Inclusion of Swimmers With A Disability
Inclusion of Swimmers With A Disability
Contents
3 Disability access
3 Awareness of issues relating to
health & safety, assisting and
handling
3 Teaching and learning
4 Parents/carers as partners
5 Overview of a variety of
conditions
7 Swimming stages
9 Practical considerations
11 Developing swimming skills
19 Additional considerations
20 Supporting and assisting
in the water
21 Next stage
23 Classification
24 Conclusion
25 Useful websites
Acknowledgements
British Swimming
Carole Barough
Liz Christian
Kaye Savory
Jill Stidever MBE
The ASA Technical Disability
Swimming Committee
Youth Sport Trust
Portage and Leicester Penguins SC
1
Introduction
2
Disability Access
The Disability Discrimination Act 1995 There may be occasions when manual
(DDA 1995) is a UK Parliamentary Act, handling cannot be avoided. Always
which makes it unlawful to discriminate discuss, plan and prepare before you
against people in respect of their assist.
disabilities in relation to employment,
the provision of goods and services,
education and transport. Before Assisting and Handling
think about:
l This act has been, and will be, altered l the TASK
in the future with the aim of making l the INDIVIDUAL
services and provisions available to l the LOAD
everyone. Current legislation needs l the ENVIRONMENT.
to be considered when any plans for
inclusion are being made to gain the
best possible provision.
Extra considerations
In practice this means that new facilities l Ensure that any participants with
should incorporate the ideal. Older balance problems are offered The swimming programme, the time
facilities require innovative ways of assistance when walking on a wet and the content will have a bearing on
making access easier. poolside. an individual’s choice. This choice may
l Swimmers with lower limb impairment be associated with personal preference,
may need assistance/prosthesis interests and staffing e.g. beginners,
Awareness of Issues Relating to needed near poolside/alternative improvers, recreation, swim for health,
Health & Safety, Assisting and assistant (chair, skateboard etc). competition and other aquatic
Handling disciplines.
l Take care when a participant with
Risk assessment is the key to all safety, paraplegia or those with minimum
assisting and handling activities in the control of their lower limbs are Assessment of Need
swimming pool environment relating to entering the water as abrasions,
both people and equipment. Assistants that take a long time to heal, may Determining the specific needs of any
need to be familiar with mechanical be caused. participant is an essential pre-requisite
lifting aids, so they can use them safely. to his/her successful involvement in any
All risk assessments and training must l Park wheelchairs parallel to the pool swimming session or club. These may
be recorded. and ensure that the brakes are on. be determined by:
l Be aware of swimmers who may have l direct consultation with the individual
seizures. 1:1 spotters are required for and parent or carer
Some Common Sense Principles epileptics. The ASA has a protocol for
competitive epileptic swimmers.
l swimming background
l Swimmers with disabilities often
need help to participate but avoid l Walk on the water side of the pool
l completion of Club registration
lifting wherever possible. when assisting someone. forms
l Always encourage people with l observation of the swimmers ability in
disabilities to help themselves and Safety of swimmer and helper is of the water
teach them how to do so. paramount importance. Ask for help
l age.
or further training if in doubt.
l Make use of swimmers own arm
and leg strength. Should the group not be able to provide
for the specific needs, the swimmer
l Make use of graduated steps, Teaching and Learning
should be given contact information and
sliding boards, shower chairs, etc. There is an ever-growing involvement directed to another more appropriate
l Some swimmers will need assisting of people with disabilities in teaching provision. Local knowledge is invaluable
but always think, plan and prepare classes and swimming club provision. at this time as well as advice from the
before you assist. There is still a place for alternative Governing Body.
arrangements either long term or on
l Assist for the shortest possible
a temporary basis. Provision may be: Constant monitoring of progress should
distance.
l fully integrated take place and achievement of goals
l Be aware of rough surfaces which should be reviewed on a regular basis.
may cause abrasions. l included and supported
l separate provision.
3
Teachers should be upskilling constantly Teaching principles Useful information is suggested in the
in order to ensure that they are abreast National Plan for Teaching Swimming
Successful teaching is dependent on:
of new ideas and initiatives. Parent Pack although the following
l good technical knowledge additional information could be useful
l willingness to be adaptable to the teacher:
Swimming fundamentals and
willingness to further knowledge
l is the swimmer able to cope in a
safety skills l
group?
All swimming sessions regardless of l sound knowledge of fundamentals
l does the swimmer require 1:1
ability should include practices to ensure acknowledgement of importance of
l
assistance to move in the water?
the swimmer is proficient, happy and basic safety skills
safe. Basic Safety Skills should form the l does the swimmer require 1:1
basis of any swimming programme. l ability to deliver appropriate sessions/ assistance to understand instructions?
