Episode Overview

Episode Title: Episode 328 – Water Safety Skills
Podcast: ABA Inside Track
Release Date: November 26, 2025
Main Theme:
This episode centers on the crucial topic of water safety skills, particularly for children with autism and other developmental disabilities. The ABA Inside Track team reviews recent peer-reviewed research addressing the high risk of drowning in this population, examines effective behavior analytic strategies for teaching aquatic safety repertoires, and provides practical insights for clinicians, parents, and swim instructors. The episode also explores the broader importance of water safety for all children and the challenges involved in implementing and disseminating these interventions.

Key Discussion Points & Insights

1. Why Water Safety Matters

• High Risk for Children with Autism: Autistic children are at particularly high risk due to tendencies for elopement and can face life-threatening situations near water. Drowning is one of the leading causes of death for children with developmental disabilities ([06:17]).
  • "You're about twice as more likely if you're an individual diagnosed with autism, twice more likely to die from drowning as ... the general population." — Robert Perry Crews [06:59]
• General Need: Drowning is the fifth highest cause of unintentional death for children in the U.S., especially under age 15 ([08:11]).
• Preventability: Many incidents are preventable through systematic skill teaching.

2. Types of Water Safety Skills

• Preventative Skills: Entering/exiting the pool safely, using flotation devices, staying with an adult, walking on wet surfaces.
• Reactionary Skills: Surface after submersion, reaching the pool side, floating, alternative swim strokes ([09:39]).
  • "Everything you do in the water technically would count as a water safety skill." — Robert Perry Crews [04:13]

3. Major Research Articles Reviewed

• Behavioral Water Safety and a Systematic Review of Interventions by Martin & Dillenberger (2019):
  Reviewed 11 studies since 2004; most focused on general swim instruction, not explicit safety behaviors.
  • Behavioral interventions (prompting, modeling, reinforcement, video modeling, BST) were effective for teaching swim skills.
  • Limitation: Most participants had existing verbal and imitation skills; little research on nonverbal or more severely affected individuals ([17:05]).
• Teaching Water Safety Skills Using a Behavioral Treatment Package by Levy et al. (2017):
  Targeted the "underwater submersion" skill—teaching children to put their head under water and re-orient to air.
  • Used shaping (seven-step hierarchy from chin wet to full head submersion).
  • Praise and access to games/reinforcers used for correct responses; non-coercive, gradual approach ([27:16]).
  • Maintained skill at 6, 12, and 24 months post-teaching ([34:11]).
• Teaching Water Safety Skills to Children with Autism Spectrum Disorder by Tucker & Inglerson (2021):
  Taught three safety responses: getting to a fixed point (grab the wall), floating on the back and yelling for help, rolling from front to back.
  • Used behavior skills training (BST) in real aquatic settings, with praise and token economies as reinforcement ([38:28]).
  • Adjusted for challenging behaviors with level systems and individualized prompting ([43:47]).
  • All participants eventually acquired and maintained skills; highlighted the need for resources for instructors without ABA backgrounds.

4. Effective Teaching Strategies

• Behavior Skills Training (BST):
  Instructions, modeling, rehearsal, feedback—remains the gold standard for both land and water safety.
  • "Everyone should know how to swim ... but also, teaching safety skills means more than just being able to swim." — Robert Perry Crews [05:53]
• Prompt Hierarchies & Shaping: Gradually increasing demands (e.g., submersion levels) yields strong outcomes, especially for fearful children.
• Reinforcement: Praise, tokens, and tangible rewards (games, toys) are key, though some children may require higher-value "jackpot" reinforcers ([44:19]).
• Adaptability: Interventions must often adapt to individual needs, breaking skills into smaller steps and responding to challenging behaviors.

5. Challenges and Limitations

• Research Gaps:
  • Almost all studies: Participants had some prior skills, relatively few behavioral challenges, and moderate language abilities.
  • Lack of research with children who have significant communication or behavioral difficulties, or those genuinely "non-swimmers" ([17:05],[36:38],[59:04]).
  • Existing studies mostly ignore open-water safety (lakes, rivers) and settings outside managed pools ([53:48]).
• Implementation Barriers:
  • Translating ABA procedures for instructors without behavior analytic training remains a big challenge.
  • More work is needed to create easy-to-use manuals, video models, and reinforcement systems that work in real-world, busy swim environments.

