THE ADAPTED SWIMMING AND EMOTIONAL ADJUSTMENT SCALE (A-SEAS) FOR CHILDREN WITH INTELLECTUAL DISABILITY (ID) AND AUTISM SPECTRUM DISORDERS (ASD)

Dimitrios Kokaridas, Christina Tsolaki, Charalampos Krommidas

Abstract


Water assessment so far included the development of aquatic tests based mainly on the Halliwick concept, whereas content comparison of these tests used in relevant studies showed that most researches primarily focused on children with cerebral palsy and other neurological disorders. The purpose of this study was to develop a new aquatic test named Adapted Swimming and Emotional Adjustment Scale (A-SEAS) assess its reliability and validity for children with intellectual disability (ID) and autism spectrum disorders (ASD) and adapt and culturally validate the new instrument from the Greek to the English language for wider international use. A-SEAS consists of fourteen (14) items designed to assess aquatic skills and emotional adjustment of children aged 6 years and older with ASD and ID. The internal reliability and validity of A-SEAS were examined via the observational ratings provided by three adapted swimming instructors. Face validity was assessed by two experts, and inter-rater reliability study was conducted with three raters. Kappa Cohen’s was used to confirm A-SEAS reliability. Findings suggest that A-SEAS is a reliable and valid tool for assessing measured values. ICC values (ICC = .966 to 1) highlight its excellent internal consistency and inter-rater reliability. Cohen’s kappa results ranging from (κ = .77 to 1) underscore its reliability, with high to flawless agreement observed across raters. High face validity confirmed by expert evaluations ensures that A-SEAS is comprehensible, relevant, and effectively aligned with its intended constructs, an overall suitable and reliable tool for future research and practice.

 

Article visualizations:

Hit counter


Keywords


adapted swimming, A-SEAS, swimming skills, emotional adjustment, ID, ASD

Full Text:

PDF

References


Aithal, A., & Aithal, P. S. (2020). Development and validation of survey questionnaire & experimental data–a systematical review-based statistical approach. International Journal of Management, Technology, and Social Sciences (IJMTS), 5(2), 233-251. http://dx.doi.org/10.2139/ssrn.3724105

Alaniz, M. L., Rosenberg, S. S., Beard, N. R., & Rosario, E. R. (2017). The effectiveness of aquatic group therapy for improving water safety and social interactions in children with autism spectrum disorder: A pilot program. Journal of Autism and Developmental Disorders, 47(12), 4006-4017. https://doi.org/10.1007/s10803-017-3264-4

Association of Swimming Therapy. (1992). Swimming for People with Disabilities. London: A. and C. Black.

Bakar, R. A., Bakar, J. A., & Khan, T. K. A. (2023). Aquatic therapy intervention for improving psychomotor skills in children with autism spectrum disorder. Gading Journal for Social Sciences (e-ISSN 2600-7568), 26(02), 15-25.

Battaglia, G., Agrò, G., Cataldo, P., Palma, A., & Alesi, M. (2019). Influence of a specific aquatic program on social and gross motor skills in adolescents with autism spectrum disorders: Three case reports. Journal of Functional Morphology and Kinesiology, 4(2), 27. https://doi.org/10.3390/jfmk4020027

Boateng, G. O., Neilands, T. B., Frongillo, E. A., Melgar-Quiñonez, H. R., & Young, S. L. (2018). Best practices for developing and validating scales for health, social, and behavioral research: A primer. Frontiers in Public Health, 6, 149. https://doi.org/10.3389/fpubh.2018.00149

Borland, R. L., Cameron, L. A., Tonge, B. J., & Gray, K. M. (2022). Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well‐being in children and adolescents with intellectual disability: A systematic review. Journal of Applied Research in Intellectual Disabilities, 35(2), 399-420. https://doi.org/10.1111/jar.12961

Bornstein, R. F. (2004). Face validity. In M. S. Lewis-Beck, A. Bryman, & T. Futing Liao (Eds.), The SAGE encyclopedia of social science research methods (pp. 367-368). Thousand Oaks, CA: Sage Publications, Inc. Retrieved from https://methods.sagepub.com/ency/edvol/the-sage-encyclopedia-of-social-science-research-methods/toc

