Clinical Decision-Making in Pediatric Aquatic Therapy: Case Studies
Presented by Kathleen (Kiki) Dickinson
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This course presents actual case studies to explore clinical decision-making in pediatric aquatic therapy using Water Specific Therapy (WST) principles and other aquatic therapy techniques. Therapists will learn how to individualize treatment strategies by examining how aquatic environments and metacentric effects can enhance motor control, posture, balance, and participation for children with diverse neurological and orthopedic conditions. From medically complex children with cerebral palsy to those with hypotonia or autism, each chapter illustrates the application of aquatic techniques, adaptive equipment, and motor learning strategies tailored to each child’s functional level. The course is ideal for physical and occupational therapists working in pediatric outpatient, school-based, or specialized aquatic therapy settings who seek to enhance their clinical reasoning and intervention skills through evidence-informed practice.
Learning Objectives
- Apply practical aquatic treatment skills and clinical decision-making for aquatic therapy treatment, including using Water Specific Therapy for a variety of children with a diagnosis of cerebral palsy (CP) who ambulate with an assistive device, to improve balance and overall strength to promote more independent ambulation and functional skills
- Apply practical aquatic treatment skills and clinical decision-making for aquatic therapy treatment of a nonambulatory, nonverbal, and medically complex child with a diagnosis of CP quadriparesis, hypoxic ischemic encephalopathy (HIE), and scoliosis, to improve head/trunk control, balance, and overall strength to increase gross and fine motor skills
- Apply practical aquatic treatment skills and clinical decision-making for aquatic therapy treatment of a child with significant hypotonia to improve head/trunk control, balance, and overall strength to increase gross and fine motor skills
- Apply practical aquatic treatment skills and clinical decision-making for aquatic therapy treatment of a child with a diagnosis of autism, club feet, and toe walking, with a focus on improving trunk control, balance, and overall strength to improve gait and increase gross motor skills
- Incorporate strategies to increase water safety awareness due to the high risk of drowning in the autistic population
Meet your instructor
Kathleen (Kiki) Dickinson
Kiki has over 30 years of experience as a physical therapist at St Croix Therapy (Therapeutic Services for Children and Adults) in Hudson, Wisconsin, serving both pediatric and adult clients. Her caseload spans the birth-to-three early intervention population, children with complex neurological conditions, and adults with…
Chapters & learning objectives
1. Aquatic Treatment for Children With CP Who Use an Assistive Device
This chapter focuses on ambulatory children with cerebral palsy who use assistive devices. Case studies demonstrate how aquatic therapy—through resistance, turbulence, and buoyancy—facilitates goals such as improving dynamic balance, gait efficiency, and postural stability. Therapists will explore WST strategies and other aquatic therapy techniques to challenge movement patterns and build endurance for greater functional mobility on land.
2. Aquatic Treatment for Medically Complex Children With CP Quadriparesis, HIE, and Scoliosis
This chapter examines aquatic intervention for a child with severe motor impairments, including spastic quadriplegic CP, HIE, and scoliosis. Clinical decisions are guided by the need to reduce pain, enhance head and trunk control, and promote participation through supported movement. Therapists will learn how to adjust the aquatic environment and provide aquatic therapy techniques to enable safe engagement and address respiratory and postural challenges.
3. Aquatic Treatment for a Child With Hypotonia
A case study of a young child with hypotonia demonstrates how aquatic therapy can improve postural control, core strength, and early motor skills. Activities target head control, trunk activation, upper extremity reaching, and visual engagement, with emphasis on using buoyancy and graded support to facilitate progress over time. The chapter also discusses the integration of OT and PT goals for functional play and self-regulation.
4. Aquatic Treatment for a Child With Autism and Club Feet
This chapter details treatment planning for a child with autism, toe walking, and bilateral club feet. Therapists will observe how aquatic therapy can enhance gait mechanics, balance, joint attention, and safety awareness through engaging activities, including balance exercises, two-footed jumps, and pool wall crawls. The case emphasizes the importance of sensory regulation, UE engagement, and progress tracking across sessions.
More courses in this series
Introduction to Water Principles for Effective Aquatic Therapy
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Aquatic Therapy to Address Obesity and Deconditioning in Pediatrics
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Clinical Decision-Making in Pediatric Aquatic Therapy: Case Studies
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