These skills include: schedules to meet individual needs
l does the swimmer have a special
l entry
l awareness of hidden medical need that is not apparent?
conditions
l exit
l good observational skills to adapt l has the disability been recently
l buoyancy/balance strokes to individuals abilities. acquired (ie. amputation, paraplegia)
l rotation/orientation and so is new to the swimmer?
aquatic breathing
l are there any restrictions or limitations
l
Parents/carers as partners
in or under the water?
l travel Information, that is relevant to l does the swimmer require medication
l co-ordination the swimming situation, needs to during session?
be communicated to the teacher/
l spatial awareness.
coach at time of registration. Initial Medical information needs to be
communication pathways set the shared where the safety of the
Teachers should be aware of
standard for future years. swimmer or teacher is concerned.
hidden conditions that might present
unexpected problems e.g. asthma,
epilepsy, diabetes, cystic fibrosis, etc.
Specific knowledge about the individual
will determine whether there is an
extra need for a watchful parent or
designated spotter.
Horizontal Float
4
Overview of a variety of conditions
A brief outline of some of the more Arthrogryposis There are three types of Cerebral Palsy
common medical conditions likely to be with further descriptions that describe
Due to a congenital condition
encountered is listed below, together limbs affected.
from birth. It causes multiple joint
with some additional observations.
contractures and is characterised by
muscle weakness.
Spastic
Achondroplasia (Dwarfs) l Weight bearing is possible but
l Increased muscle tone making limbs
movement is limited by tightness of
In the majority of cases this a genetic appear stiff.
the joints.
condition with people having restricted
growth.
Athetoid
l Attention may be needed to achieve Cerebral Palsy
balance and initial safe body position. l Co-ordination is poor because of the
This is due to an oxygen deficiency at
involuntary movements and many may
l Once water confidence and controlled birth or during an accident that may
appear clumsy. However symmetrical
breathing have been achieved, move result in some of the difficulties listed
movements are easier to learn.
towards a conventional swimming below.
technique. l Breathing difficulties may be apparent.
l Reduced muscle power.
l Increased muscle tone, causing stiff
Arthritis flexed limbs (spastic). Ataxic
Osteoarthritis – this is due to wear and l Difficulty in breath control and l The individual may lose balance
tear on joints particularly hips and knees. swallowing. without prior warning.
Rheumatoid – this is a hereditary l Involuntary, uncontrolled movements
– uncoordinated (atheoid). Medical descriptions of cerebral palsy
condition causing inflammation of joints.
may include:-
Can affect any age group. Also known l Disturbance of balance (ataxic).
as Stills disease in children. Quadraplegic - both legs and arms are
l Possible speech problems. involved. The individual may be in a
l Sculling is very useful in the early
Possible cognitive impairment. wheelchair if severely affected.
stages as it causes less pain and l
propulsion can be gained using Diplegic - legs affected more than arms.
minimum effort. Tend to walk on toes with knees turned
or rotated inwards. May/may not use
l Breathing is easier when supine
wheelchair.
(on back).
Hemiplegic - either left or right side of
body involved. Swimmers who have had
a stroke may be considered in the same
way.
Dysmelia/Amputees
Dysmelia is congenital from birth,
amputee is acquired as a result of
trauma/accident.
l Affected limbs may require protection
especially if new. Be careful not to
bang them accidentally.
l The swimmer may need to remove a
prosthesis (artificial limb) close to the
poolside.
l Individuals with lower limb loss should
establish a safe means of moving
around the poolside.
l Individuals may take longer to achieve
balance.
Achrondroplasia
5
Multiple Sclerosis l The swimmer may not notice wounds Epilepsy
that take a long time to heal.
This is due to damage to the myelin A tendency to have recurrent
sheaf. When the myelin is damaged l The swimmer may be incontinent but seizures (sometimes called fits). If a
there is interference with messages this is no barrier to swimming.** seizure occurs during the swimming
between the brain and other parts of session, recover/rescue the swimmer
** Consideration should be given to
the body. appropriately. Each swimmer requires
discreet changing facilities.
l Swimmer’s co-ordination may be a knowledgeable spotter on poolside
affected. at all sessions.
Strokes
l Swimmers will have good and bad
days. This is due to bleeding into the brain Cystic Fibrosis
and often causes a degree of paralysis,
l Early achievement is essential to aid An inherent condition where mucous is
usually to one side of the body.
longer term mobility. formed causing respiratory difficulties.
l Rehabilitation may bring back some Tissues and bowl may be required on
l Swimmers may tire easily.
movement especially when new
poolside.
balance has been achieved.
