opinions and comments New American Red Cross Material To the Editor:
LOUISE PRIEST Assistant Director, Water Safety The American Red Cross National Headquarters Washington, DC 20006 Editors Note: A review of the updated American Red Cross
materials will be forthcoming in the Book Review section of this Journal.
Volume 59 / Number 7, July 1979
Although I agree with a number of the comments made by Ms. Priest, I would first like to correct one inaccurate statement made by her in partially quoting the text of my article. I did not refer to the American Red Cross manual, Swimming for the Handicapped, and William Anderson's Teaching the Physically Handicapped to Swim as the "two widely used re sources in this country," as she stated in her letter. I clearly stated that the Red Cross manual "is probably the most well-known publication of this type avail able in this country," while Mr. Anderson "has worked extensively with handicapped swim programs in Great Britain." I would also like to point out to Ms. Priest that my article was submitted to PHYSICAL THERAPY for pub lication in April 1977 (as indicated on p 979), which was one month prior to the publication of the new Red Cross manual, Adapted Aquatics. It is unfortu nate that the time lag between submission of a man uscript and final publication of an article may take as long as 16 months but this was a factor beyond my immediate control. I have had an opportunity to review the new man ual Adapted Aquatics and indeed find it far superior to the previous 1955 manual referenced in my article. The section on cerebral palsy in Adapted Aquatics is a vast improvement over the description contained in the earlier manual. I question, however, the statement in this section that "a few individuals are subject to seizures," when recent references have indicated the incidence of sei zures to be as high as 86 percent in the spastic cerebral palsy population.1 This is certainly an important con sideration when working with cerebral palsied indi viduals in a pool program. I also question the pool procedure suggested in the section on cerebral palsy to "increase and maintain extension and body posi tion" in the water by "clasping the thumbs together when the arms are in an extended position." A ref erence list citing the source for this suggestion and for other treatment strategies included in the manual would certainly be helpful. My primary concern continues to be the minimum recommended pool temperature for relaxing hyper tonic muscles. Adapted Aquatics suggests that the water be no "cooler than 86° F." It has been my experience in working extensively with spastic cere-
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An article that appeared in your August 1978 Jour nal has recently been brought to my attention. The article, written by Susan R. Harris, is entitled "Neurodevelopmental Treatment Approach for Teaching Swimming to Cerebral Palsied Children." It is indeed unfortunate that Ms. Harris was unaware of the ma terials that the American Red Cross released in May 1977, on adapted aquatics. Of course, it is also highly unfortunate that the American Red Cross, until May 1977, was basing its instruction in this subject on a manual written in 1955. Ms. Harris, obviously, is not to blame for this; however, her comments do refer to obsolete materials, and I think it is important enough to call it to your attention. In addition, Ms. Harris refers to two publications, ours and William Ander son's, as the "two widely used resources" in this country. She has either ignored or is unaware of the YMCA's text on the subject published in 1973, and her assertion that Anderson is accepted widely as authoritative is highly questionable. Certainly, we do not recommend this book, partially for the reasons she herself cites as criticisms of the text. Thus, the sources she quotes are either obsolete or incorrectly assumed to be authoritative. As the person responsible for American Red Cross materials on this subject, I find myself greatly con cerned My concern is not solely defensive; I be lieve very strongly that if we are to effectively use aquatics as a therapeutic modality, interdisciplinary cooperation is absolutely essential. We have long sought the assistance and cooperation of knowl edgeable physical therapists, and it seems to me that the possibility of such cooperation is greatly deterred by such articles. For your information, our adapted aquatics mate rials were reviewed in, among others, Rehabilitation Literature, November 1977, and in Almanac, July 1978.
The Author Responds: