not like to be around his peers. So if we were doing circle time or music group, he just wanted to be across the room. And he would kind of one of those kids who was kind of listening from the corner, and you could tell he was listening, but his sensory system was just could not be near the group, near that noise, everything. So I thought, okay, the water might be a really good way, because he'd have deep pressure all the time. It would help with body awareness. But it turns out he was very fearful of the water, and so, you know, it created a huge barrier, as we often see in OT we have all these different barriers, and our job is to overcome them. So what we did was, while the rest of the group was working in the water on our early childhood group session, I brought in just a tub of water to put in front of him, so just one of those Sterilite containers that you could get at Walmart or the Dollar Store wherever, and I put those toys in to that they were working with in the group, into his little bins so they could, he could hear and see over there they were working with the turtles today. They had the numbers on them, and so he would have those over there, and he could kind of touch the water and be a part of it. And so he was thinking about and he was taking his time, and he was doing it on his own time. So that was great. So we did a few weeks like that. And then I went and I got one of those small backyard pools, those plastic backyard pools, and I put about two inches of water in it, and we put him in there. And then we started working there with different tools. And like I said, we wanted to be inclusive, so really trying to get him to do and modeling those fun activities that they were doing in the pool, and then putting a little bit more water, a little bit more water not and kind of stealthily sneaking in a little closer to the pool every week. And then finally, we just kind of tried it, and we didn't force it. We held them really tight, because a lot of times when kids have sensory challenges, especially challenges with not gravitational insecurity, not having that anchor in the water, can be hard. So just really holding him and showing him what they were doing. And then as time, as time went on, he started participating. So he started to do the activities that we were doing, the wall walks and the activities. And eventually, with flotation devices, he would let us go across the pool and do those activities. So eventually he was totally integrated to the therapeutic activities that they were doing as a class. And it certainly took time, but he did it on his own time. And as we know as OTs, that's a pretty amazing thing. So that's a specific just success story that I just really love, and we had to get creative. So I like the ones where you have to think really hard on and so it was, it was great. It ended up being a great situation for this particular student.
Jayson Davies
Yeah, that is a great example grading an activity for an autistic student to get him fully included. Now I want to ask you, just because this is augmentative therapy, right? So you talked a lot about what you might have done or what you did do with the student in that pool setting. Were you also seeing the student then more in the classroom setting, or was another therapist seeing the student in a classroom setting, and what did that look like?
Maggie Aschenbrener
Yeah, those were all children who were on my caseload. So they had that group time in the water. But then they also, we also saw them in the classroom, whether it was we practiced different models. I was very incorporated into the classroom. So we did a music and movement group. We did traditional one to one therapy in the classroom. We did different multidisciplinary stations in the class. So yeah, we the ultimate goal is to make sure that carryover is happening, to make sure, you know, and for that student, particularly, we want participation, which is a huge part of OT we wanted to be able him to be able to participate with the class. And we were working on that participation goal through water and then generalizing it to the classroom.
Jayson Davies
That's awesome. I love that we're gonna, we're gonna kind of wrap this up before we dive into, you know, sharing with with other OTS what they might be able to do if they want to get started in this. But one of the things that I see that we as an OT profession, we as a related service profession, even not just OTs, but PTS, SLPs, is that we're not always great at measuring our successes on a larger scale. We don't do the best program monitoring. And so I want to ask you is, did you have any opportunities to kind of really grade this on a larger scale at all? Like, you know, saying when we're using aquatic therapy, we're seeing that students are reaching their goals more frequently. Have you had the opportunity to do that at all?
