Bath Time

Bath time is an excellent way to introduce and adjust a child to the water within a safe and small environment. Children can learn beginning submersion, water to the face, and bubble blowing during bath time. Introducing children to the fun of the water during bath time will make for an easier adjustment to a pool setting. Bath time is an activity that can be done several times a week and is a part of the daily life of most children.  
Bath time activities
During bath time play a child should be sitting.  A bath chair can be used to help provide trunk support for children who are not able to sit independently. Examples of bath chairs can be ones used for toddlers and infants found at most retail stores. If a child is too large for those types of seats, Rifton and MJM International Reclining bath chair are options for providing a seated positions. The seating support needs to be low and able to be placed on the bath tub surface so the water level can be at the child’s waist of chest level. Raise bath seats will not allow the child to be submerge in the bath tub adequately. Sometimes a child does better with the parent in the bath with the child providing the necessary trunk support. 
Water level should be waist to chest level. The higher the water level on a child the more support the water provides for the trunk. Higher water levels also assist a child who struggles to lift his/her arms against gravity on land. The support of the water provides buoyancy support for a child to move his/her arms in ways her or she would not be able to do on land. However care should be taken with higher water levels to insure a child is safe and a child should never be left alone in the bathtub.  
Encourage the child to splash the water. Cups, pouring toys or squirt toys are fun activities that allow a child to feel the water move through his or her hands. Let the water pour or sprinkle water over a child’s head allowing it to run down his/her face. This encourages a child adjust to water on the face which makes it easier for face submersion later on in the pool.  
Teach a child to make sounds such as BaBaBa, DaDaDa, MaMaMa as the water flows down his/her face. This teaches lip closure and beginning breath control necessary to learn to blow bubble in the water. Let a child blow bubbles through a bubble wand to teach beginning water submersion.  
Arm movement and strengthening can also be done during bath time. Grasp and release can be done by helping a child fill and squeeze squirt toys in the water. Wrist and arm movement can be introduced by having a child scoop up toys floating on top of the water or filling and pouring water out of containers. Sing action songs such as “The Wheels on the Bus”, “Row, row, your boat”, and “twinkle twinkle” encourage arm movement with sounds as well as splashing water onto the face. 
Remember water is more resistive than air so when a child sits in water level at waist level or higher the task of breathing becomes a restive activity. The added level of the water helps strengthen a child’s respiratory system thus increasing breathing strength. Children will often vocalize more in the water as they have more support. In a bath room setting and smaller space sound carries more and often times a child will make louder vocalizations as the sound bounces off the walls. 
The added support of the water at waist and chest level will also allow a child with decreased trunk strength and sitting balance on land to sit more independently in the water. The buoyancy support and resistive components of the water allow a child more time to adjust his/her sitting balance in the water. As a child plays and reaches for toys in the bath trunk balance and strength are challenged this helps with independently sitting and posture on land. 
Bath time should be a fun and rewarding experience for all children and the introduction to water during bath time will make the transition to beginning swimming and water activities easier for the child and the family members.  
Sarah Jones, Dynamic Strides Therapist