The effects of aquatic exercise on motor skills and social behaviors in children and adolescents with autism spectrum disorder: A Systematic review

Abstract Purpose: Children and adolescents with autism spectrum disorder (ASD) have delays in developing motor skills and social behaviors compared to typically developed children. Various exercise program can improve social and motor behaviors of individuals with autism spectrum disorder. There is no consensus among researchers about how aquatic exercise effects of individuals with ASD. The purpose of this study is the comprehensively reviews the impacts of aquatic exercise on motor skills and social behaviors among children and adolescents with ASD. Methods: This systematic review is based on the PRISMA guidelines. The following criteria was used to determine acceptance into this review: the participants were children and adolescents with ASD, the experimental program was involved aquatic exercise program, and all studies were peer-reviewed English publications from 2002 to 2022. Results: After applying exclusion criteria, a total of 9 studies were identified. Analysis indicated that various aquatic programs including hydrotherapy and traditioanl swimming activities can improve motor skill levels and social behaviors in children and adolescents with ASD. Optimal duration of aquatic programs appears to be at least 8 weeks for a minimum of two times per week for 30 minutes per session. Conclusion: Results of this analysis suggest that physical therapists and physical educators should recommend this intervention when appropriate, and consider developing community-based aquatic exercise programs.