Maggie Aschenbrener
Yeah, you know, that's a good question. I feel like it was so incorporated into the curriculum for early childhood that it was just part of what they were doing and just Overall, we would see these things, and it was more anecdotal. For the older kids, you know, we would have different things, like parent report and so like, oh my gosh, I love how they're doing this. For example, I had a student, since we had benches in the pools, we could work on transfers in the water, which was really great. And so parent report things like that. One thing that I did measure specifically was I was looking at fitness levels of adolescents with and young adults with special needs. So in Wisconsin, we go up to 21 in the schools, where you could, you can be in the schools until 21 and so I did have students measure how they felt before exercise and then how they felt after exercise. So on a scale of one to 10, we had them do comments and self report, and then that one to 10 scale. And we did see some slight improvements. One thing that we did, you know, when you do research and when you're looking at things, there's always kind of those outliers. And one thing that we noticed was students who weren't used to normal exercise. You know, when you get that feeling, when you're exercising and your heart starts to pump and you know, you're working hard, since it was an unfamiliar feeling, they weren't sure that they liked that. And so even though they were doing something that was good for their body, they thought, this is unfamiliar, and I'm a bit uncomfortable with that. So we did see some students who went down afterwards because, you know, and we had to really talk them through, like, okay, but that's what happens when you work hard, and that's what it you know, fitness is, is about, and so just getting them used to being able to talk them through that. So that was an example of something that was measurable that we did, and we did see some good outcomes with that
Jayson Davies
Awesome i love that you just even thought about to do that, because that is something that, just as a profession, I don't feel like we are the best at doing. You know, we we often see our individual students make progress, but we never, kind of put it all together to show that as a whole, we are supporting all the students, or just in general, that our entire school, our entire program, is supporting students. So that's great that you even had the wherewithal to go ahead and and do that.
Maggie Aschenbrener
Yeah, and I think some, some of the things that's things that are challenging about research is like, if I looked at two aquatic or two EC classes, because we did have morning and afternoon classes, if we wanted to really compare the rates, then one group would have had to not get aquatic therapy. And so that's one of those things too, where you're like, oh, you know. And as you know, we're, you know, kind of stretched for time in school. And so it's like, okay, yeah, we could do it, but it would just when you're in the clinician mode. You it's sometimes you forget about that research portion, and now that I moved to academia, I'm like, Oh, that is so important. That's so important. We need more research backing this up. But when you're in the moment of like, as a clinician, I think sometimes you're like, Okay, I'm just going to meet my I want to meet my minutes, and I want to get the most bang for my buck. I want to do the best things I can in the little amount of time I have. And so you get, you move away from that research piece a little bit.
Jayson Davies
Yeah, you know. And I did have a, I took a course with Dr Roseanne Schaaf, and right now she is huge on talking about data, data driven decision making. Dddm, is what she calls it, and that just that ability to create our own research, even as a clinician, that as long as we are showing you know what this was the assessment piece, this is what I said I was going to do. I did it this way, and then we had positive outcomes. And doing that, you are creating your own research that way You can go back to that IEP, and you can say, this is what I did that facilitated these goals. And once you've done that, you've shown that whatever you did, it worked for that one student. It may not work for another student, but you have data that shows that it works for that single student. So, yeah, I think we all need to do that a little bit more. And I think we also need to advocate for ourselves. You know, just the the time that that does take, we need to get that you know, we are professionals. We need planning time, just like anyone else in the world does. So, yeah, yeah. All right, go ahead.
Maggie Aschenbrener
I was just gonna say another cool thing that I saw throughout my time there was the carry over into occupation as a family member, because one thing the water did do was give students the opportunity when you're used to it and when you're comfortable with it and you love it, well, in the summertime, you can go to the community pool together. Or I even had one student who had a pool in her backyard, so I went and I did a session at her house with her mom, so she her mom could see, okay, this is what I'm doing, and this is some of the stuff I can carry over. Carry Over in the summer. So some of that carry over into occupations at other occupations was pretty amazing and exciting as well. And I recently, I will give you the article or the link to the article, so you can post it if you want. But there was one study that I just looked at with. Individuals with autism and swimming, just in general, but just how it was a great way for them to participate in a typical close up family activity. So that is, you know, I to me when we can even go beyond that, yes, we're working on those school goals, but when you can see even greater outcomes, it's really cool.
Jayson Davies
Absolutely, and that's what I love, right? Things that aren't just we can only create so many goals on an IEP, right? But a lot of times when we work on those goals, we see just development, facilitation, progress in so many other areas. So that's that's awesome, that you're able to see that.
Maggie Aschenbrener
Right? And if we're looking at those quality of life aspects, if you're just in general, expanding and improving quality of life. To me, that's so important.
Jayson Davies
Yeah, all right, so now I know for a fact that not every occupational therapist, occupational therapy assistant listening to this podcast episode has a heated pool at elementary school, middle school and high school. But for anyone listening out there that you know may just want to dip their toe in the water and, you know, maybe reach out to an administrator or try this a little bit, what are some recommendations that you have for them?
