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Journal of Physical Education, Recreation & Dance

ISSN: 0730-3084 (Print) 2168-3816 (Online) Journal homepage: http://www.tandfonline.com/loi/ujrd20

The Ocean as a Unique Therapeutic Environment:

Developing a Surfing Program

Emily D. Clapham, Cortney N. Armitano, Linda S. Lamont & Jennifer G.


To cite this article: Emily D. Clapham, Cortney N. Armitano, Linda S. Lamont & Jennifer
G. Audette (2014) The Ocean as a Unique Therapeutic Environment: Developing a
Surfing Program, Journal of Physical Education, Recreation & Dance, 85:4, 8-14, DOI:

To link to this article: http://dx.doi.org/10.1080/07303084.2014.884424

Published online: 27 Mar 2014.

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as a
Unique Therapeutic
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Developing a Surfing Program
Emily D. Clapham
Cortney N. Armitano
Linda S. Lamont
Jennifer G. Audette

A ccording to the World Health Organization Prevention [CDC], 2011). Since individuals with developmental
(2010), children with disabilities have the same activity disorders tend to have lower fitness and activity levels, they also
requirements as children without disabilities. The lack of have decreased cardiorespiratory endurance, muscle strength, bal-
fitness and recreation opportunities for children with dis- ance, coordination, and motor skills (Fragala-Pinkham, Haley, &
abilities is problematic and can be consequential for proper health ONeil, 2008). Children with autism also demonstrate a higher
and development. All children need to accumulate 60 minutes or rate of obesity and motor deficits than their able-bodied peers
more of moderate-to-vigorous intensity activity throughout the day do (CDC, 2011). Furthermore, children with autism demonstrate
(World Health Organization, 2012). The participation of children hypotonia (decreased muscle tone) and motor apraxia (difficulty
with disabilities in sports and recreational activities promotes inclu- or inability to make certain motor movements; see Ming, Brima-
sion, minimizes deconditioning, optimizes physical functioning, and combe, & Wagner, 2007). As with children with autism, children
enhances overall well-being (Murphy, Carbone, & Council on Chil- with Down syndrome have higher rates of obesity and decreased
dren With Disabilities, 2008). Despite these benefits, children with fitness and physical activity levels. Many exercise programs, in-
disabilities are more restricted in their participation, have lower lev- cluding aquatic and land-based aerobics, have been proposed and
els of fitness, and have higher levels of obesity than their able-bodied studied for their ability to increase the fitness level of children with
peers (Murphy, Carbone, & Council on Children With Disabilities, developmental disabilities.
2008; Okagaki, Diamond, Kontos, & Hestenes, 1998). Children
with learning disabilities are also often alienated or excluded by
typically developing children for both social and physical reasons. Emily D. Clapham (eclapham@uri.edu) is an assistant professor, Cortney
Developmental disabilities affect about 13% of all children, N. Armitano is a graduate assistant, Linda S. Lamont is a professor, and
and an average of 1 in 110 children in the United States has an Jennifer G. Audette is an assistant professor at the University of Rhode
Island in Kingston, RI.
autism spectrum disorder (ASD; Centers for Disease Control and

