Without the structured schedule of the school year, summer opens up a world of possibility for travel, adventure and play for children. 

“Summer brings a great opportunity for kids to get outside, spend time in nature and exercise,” said Cesar Ochoa, MD, director of Developmental and Behavioral Pediatrics at Cedars-Sinai Guerin Children’s. “It’s also carefree time to connect with family and friends, on park trails and in the water. We don’t want children on the autism spectrum to miss out on these experiences.”

To create lasting memories, follow your child’s natural curiosities, which may lead them to swimming; children who have autism spectrum disorders (ASD) are more likely to favor the activity than neurotypical children.

Read: Early Diagnosis of Autism and ADHD

Swimming provides a well of physical and mental health benefits for the estimated 1 in 31 children who have ASD, according to the Centers for Disease Control and Prevention. The full-body activity helps support growing bones, muscles, hearts and lungs, as well as mood regulation, motor and social skills. 

“Children with autism often think and experience the world differently, because of how their brain makes sense of its environment,” Ochoa said. “Loud noises, too much touch or bright overhead lights can feel abrasive.” 

Swimming allows for gentle gliding with little resistance, easier for kids with limited mobility, and a refreshing sense of weightlessness, steady pressure and temperature. Swimming is also associated with fewer pediatric injuries.

“Water can be very calming, and the repetition of swimming laps is relaxing,” said Cedars-Sinai sports medicine physician Tracy Zaslow, MD. “It’s also a way for kids on the autism spectrum to interact with peers.” 

If your child or teen is interested in dipping their toe in the water but doesn’t yet know how to swim, doctors encourage a full evaluation first. Then seek out supportive one-on-one lessons from an autism-experienced instructor or school that offers specialized programs for children with autism.

Read: Summer Safety: What You Need to Know for a Safe Swimming Season

While inviting, water can also be dangerous. Drowning is the leading cause of accidental deaths in ASD: Tragically, children who have autism are 160 times more vulnerable than neurotypical children, and many more wind up in emergency departments. 

Steve Roush, executive director of Cedars-Sinai partner Southern California Swimming, urges swim water safety and survival training for all high-risk children. One key skill: learning to float. 

“It’s simple,” Roush explained, “but it involves practice, learning to breathe and relax.” 

Knowing how to “starfish,” or float on your back, can prevent panic when they can’t touch bottom and buy children time to move to a shallower area. 

“Just by learning to swim, kids are getting safer with swimming,” Zaslow said.

A few tips to help the new skills stick: 

• Learn as a family. The American Academy of Pediatrics recommends parent-child swim lessons for young children—especially if a parent isn’t comfortable in the water. That way, you can both build “water-safe” habits together.
• Emphasize the importance of a “buddy system.” Kids should know never to enter standing water alone, Zaslow said, even if it’s a bath or puddle that looks shallow. Instead, have them go in with a competent swimmer, under adult supervision for an extra set of eyes.
• Reinforce critical precautions at home. Ochoa suggests using visual aids such as signs or “social stories,” which share how a child puts themselves in harm’s way and how to avoid that behavior: Kids on the autism spectrum are often more responsive to visual instruction than verbal.
• Train in CPR. Be prepared for an emergency by learning resuscitation, as well as basic water rescue—especially if you live or vacation in a house with a pool, or on a lake or beach. Many hospitals and organizations, such as the American Red Cross, offer CPR certification.
• Secure your surroundings. Autism can lead some kids to seek out more intense sensory stimulation. All pools should have physical barriers including covers, gates, door locks and alarms.

“The more layers that can be present, the more we can prevent drowning,” Zaslow cautioned.

Read: Know the Signs of Water Distress

Ease your child into swimming and other new experiences, Ochoa recommended, rather than diving in all at once, and explain changes ahead of time.

For summer camps, programs or swim lessons, always disclose how your child’s autism shows up, especially challenges involving:

• Learning 
• Communication
• Attention
• Anxiety 
• Shyness 
• Sensory processing
• Wandering—a major risk factor for drowning and falls in kids on the spectrum

Be mindful that children with ASD are more vulnerable to stress, heat and sunlight, and they might struggle to notice or communicate signs of heat exhaustion and dehydration. Stay indoors during peak hours of sunshine (between 10 a.m. and 2 p.m.), and take consistent breaks every hour or two to rest, refuel and apply sunscreen. Clothes and sunblock should offer strong sun protection, while remaining soft and lightweight. 

Children on the autism spectrum can still enjoy the freedom and magic of the water—splashing, paddling and floating—in a safe, supported way.