Bouzas, S., Martinez-Lemos, I., & Ayan, C. (2019). Effects of exercise on the physical fitness level of adults with intellectual disability: a systematic review. Disability and Rehabilitation, 41, 3118-3140. https://doi.org/10.1080/09638288.2018.1491646

Brody, L. T., & Geigle, P. R. (Eds.). (2009). Aquatic exercise for rehabilitation and training. Champaign, ILL: Human Kinetics. Retrieved from https://books.google.ro/books/about/Aquatic_Exercise_for_Rehabilitation_and.html?id=6K8Zj6TR_24C&redir_esc=y

Casey Ph D, A., Blok, J., Vaughan, K., & O'Dwyer, W. (2020). Parental perceptions of water safety among children with autism spectrum disorders. International Journal of Aquatic Research and Education, 12(4), 5. https://doi.org/10.25035/ijare.12.04.05

Calderón-Porras, S. E., Mancilla-Ramírez, A., & Rolón-Lacarriere, O. G. (2012). Efficacy of the aquatic program with hydrokinesitherapy and Halliwick techniques in children with meningomyelocele with functional level L3 or lower. Revista Mexicana de Neurociencia, 13(2), 86-92. Retrieved from https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=44828

Chacham, A., & Hutzler, Y. (2002). Reliability and validity of the aquatic adjustment test for children with disabilities. Movement, 6, 160-189.

Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37-46. https://doi.org/10.1177/001316446002000104

Colombo-Dougovito, A. M., & Block, M. E. (2019). Fundamental motor skill interventions for children and adolescents on the autism spectrum: A literature review. Review Journal of Autism and Developmental Disorders, 6, 159-171. https://doi.org/10.1007/s40489-019-00161-2

Conatser, P., Balkin, R., & White, S. (2009). Conatser Adapted Aquatics Swimming Screening Test (CAASST). U.S. Swim School Association. Retrieved from http://www.adaptedaquatics.org/assesment.htm

Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7(2), 189-195. https://doi.org/10.1038/nn1176

Declerck, M., Verheul, M., Daly, D., & Sanders, R. (2016). Benefits and enjoyment of a swimming intervention for Youth with Cerebral Palsy: an RCT Study. Pediatric Physical Therapy, 28(2), 162-169. https://doi.org/10.1097/PEP.0000000000000235

Fazlioglu, Y., & Gunsen, M. O. (2011). Sensory motor development in autism. A Comprehensive Book on Autism Spectrum Disorders, 345. http://dx.doi.org/10.5937/specedreh1201051J

Fernandes, J. M., de Milander, M., & van der Merwe, E. (2024). Motor proficiency of learners with moderate to severe intellectual disabilities. African Journal of Disability, 13, 1262. https://doi.org/10.4102/ajod.v13i0.1262

Floyd, J. & Fowler, Jr. (2013). Survey research methods. Washington, DC: Sage publications, Inc. Retrieved from https://uk.sagepub.com/en-gb/eur/survey-research-methods/book239405

Güeita-Rodríguez, J., Florencio, L. L., Arias-Buría, J. L., Lambeck, J., Fernández-de-Las-Peñas, C., & Palacios-Ceña, D. (2019). Content comparison of aquatic therapy outcome measures for children with neuromuscular and neurodevelopmental disorders using the international classification of functioning, disability, and health. International Journal of Environmental Research and Public Health, 16(21), 4263. https://doi.org/10.3390/ijerph16214263

Hakim, R., Ross, M., Runco, W., & Kane, M. (2017). A community-bases aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability. Journal of Exercise Rehabilitation, 13(1), 89. https://doi.org/10.12965/jer.1732838.419

Holden, R. R. (2010). Face validity. Encyclopedia of Research Design, 544-546. Washington, DC: Sage Publications, Inc.

