The Impact of Water and Sensory Conditions on Individuals with Sensory Processing Disorders

By Sigrid Wang

Sensory Processing Disorders

Sensory Processing Disorders (SPD) refer to conditions in which the brain has difficulty receiving and responding appropriately to sensory input, such as sight, sound, touch, taste, smell, or body position. Individuals with SPD may show either hyper-responsiveness or hypo-responsiveness to sensory stimuli, which can significantly affect their attention, behavior, and emotional regulation, particularly in cognitively demanding environments. Research suggests that between 5% and 16% of children may exhibit symptoms consistent with sensory processing disorder (SPD) [1][3].

Definition of Angelman Syndrome, Autism and Sensory Processing Disorders

Angelman Syndrome (AS) is a rare neurogenetic disorder typically caused by a deletion or dysfunction of the UBE3A gene on the maternal chromosome 15. This gene is essential for proper brain development. Its disruption results in a range of neurodevelopmental impairments. Individuals with AS often present with significant delays in cognitive and motor milestones, limited or absent speech, balance difficulties and unique behavioral features [6]. One of the prominent features of AS is altered sensory processing, which often overlap with features commonly associated with sensory processing disorder.

Similar to Angelman Syndrome, Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that also involves differences in sensory processing and social communication. ASD often co-occurs with other conditions such as anxiety, ADHD, and mood disorders, adding to its complexity. Like AS, early diagnosis and tailored interventions have been shown to significantly improve developmental outcomes [5].

Sensory processing difficulties may manifest as either hyper-responsiveness, an exaggerated sensitivity to sensory input or hypo-responsiveness, where the individual appears under-reactive of sensory cues. For example, those who are hyper-responsive may become distressed by certain fabrics, lights, or sounds, and might strongly avoid routine activities like dressing. While hypo-responsive individuals may not register pain or temperature changes and often seek intense sensory input through deep pressure or vigorous play. These sensory-seeking behaviors are considered coping mechanisms that help regulate sensory input and maintain engagement with the environment [6].

Water as a Sensory Medium

Water provides a distinctive sensory environment that can be both calming and stimulating. Its rhythmic and predictable nature with the gentle resistance of movement and the sound of splashing can create a structured sensory experience. It is often easier for individuals with sensory processing disorders to manage.

One of the most therapeutic aspects of aquatic environments is hydrostatic pressure. Similar to the effects of weighted vests or compression garments, this deep and consistent water pressure input has been associated with calming effects on the nervous system, enhancing body awareness and supporting emotional regulation [2]. Additionally, water offers multi-sensory stimulation: visual (light reflecting on water), auditory (splashing), tactile (temperature and pressure), and vestibular (movement and balance). These properties make water-based activities especially beneficial for individuals with AS, offering a rich sensory environment.

Water and Sensory Processing Disorders

Due to Sensory Processing Disorders’ impact on the central nervous system and sensory processing pathways, it presents unique challenges in motor control, communication, and sensory regulation. Under such circumstances, water environments can serve as powerful multisensory therapeutic platforms, enhancing engagement, promoting emotional well-being, and supporting both social interaction and functional skill development in individuals with Sensory Processing Disorders.

The buoyancy of water reduces gravitational demands on the body, enabling smoother and less effortful movement. This property is especially beneficial for individuals with Sensory Processing Disorders, who frequently exhibit motor impairments and balance difficulties. By decreasing effective body weight, aquatic therapy can help improve balance, proprioceptive feedback and movement control, often resulting in greater physical confidence and increased willingness to engage in motor tasks [7].

Furthermore, aquatic settings can play a key role in emotional and sensory regulation. The calming nature of hydrostatic pressure and rhythmic movement in water has been shown to decrease agitation and support transitions between activities, which is an area where individuals with Sensory Processing Disorders often struggle. For non-verbal or minimally verbal individuals, water-based play can offer alternative modes of expression, where emotions, intentions, and preferences are conveyed through gesture, eye contact, and movement, bypassing traditional verbal communication pathways.

Applications and Risks

The therapeutic application of water in supporting sensory and motor development begins with two foundational approaches: Sensory Integration Therapy (SIT) and Sensory-Based Interventions (SBI). SIT is a clinician-led method, most often implemented by occupational therapists involving individualized interventions designed to help the brain process and respond more effectively to sensory information. In contrast, SBI encompasses less formal but more accessible strategies, such as sensory play including aquatic play in community settings.

Within both models, hydrotherapy and aquatic sensory activities have been shown to improve gross and fine motor skills, support self-regulation, and foster adaptive behaviors in individuals with sensory processing difficulties. For children with Sensory Processing Disorders, such interventions can promote motor strength, help establish consistent daily routines, and facilitate positive social interaction through collaborative and structured water-based activities [8].

However, despite these benefits, water-based environments present critical safety concerns.  Individuals with hypo-responsiveness to sensory input may fail to perceive threats such as water temperature changes or the presence of deep water. Conversely, individuals who are hyper-responsive may experience heightened discomfort or distress due to the acoustic or tactile features of water play, including splashing or sudden temperature changes potentially leading to avoidance or sensory overload [4].

In addition, children with intense sensory-seeking behaviors may develop unsafe fascinations with water, often being drawn to ponds, pools, or other open water sources without a full understanding of the associated risks. Studies indicate that drowning is the most common cause of unintentional death in children with autism or sensory processing disorders, underscoring the need for careful supervision during water-related activities.

Considering these safety concerns, water activities should be introduced in a structured and supervised manner with adaptations that reflect each person’s unique sensory processing profile. When supported appropriately, aquatic environments can become valuable spaces for learning, growth, and enjoyment without compromising safety.

Conclusion

Water offers significant therapeutic potential as a sensory medium for individuals with Angelman syndrome. Its inherent characteristics including rhythmic, predictable movement and consistent deep pressure through rich multi-sensory input create an environment that can both soothe and stimulate. When tailored to individual sensory profiles, these aquatic experiences may support not only motor development but also emotional and sensory integration. However, realizing these benefits requires a clear understanding of individual risks and needs. With structured implementation and appropriate safety measures, water-based interventions can serve as effective and enriching modalities for enhancing the overall well-being of individuals with complex sensory processing challenges.

References:

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[2] Baranek, G. T. (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32(5), 397–422. https://doi.org/10.1023/A:1020541906063

[3] Crasta, J. E., Salzinger, E., Lin, M.-H., Gavin, W. J., & Davies, P. L. (2020). Sensory Processing and Attention Profiles Among Children With Sensory Processing Disorders and Autism Spectrum Disorders. Frontiers in Integrative Neuroscience, 14, 22–22. https://doi.org/10.3389/fnint.2020.00022

[4] Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–140. https://doi.org/10.5014/ajot.61.2.135

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[6] Sarika Peters. (2020) Cognitive Issues and Sensory Impairments in AS, Angelman Syndrome Foundation,available: https://www.angelman.org/cognitive-sensory-influences-on-aggression/. [accessed 24 May 2025].

[7] Schaefer, S. Y., Bittman, M., & Little, L. M. (2015). The effects of aquatic therapy on postural stability and motor function in children with motor impairments: A review. Pediatric Physical Therapy, 27(4), 390–398. https://doi.org/10.1097/PEP.0000000000000189

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