Aquatic-Based Therapy & Gestalt Language Processing

May 08, 2024

We’ve teamed up with Christine Sumara, SLP from HLC Therapy Group to discuss a unique way to support gestalt language processors. Aquatic therapy helps kids meet goals related to physical needs, like building strength and coordination, as well as needs related to sensory processing and communication. The warm water provides constant pressure, or sensory input, helping to organize the child’s sensory system for improved outcomes with regulation, attention, engagement, communication, and positive social interactions. The approach used in the water overlaps with the strategies we use with our gestalt language processors. 

We build trust

We let them hold on to us as tight as they need until they are ready to let go. It may take several sessions to get in the pool for our more hesitant kids. 

We might play on the side of the pool or on the steps. We may play at the drinking fountain, or in the lobby. We offer support and encouragement and they show us when they are ready. Similarly, trust must be established for a child to accept our language models and reciprocate authentically.

We let them lead 

We follow the movements of their body. When their body turns right, we turn right with them. When their body propels forward, we propel forward, too. When their words, gestures, or communicative behaviors indicate a desire to stop, go, or change activities, we let them know they are heard, understood, and respected. Child-led play increases a child’s intrinsic motivation for engagement and communication.

We listen and allow for silence

We practice silence. It is harder than it sounds, but also more powerful than it sounds.”Silence is powerful and allows a child’s true, spontaneous language to emerge.”-Alexandria Zachos,  Plus, sometimes kids need more time than we expect or assume; time to process, formulate ideas, and motor plan movements, without the interruptions of more input from us.

We model language naturally

 Instead of asking questions, which can be tricky for our gestalt language processors to answer accurately, we use declarative language, commenting and narrating and model easily mitigable potential gestalts in a variety of ways and for a variety of purposes. For example, the potential gestalt, “that’s fun!” is often a meaningful chunk of language we use across a variety of activities in the water!

We share joy

Joint routines are effortless to create with the movement of the water, making big splashes, small splashes, kicking feet, blowing bubbles, etc. The child is positioned at eye-level, where they typically stay for safety and body support. Intrinsic motivation for engagement builds rapidly during these cause and effect moments of pure, fun, connection. Shared joy is often one of the most rewarding and noteworthy components of this therapy model.

We act as detectives

We closely watch and feel the movements of the child’s body. We co-regulate to assist the child in maintaining a regulated state, optimal for communication and learning. When a child is dysregulated, it is our job to be the detective and offer support; it is not the child's job to regulate on their own. When a child is scripting or attempting communication, it is our job to be the detective and learn their intent so we can respond in a way that is meaningful and promotes more communication.

We pair meaningful experiences with potential gestalts

We know that pairing a meaningful experience with a gestalt frequently results in that gestalt “sticking”, and the pool is full of natural opportunities for meaningful experiences! We start with each child’s individual interests and familiar gestalts and we build language into our play! We use the rhythmic motions in the water to match the intonation of the speech so the child can hear our model and feel the tactile input to match.

We modulate sensory experiences

Water intrinsically offers increased sensory feedback and fun sensory motor experiences.Water motion can be calming or alerting. The water’s pressure on the body increases with depth. The resistance of the water provides proprioceptive feedback which can be increased or decreased depending on the plane of movement, speed, and turbulence created by the movement. We know that smooth, slow, rhythmic motions tend to be the most calming, while jumping in and breaking the surface of the water tends to be alerting. Water is a constant tool used to adjust the sensory environment to meet the needs of our kids from one moment to the next. Regulation promotes connection; connection promotes communication.

We have seen firsthand how language increases as children’s bodies move in and interact with the water. Research suggests one of the greatest potential benefits of aquatic therapy includes “stimulation and vocalization of language.” We blow bubbles in the water to teach breath control; a primary foundation of purposeful speech production. We may not have adequate proof yet, but what we see kids do in the water versus on land at times may best be described as magic, because like we often say here at Meaningful Speech,  ”when we move, language moves”.

Want to learn more in-depth information about how to support gestalt language processors?

  1. There are many free podcasts, webinars and articles to get you started. A comprehensive list of resources can also be found on our website. We just released a new FREE masterclass on echolalia and child-led therapy that is perfect for anyone starting their learning journey or on the fence about purchasing our courses! 
  2. Consider taking the Meaningful Speech course to learn more about how your child or client processes language, how you can help support them from echolalia to self-generated (original flexible) language, child-led therapy, and neurodiversity-affirming practices. Looking for something shorter? We have a 1-hour introductory course perfect for extended family, daycare or school staff.
  3. Consider taking our AAC + Gestalt Language Processing course. It will teach you how to identify, evaluate and support gestalt language processors who use AAC or who you think might benefit from AAC.
  4. Look for a speech-language pathologist (SLP) who "gets it" and can help you in supporting your child's language development. Check out our registry for SLPs who understand gestalt language processing and child-led therapy.
  5. Are you a school-based or private practice clinician looking for intake forms for new clients/students or creative visual reminder posters for your space? Check out the Meaningful Speech Marketplace.
  6. For FREE social stories, toy recommendations to target developmental milestones, and access to the HLC Connection on youtube, visit
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