Houwen, S., Visser, L., van der Putten, A., & Vlaskamp, C. (2016). The interrelationships between motor, cognitive, and language development in children with and without intellectual and developmental disabilities. Research in Developmental Disabilities, 53, 19-31. https://doi.org/10.1016/j.ridd.2016.01.012

Huggins, C. F., Cameron, I. M., & Williams, J. H. (2019). Different aspects of emotional awareness in relation to motor cognition and autism traits. Frontiers in Psychology, 10, 2439. https://doi.org/10.3389/fpsyg.2019.02439

Humphries, K. M. (2008). “Humphries’ Assessment of Aquatic Readiness”, unpublished Master’s thesis. Texas Women’s University, Denton, TX. Retrieved from https://www.yumpu.com/en/document/view/27404421/humphries-assessment-of-aquatic-readiness-haar-a-

Jalaludin, M. Y., Fuziah, M. Z., Hadhrami, M. Z., Hong, J. Y. H., Mohamad-Adam, B., & Jamaiyah, H. (2013). Reliability and validity of the Malay translated version of diabetes quality of life for youth questionnaire. Malaysian Family Physician, 8(1), 12-19. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25606262/

Jorgic, B., Dimitrijevic, L., Aleksandrovic, M., Okicic, T., Madic, D., & Radovanovic, D. (2012). The swimming program effects on the gross motor function, mental adjustment to the aquatic environment, and swimming skills in children with cerebral palsy: A pilot study. Specijalna Edukacija i Rehabilitacija, 11(1), 51-66. DOI: 10.5937/specedreh1201051J

Kapsal, N. J., Dicke, T., Morin, A. J. S., Vasconcellos, D., Maïano, C., Lee, J. and Lonsdale, C. 2019. Effects of physical activity on the physical and psychosocial health of youth with intellectual disabilities: a systematic review and meta-analysis. Journal of Physical Activity and Health, 16, 1187-1195. https://doi.org/10.1123/jpah.2018-0675

Kerr, M. P., Watkins, L. V., Angus-Leppan, H., Corp, A., Goodwin, M., Hanson, C., ... & of the International, T. B. B. (2018). The provision of care to adults with an intellectual disability in the UK. A special report from the intellectual disability UK chapter ILAE. Seizure, 56, 41-46. https://doi.org/10.1016/j.seizure.2018.01.026

Kokaridas, D., & Lambeck, J. (2015). The Halliwick concept: Toward a collaborative aquatic approach. Inquiries in Physical Education and Sport, 13(2), 65-76. https://doi.org/10.26253/heal.uth.ojs.ispe.2015.1456

Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155-163. https://doi.org/10.1016/j.jcm.2016.02.012

Lambeck, J., & Gamper, U. (2009). The Halliwick Concept. In L. T. Brody, & P. R. Geigle (Eds.), Aquatic exercise for rehabilitation and training (pp. 45-72). Champaign, IL: Human Kinetics. Retrieved from https://books.google.ro/books/about/Aquatic_Exercise_for_Rehabilitation_and.html?id=6K8Zj6TR_24C&redir_esc=y

Landis, J. R., & Koch, G. G. (1977). An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics, 363-374. https://doi.org/10.2307/2529786

Lee, J., & Poreta, D. L. (2013). Enhancing motor skills of children with autism spectrum disorder: A pool- based approach. Journal of Physical Education, Recreation and Dance, 84(1), 41-45. https://doi.org/10.1080/07303084.2013.746154

Lepore, M., Gayle, G., & Stevens, S. (2007). Adapted aquatics programming: A professional guide (2nd ed.). Champaign, IL: Human Kinetics. Retrieved from https://www.researchgate.net/publication/281620657_Adapted_Aquatics_Programming_A_Professional_Guide

Li, Q., Wang, Q., Xin, Z., & Gu, H. (2022). The impact of gross motor skills on the development of emotion understanding in children aged 3-6 years: The mediation role of executive functions. International Journal of Environmental Research and Public Health, 19(22), 14807. https://doi.org/10.3390/ijerph192214807

Martin, C., & Dillenburger, K. (2019). Behavioural water safety and autism: a systematic review of interventions. Review Journal of Autism and Developmental Disorders, 6(4), 356-366. https://doi.org/10.1007/s40489-019-00166-x

McHugh, M. L. (2012). Interrater Reliability: The Kappa Statistic. Biochemia Medica, 22(3), 276-282. https://doi.org/10.11613/BM.2012.031

Milligan, H., Glanzman, A., Waasdorp, I., Kinslow, T., Hagenbaugh, M., Pipan, M., Harrington, A.& Palombaro, K. (2022). The benefits of group aquatic therapy for young children with Down syndrome. The Journal of Aquatic Physical Therapy, 30(1), 12-21. https://doi.org/10.1097/pxt.0000000000000011