6. Future Directions and Applied Insights

• Manualized Protocols: Need for user-friendly, accessible materials for swim instructors and parents.
• Broadened Populations: Studies should include nonverbal individuals and those with co-occurring intellectual or behavioral challenges.
• Expanding Contexts:
  • Research on open water, clothing vs. swimwear, and generalization to unsupervised settings.
  • Identification of water as inherently dangerous and building "ask for adult" before getting in as a critical communication response ([50:57]).
• Safety Precautions: Always conduct in supervised, lifeguarded environments; some skill components (floating, rollovers) may require qualified swim instructors to avoid unintentional harm ([54:41]).

7. Dissemination and Practice Recommendations

• Clinicians and parents should prioritize basic water safety skill instruction, especially for children with elopement tendencies.
• If not a trained instructor, work in partnership with lifeguards or certified swim professionals, applying ABA strategies.
• Use pools with lifeguards; never practice in unsupervised settings.
• Think of BST not just for clients, but for training swim instructors themselves.

Notable Quotes & Memorable Moments

• "Swimming, while it's great ... if you do not know how to swim ... there's an increased risk for death because of swimming." — Robert Perry Crews [05:53]

• "All kids need to learn how to swim for safety reasons, but then that concern can carry out further if you have a child with a developmental disability."
  — Diana Perry Crews [07:19]

• "Breaking the skill down and modeling it in this fashion seemed very effective for all three of these participants."
  — Diana Perry Crews re: shaping submersion [34:14]

• "Anything that we can do to keep kids out of the water when they're by themselves, I think ... we have to look at some of the elopement literature too, of like, what is that allure?"
  — Robert Perry Crews [51:59]

• "If you are not a swim instructor, either go become a swim instructor, then come back and do safety skills. The family might not want to wait that long ... or go to a common pool with a lifeguard ... and teach the submersion, which anyone can do."
  — Robert Perry Crews & Jackie McDonald [56:52]

Timestamps for Important Segments

• Introduction to Water Safety (and stats): [01:05]–[08:35]
• Benefits/Drawbacks of Swimming: [04:28]–[06:17]
• Divide: Preventative vs Reactionary Skills: [09:37]–[10:21]
• Review of Martin & Dillenberger (2019): [11:00]–[17:05]
• Discussion of teaching procedures, BST: [15:15]–[17:03]
• Limitations of prior research (participant profiles): [17:05]–[19:00]
• Levy et al. (2017): Underwater Submersion Shaping Study: [22:33]–[35:19]
  • Steps of shaping: [27:10]–[28:06]
  • Outcomes and generalization: [34:11]–[35:34]
• Tucker & Inglerson (2021): Three Water Safety Skills, BST: [36:21]–[50:14]
  • Description of skills and BST process: [38:28]–[44:19]
  • Challenges and need for instructor training: [44:19]–[44:26]
  • Data collection and reinforcement details: [41:43]–[43:47]
• Limitations & Future Research Ideas: [50:57]–[54:23]
• Practical Recommendations/Dissemination: [54:41]–[57:52]
• Pairings & Related Episodes: [61:31]–[63:54]
• Closing Remarks: [64:21]–[66:52]

Recap & Flow

The episode maintains its usual lively, slightly irreverent but informative tone, mixing banter with deep dives into empirical research. Real-world problems are foregrounded (elopement, fears, challenging behavior), and the hosts return repeatedly to the need for practical, disseminable approaches and the gaps in available research. The take-home message is one of urgency but also optimism—ABA strategies work when tailored to water safety skills, but more research and resources are needed to empower a broader range of instructors and reach more vulnerable children.

For Further Listening/Reading

• Episode 325: On "land" safety and BST for safety skills.
• Episode 132: On advanced behavior skills training.
• Episode 89: On chaining procedures with Dr. Stacy Bancroft.

Final Recommendation

Behavior analysts, parents, and educators should prioritize teaching at least the basics—submersion recovery, turning and grabbing, floating and calling for help—to all children (especially those at risk for elopement or with developmental disabilities), using behavior analytic strategies in partnership with swim professionals and always in safe, lifeguarded environments. There’s a crucial need for manualized, accessible safety curricula and for research extending these solutions to more challenging learners and settings.