8 Volume 85Number 4April 2014

Adapted aquatics offers necessary physical activity and educa- during, and after the implementation of the surf program. Chil-
tional programming to children with disabilities, and the benefits dren were recruited from local adapted physical education (APE)
for these students are more pronounced and significant than for classes, the Rhode Island Special Olympics, and through flyers and
their peers without disabilities (Koury, 1996). Due to waters buoy- word-of-mouth advertising. Seventeen children participated, rang-
ancy, many children with disabilities who would typically show ing in age from five to 17 years old. The University of Rhode Is-
impaired mobility on land are able to function independently in lands Institutional Review Board (IRB) granted approval for the
an aquatic environment, without the assistance of mobility devices research and program, which ensured the safety and protection of
such as braces, crutches, or walkers. It should be emphasized that the participants. Parents and guardians were required to sign forms of
swimming also strengthens the muscles that allow for postural stabil- consent from the program leaders outlining the risks of participating
ity during both locomotor and object-control activities. Water sup- in the surf program. Participants were also required to sign a similar
ports the body, enabling some to walk for the first time, which can in- form of assent. Prior to starting the program, all parents and guard-
crease strength in the muscle groups needed for ambulating on land. ians were questioned regarding their childs swim ability and comfort
Adapted aquatics also enhances breath control, upper-body strength, level in the ocean. Children who were not viewed as good swimmers
flexibility, and cardiorespiratory fitness (Koury, 1996; Yilmaz, Ya- or comfortable in the ocean were not recommended for participation
nardag, Birkan, & Bumin, 2004). in the surf program.
However, the benefits of aquatics are not limited to the physical Prior to the start of the program, a parent or guardian reported dis-
domain. Carefully planned water activities that are implemented to ability information for each child. Based on this information, the pro-
meet a childs individual needs can contribute to psychosocial and gram leaders recruited trained volunteers to work one-on-one with
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cognitive development as well. Research with children with autism each enrolled child. The volunteers were undergraduate and graduate
has demonstrated a decrease in stereotypical movements such as students in kinesiology and physical therapy, as well as other members
spinning, swinging, and delayed echolalia as a result of water ac- of the local university and surfing community. The program leaders in
tivities (Yilmaz, Yanardag, Birkan, & Bumin, 2004). Importantly, as the departments of kinesiology and physical therapy advertised the
children with physical disabilities learn to move through the water adapted surf program to students enrolled in their courses and re-
unassisted, their self-esteem and self-awareness improve. This free- quested assistance from their students. Students were also offered
dom of movement boosts morale and provides an incentive to maxi- independent-study credits and APE practicum hours for volunteer-
mize potential in other aspects of their rehabilitation (Koury, 1996). ing. Several volunteers were recruited from the local surf com-
The motivational and therapeu- munity. These volunteers
tic properties of water provide a
stimulating learning environment Carefully planned water activities willingly donated their time
without compensation. All
for children with disabilities. volunteers were welcomed
Similar benefits could poten- that are implemented to meet and accepted by the pro-
tially be derived from surfing in gram leaders.
the ocean. There are several surf
programs offered to people with
a childs individual needs can The program leaders
formally trained the vol-
disabilities around the world (e.g.,
Surfers Healing, Ride-a-Wave,
contribute to psychosocial and unteers by reviewing the
program goals and skills,
and the Disabled Surfers Asso-
ciation in Australia), and they are cognitive development. as well as presenting cue
words and progressions of
quickly gaining popularity. Chil- the skills. In addition, dis-
dren with autism and other dis- ability information about
abilities often become overwhelmed by sensory stimuli, suffer from each child was privately shared with the childs volunteer instruc-
severe social isolation, and lack communication skills (Delaney & tor. The volunteer instructors were encouraged to find each childs
Madigan, 2009). The sport of surfing, like running, is solitary, re- optimal learning style and offer an appropriate level of support that
petitive, and requires determination and stamina, which are traits promoted full participation in ocean surfing. Some children needed
that most children with autism possess (Delaney & Madigan, 2009). to participate in surfing hand-over-hand with their instructor, while
Furthermore, surfing provides the opportunity for independent par- others participated nearly independently. The level of support was
ticipation without complicated rules or close contact with others, determined by the recommendations provided by the parents and
which can help children with disabilities to overcome social barriers caregivers, and observations made by program leaders and volunteer
(Delaney & Madigan, 2009). Due to the properties of the ocean and instructors. The volunteers were also encouraged to use aids such
the nature of the sport, surfing could be a therapeutically beneficial as communication boards, pictures, and sign language to communi-
option for children with disabilities. cate with their assigned child. A formal safety orientation was pre-
sented by an experienced surfer from the local surfing community.
She highlighted safety precautions including how to prevent getting
The Adapted Surf Program hit with the surfboard, avoiding riptides in the ocean, and keeping
A twice-weekly, eight-week surf instruction program was imple- children and instructors together at all times while in the ocean.
mented for children with disabilities at a public beach in Rhode The local community was supportive of this program and pro-
Island. The surfing program was designed to develop and enhance vided beach access, and three lifeguards were hired to patrol the
the childrens strength, flexibility, range of motion, coordination, beach for additional water safety. Surf equipment was rented from
balance, and psychosocial development. The Brockport Physical a local surf shop, and various sizes of surfboards were delivered to
Fitness Test (Winnick & Short, 1999), heart rate monitors, and the beach each day. Because of the varied sizes of the participants
activity monitors were used to measure physical changes before, and program volunteers and the need to wash each wetsuit after