Murphy, K. L., & Hennebach, K. R. (2020). A systematic review of swimming programs for individuals with autism spectrum disorders. Journal of Disability Studies, 6(1), 26-32. http://pubs.iscience.in/jds

Neto, J. L. C., Silva, É. A., & Guedes, M. S. (2023). Analysis of motor learning task in children with intellectual disability. Retos: nuevas tendencias en educación física, deporte y recreación, (49), 807-812. https://doi.org/10.47197/retos.v49.98355

Odeh, C. E., Gladfelter, A. L., Stoesser, C., & Roth, S. (2022). Comprehensive motor skills assessment in children with autism spectrum disorder yields global deficits. International Journal of Developmental Disabilities, 68(3), 290-300. https://doi.org/10.1080/20473869.2020.1764241

Ohara, R., Kanejima, Y., Kitamura, M., & Izawa, K P. (2019). Association between social skills and motor skills in individuals with autism spectrum disorder: a systematic review. European Journal of Investigation in Health, Psychology and Education, 10(1), 276-296. https://doi.org/10.3390/ejihpe10010022

Oluwatayo, J. A. (2012). Validity and reliability issues in educational research. Journal of Educational and Social Research, 2(2), 391–400. Retrieved from https://www.richtmann.org/journal/index.php/jesr/article/view/11851

Omar, K., Bujang, M. A., Daud, M., Iryani, T., Abd Rahman, F. N., Loh, S. Haniff F., Kamarudin R. Ismail F., & Tan, S. M. (2011). Validation of the Malay Version of Adolescent Coping Scale. International Medical Journal, 18(4) 288-292.

Pan, C. Y. (2010). Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders. Autism, 14(1), 9-28. https://doi.org/10.1177/1362361309339496

Pan, C.Y. (2011). The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders, Research in Autism Spectrum Disorders, 5, 657-665. https://doi.org/10.1016/j.rasd.2010.08.001

Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Gross motor function classification system for cerebral palsy. Developmental Medicine & Child Neurology, 39(4), 214-23. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x

Palisano, R. J., Cameron, D., Rosenbaum, P. L., Walter, S. D., & Russell, D. (2006). Stability of the gross motor function classification system. Developmental Medicine & Child Neurology, 48(6), 424-428. https://doi.org/10.1017/S0012162206000934

Peacock, K. (1993) Swimming with Independent Measurement: Manual for Evaluation. Halliwick London: Association of Swimming Therapy.

Portney, L. G., & Watkins, M. P. (2009). Foundations of clinical research: applications to practice (Vol. 892, pp. 11-15). Upper Saddle River, NJ: Pearson/Prentice Hall. https://doi.org/10.1016/S0039-6257(02)00362-4

Ruggeri, A., Dancel, A., Johnson, R., & Sargent, B. (2020). The effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder: A systematic review. Autism, 24(3), 544-568. https://doi.org/10.1177/1362361319885215

Salse-Batán, J., Suárez-Iglesias, D., Sanchez-Lastra, M. A., & Ayan Perez, C. (2023). Aquatic exercise for people with intellectual disabilities: findings from a systematic review. International Journal of Developmental Disabilities, 69(2), 134-146. https://doi.org/10.1080/20473869.2021.1924033

Sangoseni, O., Hellman, M., & Hill, C. (2013). Development and validation of a questionnaire to assess the effect of online learning on behaviors, attitudes, and clinical practices of physical therapists in the United States regarding evidenced-based clinical practice. Internet Journal of Allied Health Sciences and Practice, 11(2), Article 7. http://dx.doi.org/10.46743/1540-580X/2013.1439

Schoen, S. A., Ferrari, V., & Spielmann, V. (2021). A trampoline exercise group: Feasibility, implementation, and outcomes. The American Journal of Occupational Therapy, 75(S2), 7512520395p1-7512520395p1. https://doi.org/10.5014/ajot.2021.75S2-RP395