Muscular Dystrophy l Speech is often affected,
understanding is not. Heart conditions
This is congenital from birth condition
although it is not obvious until later. It l Frustration is displayed often because A condition where the heart is
is a progressive degenerative disease of of limitations in communication. damaged.
muscles. l A medical certificate is advised.
l Swimming helps to keep muscles as
Sensory impairments l Do not over tire, most people know
fit as possible.
their own limitations.
Visual
l Swimmers have good and bad days.
This can range from total loss (blind) to
l Activities should be adapted
individuals who remove their glasses and Diabetes
accordingly.
cannot see clearly.
A condition where the body produces
l As much as possible should be
little or no insulin.
taught in the early stages.
Hearing l Some swimmers may require special
This can range from totally deaf to loss dietary requirements before or after
Osteo-genesis Imperfecta (Brittle of hearing in a crowded environment, the session as recommended by their
bones) loss of pitch and to those who cannot doctor.
This is due to a congenital condition hear when they remove their aids.
from birth.
Haemophilia
l Bones may break easily. Learning Disabilities A generic condition where the blood
l Medical limitations may be set. This is due to a congenital condition or fails to clot easily.
l Care is needed to avoid contact with as the result of infection, injury, poison l More appropriate to swim in the
the poolside and other swimmers. or nutrition. prone position when learning to
swim in order to prevent knocking
Other swimmers, who do not fit the
into obstacles.
Spina Bifida and spinal injuries descriptor above, may have learning and
resulting in paraplegia/tetraplegia /or co-ordination difficulties that could
affect learning to swim. Some examples Further information on these and
This is due to a lesion or injury to the are:- ADHD, Down’s Syndrome, Fragile other conditions can be found in the
spine. The point of the lesion/break on X Syndrome, Aspergers, Dyslexia, Caf Directory www.cafamily.org.uk
the spine will determine the degree of Dyspraxia and Autism. or from local support groups.
paralysis.
For further information on Disability
l Many may have total sensory and
Hidden conditions Specific Sports Organisations please
motor loss below the site of the
refer to page 24.
lesion.** Asthma
l Care must be taken of paralysed limbs A condition that affects the airways to
so that they do not get trapped or the lungs. The swimmer may require
trail on abrasive surfaces when lifted prescribed medication prior to or during
or handled. exercise. If an attack occurs during the
session sit the pupil out and call for
appropriate assistance.
6
Swimming stages
Swimmers with a disability require Listed below is a variety of equipment Floats/woggles (opposite)
the same opportunities as their peers that has been found to be useful. l Encourage a horizontal position.
to become familiar with the water Teachers have differing views on
environment and to progress with swimming aids, as do individual l Allow early kicking skills to develop.
swimming skills. Extra time, support swimmers. Aids can be used to obtain l Allow concentration on specific
and skill adaptations may be needed. a safer, streamlined position, they are actions.
not for life saving.
The teaching principles and practises l Can be adapted to suit very small
used are the same for all swimmers hands.
with the techniques adapted to suit Arm bands/arm rings
the individual. The important factor l Develop early confidence and Variety of balls
is that rarely are two people identical
independence.
and the teacher must consider how l Encourage confidence in water.
the individual’s physique, mobility l Buoyancy can be reduced as
and application affects the swimming confidence grows. l Can give different amounts of
technique. buoyancy.
l Lessons become active.
Breathing skills are very important. l They are non restrictive.
People who have difficulties swallowing Egg flips (opposite)
may be at risk and require careful l Encourage breathing through the
observation Buoyancy suits mouth at surface of water.
l All of the above, plus they encourage
a more streamline body position.
First steps Toys (opposite)
The first steps are usually the biggest. l Encourage water confidence
Specialist swimming aids are rarely Head floats (specialist aids in certain (watering cans, squirters).
required - the purpose being to ensure circumstances)
safety in as positive a swimming position
l Can be used for games.
l Help support head above water line,
as possible, taking into consideration but some can restrict streamlining. l Pushing, pulling.
individual preferences.
l Can be used as objects to chase.
Rings
l Short term use for swimmers who Sinking objects, eg bricks, hoops,
learn propulsion in an upright novelties (opposite)
position. l Encourage submerging and opening
the eyes under water.
l Can be used to develop other skills
e.g. colours, counting.
7
Float
Woggle
Egg flip
Sinking objects
8
Practical considerations
Many pools have mechanical assistance to enter/exit the water and these are extremely useful. In some cases,
these can remove the independence of the swimmer. Whenever possible, swivel and forward entries, with or
without support, should be encouraged. Extra steps to lower from wheelchair to poolside may be required to
foster independence.