Maggie Aschenbrener
Well, I will say that one thing that's great is there has been more and more research. So start with the evidence. When I got my master's in, I graduated with my master's in 2010 there was a lot less research. So in just in the past 12 years, now I'm working on my doctorate, there's so much more research. So bring that evidence in and say, like, look what we're able to do. And we, if you have a school pool, we have this tool, so let's use this and even start with supporting inclusively. So if a student as part of their gym unit, if they have a swimming unit, say, You know what, I'm going to take my student in to the pool, I'm going to be with them in the pool, so we can see how they can participate along with their classroom for gym. Because it is, it can be really inclusive. It's not just that particular school that I was in. So you can do those things. And you know, also, it is a niche, and like, not everybody wants to get in the water. Like to me, I think, well, why wouldn't you want to? But if you have that want, just know, like, maybe other people don't want to. Yes, that's me totally mad. Yeah. So, you know, think about like, even though you think that this, to me, is the best and most exciting thing in the world, you might be one of few people who want to get into a swimming suit at work. So you can raise your hand and say, Hey, I'm willing to do it if nobody else wants to. And then go ahead and expand and create from there. When you have, you know, outcomes that you can show people, and once people start to see it does become contagious. You know, I had some speech pathologists that I really kind of had to convince to get into the water. But when once I had them convinced, they were sold. And so really just using that, just start with that little seed and then grow it.
Jayson Davies
100% and you know, also, for some of you out there, you know you love school based OT, but maybe you're also thinking that you want to do something else. And if you love water, there's a lot of people that are starting niche type of businesses, and I could imagine this aquatic occupational therapy being a potential business that your area needs. And just like a clinic might, there might be options for you to actually be a contractor for a school district and still provide some services for that school district, but at your clinic after school, or whatever it might be, or you just see private clinic or private clients whenever you want. So just don't feel limited because you're school based OT, that you can't do this there. You might be able to do it at school based OT, or you might be able to find a route to do it elsewhere,
Maggie Aschenbrener
Right? And, you know, one thing, because I have done things outside of school on my own too, and I will say that having the summer off as a school based therapist, you know, I've done hippotherapy, I've done aquatic therapy. So really thinking about, like, okay, you know, how can I make this work? You know, being a school based therapist during the school year, and then I have this extra time in the summer, and so I can kind of spread my wings and maybe try things, and then bring those ideas back to the school. And, you know, it's just a matter of having an idea, getting some insurance to cover your small business, and then going from there. So, and it's, I mean, I've done it. And paperwork isn't something I totally love, but you work through all the billing stuff, and you get through that. So you just, you do. And I actually hired somebody else to help with, like insurance billing for hippotherapy. So, you know, things like that, just getting creative. Like, I know I'm good at this, but billing insurance like might not be my strong suit, so I'm going to hire somebody to help me do that in the beginning and then teach me. So there are ways. I guess my point is, there are ways to get things done and to meet your own personal goals as well. Absolutely. Maggie, I love everything that we've talked about today. I want to give give you the opportunity to share your information for anyone who is just super excited about aquatic therapy, and maybe they want to reach out to you or find more about you. Where can they go to learn more about you? Well, I have an email address, a private email address, so I can give you the link if you want to post that, and I guess that would be it. I don't have any kind of podcast, any website, anything like that, not yet. But I anybody with questions. As you can see, I'm really passionate about aquatic therapy, and I'm also really passionate about helping people who are in the beginning stages of OT. Love ot as much as I do. So if you have questions or you even just want to chat about aquatic therapy, feel free to email me and reach out to me.
Jayson Davies
Sounds fantastic. Thank you so much for sharing all that you did today about aquatic therapy. Really looking forward to a just learning more from you. You know, from now until the rest of time, but also just, I know that we're going to receive emails myself and you are going to receive emails from people that listen to this podcast today and started, started using aquatic therapy to augment their regular therapy. I'm excited to hear emails like that from people. It's going to be awesome. And yeah, just thank you so much for being here today.
Maggie Aschenbrener
Thank you so much. It was my pleasure
Jayson Davies
one more time. Thank you so much to Maggie for coming on the show and sharing about how she uses aquatic therapy to augment her everyday school based occupational therapy within the schools. Really appreciate you all listening in and let me know what you thought about this episode. Hit me up on Instagram or Twitter at otschoolhouse com. I would love to hear if you think maybe you can implement some aquatic therapy in your school setting. I'd love to hear more from you, and yeah until the next episode, take care and I will see you next time.
Amazing Narrator
Thank you for listening to the otschoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.
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