Shams-Elden, M. (2017). Effect of aquatic exercises approach (Halliwick-therapy) on motor skills for children with autism spectrum disorders. Science, Movement and Health, 17(2), 490–496. Retrieved from https://www.analefefs.ro/en/anale-fefs/2017/i2s/pe-autori/SHAMS-ELDEN%20Mohamed%201.pdf

Sršen, K. G., Vidmar, G., Pikl, M., Vrecar, I., Burja, C., & Krušec, K. (2012). Content validity and inter-rater reliability of the Halliwick-concept-based instrument “Swimming with Independent Measure”. International Journal of Rehabilitation Research, 35(2), 116-123. https://doi.org/10.1097/MRR.0b013e32835277ab

Smith, N., Tessier, D., Tzioumakis, Y., Quested, E., Appleton, P., Sarrazin, P., Papaioannou, A., & Duda, J. L. (2015). Development and validation of the multidimensional motivational climate observation system. Journal of Sport & Exercise Psychology, 37(1), 4-22. https://doi.org/10.1123/jsep.2014-0059

Stan, A. E. (2012). The benefits of participation in aquatic activities for people with disabilities. Sports Medicine Journal/Medicina Sportivâ, 8(1), 1737 – 1742. Retrieved from https://medicinasportiva.ro/SRoMS/RMS/29/benefits_aquatic_activities_people_disabilities.pdf

Tan, S. M., Loh, S. F., Bujnag, M. A., Haniff, J., Rahman, A., Nazri, F., Ismail, F., Omar, K., Daud, M., & Irvani, T. (2013). Validation of the Malay Version of Children's Depression Inventory. International Medical Journal, 20(2), 188-191.

Tirosh, R., Katz-Leurer, M., & Getz, M. D. (2008). Halliwick-based aquatic assessments: reliability and validity. International Journal of Aquatic Research and Education, 2(3), 224 - 236. http://dx.doi.org/10.25035/ijare.02.03.04

Van den Berghe, L., Soenens, B., Vansteenkiste, M., Aelterman, N., Cardon, G., Tallir, I. B., & Haerens, L. (2013). Observed need-supportive and need-thwarting teaching behavior in physical education: Do teachers' motivational orientations matter? Psychology of Sport and Exercise, 14(5), 650-661. http://dx.doi.org/10.1016/j.psychsport.2013.04.006

Vanluyten, K., & Iserbyt, P. (2024). A water-based intervention for a young child with an acquired brain injury: A case study. Palaestra, 38(2), 38 - 42. Retrieved from https://js.sagamorepub.com/index.php/palaestra/article/view/12616

Vodakova, E., Chatziioannou, D., Jesina, O., & Kudlacek, M. (2022). The effect of Halliwick method on aquatic skills of children with autism spectrum disorder. International Journal of Environmental Research and Public Health, 19(23), 16250. https://doi.org/10.3390/ijerph192316250

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health, 8(2), 94-104. https://doi.org/10.1111/j.1524-4733.2005.04054.x

World Health Organization (WHO). (2001). International Classification of Functioning, Disability, and Health: ICF-CY. World Health Organization. Retrieved from https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

Yoder, P. J., & Symons, F. J. (2010). Observational Measurement of Behavior. New York, NY: Springer Publishing Company. Retrieved from https://brookespublishing.com/wp-content/uploads/2021/01/Yoder-2e_excerpt.pdf?srsltid=AfmBOopyp4F4ULEDOvjyebyJMtwac-E8jscMkydfvcptN73g41spXLGo

Yunus, A., Seet, W., Mohamad Adam, B., & Haniff, J. (2013). Validation of the Malay version of Berlin questionnaire to identify Malaysian patients for obstructive sleep apnea. Malaysian Family Physician, 8(1), 5-11. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4170461/




DOI: http://dx.doi.org/10.46827/ejpe.v12i6.6037

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Dimitrios Kokaridas, Christina Tsolaki, Charalampos Krommidas

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2015 - 2026. European Journal of Physical Education and Sport Science (ISSN 2501 - 1235) is a registered trademark of Open Access Publishing Group. All rights reserved.

This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library (Biblioteca Nationala a Romaniei). All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All authors who send their manuscripts to this journal and whose articles are published on this journal retain full copyright of their articles. All the research works published on this journal are meeting the Open Access Publishing requirements and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License (CC BY 4.0).