shallow water with the child practicing balance
in a stationary position while the surf instruc-
tor stabilized the board as necessary. Once the
child was able to perform a seated balance on the
board, they practiced lying on the board. Next
they were encouraged to ride a wave onto the
beach while on their stomach and to progress to
riding a wave while kneeling on the board. Once
kneeling was mastered, the child was encouraged
to attempt standing up on the board and riding
onto the beach. Each child progressed through
these stages at their own individual pace over the
course of the eight-week program.
Throughout the program, the children and
surf instructors were encouraged to set realistic
individual goals. For instance, two children in the
program were able to ride waves in the standing
position by the end of the program. Another was
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able to ride waves tandem with his surf instruc-

tor by hugging his instructors waist. Yet another
child was able to ride waves on her stomach.
Some children in the program focused solely on
balancing and paddling on their surfboard with
their instructors help. Last, one child preferred
to ride the waves with his body instead of using a

Annie Babineau
surfboard. All forms of surfing were encouraged
and accepted by the program leaders and surf
instructors. Further, the program leaders, surf
instructors, and parents noted dramatic physical
and social improvements in all children, regard-
Figure 1.
less of the skill level that was finally achieved.
Getting assistance with putting on the wetsuit Some of these improvements included increased
verbalization, excitement and enthusiasm about
physical activity, motivation, improvements in
surfing skills, and love of the ocean.
class, the suits were loaned to each for the entirety of the program.
The volunteers assisted the chil-
dren with putting their wetsuits Final Thoughts
on (Figure 1).
All forms of surfing were Overall many positive outcomes
resulted from this instructional
Instructional Goals of encouraged and accepted by surf program. The program lead-
ers observed that the children
the Adapted
Surf Program the program leaders and surf seemed more self-confident, made
gains in social development by in-
The instructional goals of the
adapted surf program were to instructors. teracting with the volunteers and
other participants, and appeared
teach the children to (1) paddle to be more relaxed in the water.
while on the surfboard; (2) bal- The student volunteers who par-
ance on the surfboard on their stomach and in a seated, kneeling, ticipated in the experiential-learning environment outside of the
and standing position; (3) learn to catch a wave and ride it onto classroom learned new skills that they will be able to apply in
shore on their stomach and progress to riding while sitting, kneel- their future professions, including strategies for working with a
ing, and standing; and (4) paddle back out through the waves to child with a disability.
repeat the process. Furthermore, several outcomes of the program carried over
First, the goals were reviewed and demonstrated using a large- into other areas of the participants lives. After the completion
group instructional method. Then, with their assigned volunteer of the program, eight of the 17 children went on to compete in
instructor, all of the children practiced paddling, balancing, and the Rhode Island Special Olympics State Games. They competed
moving into a sitting, kneeling, and standing position on their surf- in several swimming and track and field events. Three of the 17
board while on the beach (before attempting it in the ocean). Table children participated in Unified Sports through Special Olympics
1 provides a description of how each skill was explained. and other inclusive sports offered at their schools. Participation
After each skill was practiced and mastered on the beach, the in the surf program helped participants to acquire the self-confi-
children and instructors entered the water in pairs. They began in dence, social skills, and physical fitness necessary to increase their

10 Volume 85Number 4April 2014

Table 1.
Explanation of Surf Skills
Surf Skill Cues From the Instructor Modifications
Paddling 1. Lay prone in the center of the 1. The child and instructor can paddle
(see Figure 2) surfboard. together on the board in an I
2. Balance in a comfortable position prone formation.
in the center of the surfboard. 2. The instructor can hold the child on
3. Alternate reaching and pulling the sand the board while the child paddles.
or water with your right and left arm, 3. The child can use a Boogie Board
using an overhead motion. instead of a surfboard.
4. The child can use a paddleboard
instead of a surfboard.

Balancing 1. Center yourself on your board in a 1. The child and instructor can balance
(see Figures 3 and 4) sitting or lying position. together on the board.
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2. Move your legs in a circular motion. 2. The instructor can hold the child on
This will give you more stability on the the board while the child attempts to
surfboard. balance independently.
3. Once you are comfortable in a seated
position you can try a lying position.
4. Lie down in the center of your board in
a prone position.

