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A 9-year-old has difficulty joining group activities due to anxiety and sensory overload. On day 2 of surf camp, she rides tandem with her instructor and begins waving to peers in the water. By the end of the week, she initiates conversations and shares encouragement with others. Sensory input from the ocean supports her regulation, allowing more consistent social engagement.

Treatment Approach: Surf Therapy in ocean camp

Area of Occupation: Social Participation

Performance Skills:

Initiates: Greets surf partner and shares high-fives

Endures: Stays actively engaged for entire 45-minute surf session

Client Factors:

Sensory Functions: Improved balance and spatial awareness via wave movement

Emotional Functions: Reduced anxiety through rhythmic sensory input

Source:

Occupational Therapy Practice Framework: Domain and Process-Fourth Edition. (2020). The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

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Matos, M., Smith, J., & Thompson, L. (2020). Surf therapy for youth with autism: A qualitative case study. Journal of Outdoor Therapy, 4(2), 123–135.

Snelling, K., Williams, A., & Clark, J. (2021). Impact of surf therapy on children with autism spectrum disorder: A quantitative analysis. Pediatric Rehabilitation Journal, 8(3), 215–227.

Occupational Therapy Practice Framework: Domain and Process-Fourth Edition. (2020). The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

Surfers For Autism. (n.d.). Surfers for autism. https://surfersforautism.org/

Yuan, H. L., Lai, C. Y. Y., Wong, M. N. K., Kwong, T. C., Choy, Y. S., Mung, S. W. Y., & Chan, C. C. H. (2022). Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review. Children (Basel, Switzerland), 9(10), 1584. https://doi.org/10.3390/children9101584

Surfers Healing. (n.d.). Our story. https://www.surfershealing.org

International Surf Therapy Organization. (n.d.). Training resources. https://www.intlsurftherapy.org

Waves of Impact. (n.d.). https://www.wavesofimpact.com

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Freepic | Check Generic Flat icon [Photo] | Freepik

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Yes!

Qualitative: Case studies highlight emotional growth, parent-reported improvements in mood, and social initiation (Matos et al., 2020)

Quantitative: Measurable increases in social behaviors and reductions in behavioral outbursts (Snelling et al., 2021)

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Agency Analytics (2022) Target with arrow in bulseye [Photo]

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Increased peer interaction and reciprocated communication (Matos et al., 2020)

Improved tolerance to frustrations, and social interaction, and turn-taking

Greater confidence and responsibility (Matos et al., 2020)

Reduction in sensory defensiveness

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1. Sensory:

Vestibular input (balance on surfboard, wave motion)

Proprioceptive input (paddling, climbing back onto board)

2. Emotional:

Emotional regulation – staying calm and motivated during new/unpredictable stimuli (e.g., cold water, waiting turns)

Source:

Occupational Therapy Practice Framework: Domain and Process-Fourth Edition. (2020). The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

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Focusing on social participation:

1. Initiates – The child begins or appropriately responds to interaction (e.g., greeting, encouraging peers)

1. Endures – The child maintains attention and physical effort in a challenging environment (waves, wetsuits, waiting turns)

Source:

Occupational Therapy Practice Framework: Domain and Process-Fourth Edition. (2020). The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

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Teachers Pay TeachersOccupational Therapy Printable Wall Art- Areas of Occupation [Photo]

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Primary:

Social Participation – engaging in interaction with peers, instructors, and adults in community recreation

Also addressed:

Play – engaging in spontaneous or structured water-based activities

Leisure – developing lifelong skills in recreation and self-fulfillment

Education – group lessons promote following instructions and cognitive flexibility

Source:

Occupational Therapy Practice Framework: Domain and Process-Fourth Edition. (2020). The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

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Gainesville, (2010) - Surf lessons open new vistas for disabled kids [Photo] Gainesville

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Ages: Typically 5 to 18 years old

Diagnosis: Children with Autism Spectrum Disorder, particularly those with sensory processing or social participation challenges

Needs: Participants should have basic swimming safety awareness and be comfortable near water with adult support

Cost: Can range depending on the program/camp being attended. Typically around $450/week but funding is available from outside sources.

Source:

Yuan, H. L., Lai, C. Y. Y., Wong, M. N. K., Kwong, T. C., Choy, Y. S., Mung, S. W. Y., & Chan, C. C. H. (2022). Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review. Children (Basel, Switzerland), 9(10), 1584. https://doi.org/10.3390/children9101584

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Jacksonville, (2024) - Volunteers and autistic participants get a thrill taking to the waves at HEAL Surf Camp [Photo] - Jacksonville

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Surf therapy - a recreational, alternative therapy combining surfing, ocean exposure, and guided social interaction. Children ride waves with trained instructors, most often in a 1:1 ratio.

OTs in Surf Therapy:

Provide sensory integration strategies (e.g., calming techniques, transitions)

Facilitate peer engagement, turn-taking, and modeling social behavior

Support fine and gross motor planning

Use play-based interaction to build communication and overall confidence

Source:

Surfers For Autism. (n.d.). Surfers for autism. https://surfersforautism.org/

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Great Lakes Water Safety, (2023) Banner Picture Winner Provides Adorable Beach Checklist [Photo] - Great Lakes Water Safety

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While no universal certification is required for OTs to implement surf therapy, they often participate in training programs focused on:

Water safety and CPR

Basic surf instruction

Sensory processing in neurodivergent youth

Behavioral support strategies

Who can use this approach?

Pediatric OTs, PTs, STs

Special education teachers

Parents and volunteers (with training/supervision)

OTs involved should be trained in pediatric sensory and behavioral interventions, and comfortable in aquatic settings.

Source:

Surfers For Autism. (n.d.). Surfers for autism. https://surfersforautism.org/

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 Surfers Healing, (2023) Banner Picture [Photo] Surfers Healing                                                                               “We couldn’t cure autism, but we could ride the waves together.” – Israel Paskowitz

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Surf therapy originated in the late 1990s when former professional surfer Israel Paskowitz and his wife Danielle noticed the calming, joyful effect the ocean had on their autistic son, Isaiah.

They founded Surfers Healing, the first surf camp tailored to children with Autism Spectrum Disorder (ASD).

Since then, the model has expanded globally, promoting therapeutic surfing through nonprofits and programs like the International Surf Therapy Organization (ISTO) and Waves of Impact.