What a child in the water taught me

"Names and identifying details have been changed. Descriptions are composited across multiple children to protect privacy. I am not a clinician, and nothing here should be read as medical advice."

'Want to make a difference — Volunteer as a swim instructor with the adaptive swim program!'

I stopped to read the flyer as I was walking out finishing my volunteering shift at a nearby hospital. I was a club and varsity swimmer for several years with an evolving interest in neuroscience, and this post had my name written all over it. I applied and was selected as a swim instructor for neurodivergent children.

I showed up for my orientation session and was greeted by a pool unlike anything I had seen before. Integrated skylights flooded the pool area with daylight, and vibrant tiles created a kaleidoscope of color. It felt more like a Caribbean holiday resort than a hospital. I knew the pool was designed to create a playful, inviting space for children, but there had to be more to this. As I researched this area, I learned more about the impact of multi-sensory input on cortical regulation. Multiple simultaneous sensory inputs — visual, auditory, tactile, thermal, olfactory — each engage a different sensory cortex. For neurodivergent brains with sensory-seeking profiles, this coherent multi-sensory input organizes one's attention rather than overwhelming it. The pool environment was designed this way clinically, not decoratively.

Water uniquely provides three regulating inputs at once — proprioceptive pressure (heavy water hug), thermal input (soothing pool warmth), and vestibular shift (balance changes). Neurodivergent children are often drawn to it instinctively because their brains are seeking exactly this input. The pull is neurological, not preferential. A child knows what their brain needs before anyone tells them. One of the children I worked with in the first few weeks — I will call him J (name changed for privacy) — walked towards the water and touched the surface with his fingers before entering it. This common reaction was due to our body's sympathetic response system — the amygdala firing up, triggering a cortisol spike as the brain checked whether the new environment was safe. Amongst neurodivergent children, this assessment takes a little longer as the sensory information must be processed, and as an instructor, I had to resist the urge to rush through this, as I would have interrupted the very process that allows regulation to begin.

As we continued the sessions, I was grateful to witness the progress the children were making over time. I had slowly earned their trust. Each activity was customized with each one's abilities in mind, and each session had to be paced differently based on how the kids responded on a particular day. Over time, the pool became familiar, and soon many of them no longer needed the long pause before entering. They were able to follow instructions without a lot of assistance, and some of them rewarded me with a smile — a smile that reflected their joy of being in the pool.

All of this left me wondering: if the same environment impacts different brains differently, what determines the difference?

Disclaimer: This essay reflects my personal observations and interpretation as a volunteer, informed by my ongoing study of neuroscience. It is not affiliated with, endorsed by, or reviewed by any hospital, healthcare provider, or professional body. Any child or family described has been anonymised and composited. Readers seeking medical guidance about a specific child should consult a qualified healthcare professional.

Sources: 

Mortimer, R., Privopoulos, M., & Kumar, S. (2014). The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: a systematic review. Journal of Multidisciplinary Healthcare, 7, 93–104.

Roelofs, K. (2017). Freeze for action: neurobiological mechanisms in animal and human freezing. Philosophical Transactions of the Royal Society B, 372(1718), 20160206.

Harvard Center on the Developing Child. InBrief: The Science of Neglect and Stress Response. YouTube. Available at: youtube.com/@HarvardCenter

Sapolsky, R. (2011). Human Behavioral Biology. Stanford University Lecture Series. YouTube.