Moving Into a Sitting Position Once you catch a wave with your 1. The child and instructor can ride
(Figures 5 and 6) surfboard, try moving from a lying position the waves together in the seated
This is attempted once the child has on the board to a seated position on the position.
progressed to successfully catching board. 2. The instructor can push the child
waves in the prone position with their into the wave to help the child catch
surfboard. the wave with the surfboard.
3. The child can bodysurf the wave
without a surfboard or use a Boogie

Moving Into a Kneeling Position Once you catch a wave with your 1. The child can catch and ride the
(Figure 7) surfboard in the lying position, kneel on wave tandem in the kneeling
This is attempted once the child has the board and ride the wave onto shore. position with the help of the
progressed to successfully catching instructor.
waves in the prone position with their 2. The instructor can push the child
surfboard. into the wave to help the child catch
the wave with the surfboard.
3. The child can bodysurf the wave
without a surfboard or use a Boogie

Moving Into a Standing Position 1. Once you catch a wave with your 1. The instructor can push the child
(Figure 8) surfboard, pop up to a standing position into the wave to help the child catch
This is attempted once the child has on your surfboard. the wave with the surfboard.
progressed to successfully catching 2. You can shift your weight from right to 2. The child can bodysurf the wave
waves in the sitting or kneeling position. left to steer your surfboard and ride the without a surfboard or use a Boogie
wave onto the beach. Board.
3. The instructor and child can ride
the wave tandem in the standing
4. The child can use a paddleboard
instead of a surfboard and start in
the standing position.

Annie Babineau
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Figure 3.
Balancing in the sitting position

Annie Babineau

Annie Babineau
Figure 2. Figure 4.
Paddling Balancing in the prone position

Annie Babineau

Figure 5.
Catching a wave in the prone position

12 Volume 85Number 4April 2014

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Annie Babineau
Figure 6.
Catching a wave in the sitting position

Annie Babineau

Figure 7.
Catching a wave in the kneeling position

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Annie Babineau
Figure 8.
Catching a wave in the standing position

participation in organized sport and physical activity. The pro- Ming, X., Brimacombe, M., & Wagner, G. C. (2007). Prevalence of motor
gram leaders are currently searching for additional funding and impairment in autism spectrum disorders. Brain and Development, 29,
plan to implement the program again in the future. 565570.
Murphy, N. A., Carbone, P. S., & Council on Children with Disabilities.
(2008). Promoting the participation of children with disabilities in
Funding sports, recreation, and physical activities. Pediatrics, 121, 10571061.
Okagaki, L., Diamond, K. E., Kontos, S. J., & Hestenes, L. L. (1998). Cor-
Grant funding to support the program was obtained from the Uni- relates of young childrens interactions with classmates with disabilities.
versity of Rhode Islands College of Human Science and Services Early Childhood Research Quarterly, 13(1), 6786.
($5,000) and from the Fogarty Foundation ($4,000). A local surf Rimmer, J. H., Riley, B., Wang, E., Rauworth, A., & Jurkowski, J. (2004).
shop, Peter Pan Surf Academy, donated 50% of the cost of the Physical activity participation among persons with disabilities. American
equipment rentals. Journal of Preventative Medicine, 26, 419425.
Winnick, J. P., & Short, F. X. (1999). The Brockport Physical Fitness Test
manual. Champaign, IL: Human Kinetics.
References World Health Organization. (2010). Global recommendations of physi-
cal activity for health. Retrieved from whqlibdoc.who.int/publications/
Centers for Disease Control and Prevention. (2011). Autism spectrum 2010/9789241599979_eng.pdf
disorders: Signs and symptoms. Retrieved from http://www.cdc.gov/ World Health Organization. (2012). Global strategy on diet, physical ac-
ncbddd/autism/signs.html tivity and health: Physical activity and young people. Retrieved from
Delaney, T., & Madigan, T. (2009). The sociology of sports: An introduc- http://www.who.int/dietphysicalactivity/factsheet_young_people/en/
tion. Jefferson, NC: McFarland. index.html
Fragala-Pinkham, M., Haley, S. M., & ONeil, M. E. (2008). Group aquatic Yilmaz I., Yanardag, M., Birkan, B., & Bumin, G. (2004). Effects of swim-
aerobic exercise for children with disabilities. Developmental Medicine ming training on physical fitness and water orientation in autism. Pedi-
& Child Neurology, 50, 822827. atrics International, 46, 624626. J
Koury, J. (1996). Aquatic therapy programming. Champaign, IL: Human
To learn more about this topic, refer to this SHAPE America resource
Matson, M. L., Matson, J. L., & Beighley, J. S. (2011). Comorbidity of
at www.shapeamerica.org/shop: Adapted Aquatics Instructor Creden-
physical and motor problems in children with autism. Research in De- tialing Prep.
velopmental Disabilities, 32, 23042308.

14 Volume 85Number 4April 2014