Entries
Hemiplegia
Single arm amputees
Swimmers with lower or one Learning disabilities
Steps
side of body strength Arthritis
Polio
Legge-Perthes
Paraplegia
Swivel entry Swimmers with good Cerebral palsy diplegia
with or without upper body strength i.e. Learning disabilities
support paraplegia Polio
Legge-Perthes
Amputees
Swimmers with ability to Cerebral Palsy
Diving stand on blocks with/ Learning disabilities
without support Visually impaired
Hearing impaired
9
Advantages Disadvantages Help
Fastest entry for competition Some swimmers may find blocks Some swimmers may require assistance of
awkward to get on to support at hip level to control balance
10
Developing Swimming Skills
The basic principles of swimming are the same for all swimmers. No two swimmers have the same physique, strength,
balance, physical or learning ability. Be prepared to experiment to find out what works best for an individual. Allow
plenty of time for skills to be achieved, practised and developed to maximum ability.
Every swimmer has a unique style regardless of ability. The strokes taught should be as near as possible to the norm.
The following are examples of possible variations that may assist in the initial stages.
body position
legs
11
Condition Positives Negatives
Achondroplasia Comfortable
Down’s Syndrome Easy propulsion Fear may be introduced by over emphasis
Hydrocephalus Help towards safe conventional of early conventional swimming position
Double leg amputees swimming position
Young children
Paraplegia Streamline
Spina bifida Less resistance
Double above knee amputees
12
Difficulty Observation Suggestion
No leg
propulsion but Co-ordination difficulties Use any leg movement for
with minimum No lower body movement/ balance (leg drills should be
control of trunk control or unable to attempted) or drag for less
and legs to hold perform legal leg kick resistance
in one position
ARMS
13
Condition Positives Negatives
Streamline
Cerebral palsy diplegia Less resistance More work for arms
Improving muscle tone and core
stability
Dysmelia
Double arm amputee Swimming Difficulties judging direction
Cerebral palsy quadriplegia
Leg amputees
More effective balance Shorter pull if not accompanied by roll
Cerebral palsy diplegia
14
Difficulty Observation Suggestion
Arms crossing
centre line Discourage pull across centre
Excessive snaking of body
under body in line of body
front crawl
Breathing
Swallowing
and blowing Choking, spluttering,
Coping with Teach on back
coughing
stiffness and
pain
15
Condition Positives Negatives
Paraplegia
Cerebral palsy diplegia Requires considerable effort and breath
Continual forward movement
Quadriplegia timing
Dysmelia
Paraplegia
Cerebral palsy diplegia Restricts stroke once established
More effective stroke
Quadriplegia Can become habit
Athetoid cerebral palsy Easier position to breathe Unable to see what is going on around
Arthritics Less pain Effort to regain standing position
16
Difficulty Observation Suggestion
Timing
Exits
Hemiplegia
Swimmers with lower or one Single arm amputees
Steps
side of body strength Learning disabilities
Arthritis
Paraplegia
Push up to pool Swimmers with good upper Cerebral palsy diplegia
side body strength i.e. paraplegia Leg amputees
Learning disabilities
Paraplegia
Use of poolside Swimmers with good upper Cerebral palsy diplegia
corner to push up body strength i.e. paraplegia Leg amputees
Learning disabilities
17
Condition Positives NEGATIVES
Independence
Rough poolsides Use mat/towel to cover poolside
Common method of entry Help from behind at waist level
18
Additional Considerations
l Use a tapper to notify the swimmer remove them for swimming. pictures and basic signing to reinforce
when nearing the end of pool. verbal instructions.
l Swimmers who wear glasses may l Allowing time for steps to be learned
have severe difficulties once they and repeating often.
remove them. Prescription goggles l Using praise to reinforce small steps -
are available. verbal, thumbs up and smiles work
well.
19
Supporting and Assisting in the Water
Support for head in prone Long arm in prone Support to roll from front to back
In initial stages float can be used, Palm support initially at waist level Assistant supports swimmer with hands
progressing to hand support, then no reducing to minimal support as either side at hip level. The adjacent
extra help. confidence is gained. hand pushes gently whilst the other
hand pulls to perform the rotation.
20
Next Stage
21
Classification
Classification, where the aim is to Minimum eligibility criteria for Functional S(SB,SM) 11-13
“ensure a fair playing field for all classification system (S1-S15) Visually impaired swimmers
swimmers”, is a requirement of many The degree of vision is measured (with
The groups S(SB)(SM) 1-10 are for those
competitions. There are two main the best correction) ranging from blind
swimmers with a functional, visual,
forms of classification: to visually impaired.
learning or hearing impairment.
22
Conclusion
23
Useful Websites
24
Principal Partner Official Partners Official Endorsed and
Suppliers Approved
Products
Harold Fern House Derby Square Loughborough LE11 5AL
Tel: 01509 618700 Fax: 01509 618701
www.britishswimming.org