As aquatic-therapy centers grow in response to the need for rejuvenation and social wellness, they are also growing for children with rehabilitation needs and developmental disorders.
Colorful environments and interactive water are part of a stimulating, effective, and cathartic treatment, while specific design elements are ultimately inspired by the rehabilitative needs of children.
For example, the five-story Children’s Specialized Hospital in New Brunswick, N.J., includes four above-grade floors and one below-grade, where the kid-centric therapy natatorium offers a combination of planned components.
Aquatic designers created the kid-friendly, slip-resistant, uplifting therapy facility to meet the needs of young patients and their families.
The facility includes an array of kid-approved amenities, including an ergonomically designed 800-square-foot, shallow-water therapy pool, a ceiling-track patient-lift system, ramp entry, and colorful tile work.
Ambience is vital when providing a comfortable and well-balanced space based on considerations inspired to bolster children’s vigor. Since patients typically perform better in environments with daylight, the below-grade pool at the hospital includes the use of skylights and light wells to allow in natural light.
Moreover, adding illumination to steps and water features enhances aesthetic appeal and safety. A view of outdoor foliage through a wall of windows may offer a more secluded experience to be shared with Mommy Nature.
Many children fear being the center of attention in such a facility, so viewing windows with adjoining spaces may be undesirable. Parents, for example, can view their child’s therapy session directly from the pool deck.
Because children depend on those closest to them for support, 8-foot pool decks are generally accessible on all sides of the pool in a non-slip finish, allowing space for families, friends, and sometimes pets to further aid accomplishment. Decks also provide space for therapy equipment and benches, and cubbies for mobility devices, including wheelchairs and walkers.
To further increase energy, tiled walls with whimsical decorations surrounding an aquatic-therapy pool can create inspiration. This can be achieved through the use of color themes that lend an impression, such as blue and yellow for a Cape Cod theme with tile murals of sailboats; warm poppy red, cobalt blue, olive green, and golden sunflower for a Mediterranean feeling with a tile mural of waterfalls and palm trees; or a Caribbean touch with tile mosaics of tropical fish.
The hospital opted for a peach-and-blue scheme with an assortment of colorful tiles in purple, blue, green, red, and yellow to surround the wheelchair-accessible pool.
To boost the mood, ambient music from a built-in sound system can be incorporated into the children’s wellness facility, or even into the pool structure itself. Listening to relaxing music can envelop children as sound vibrations pass through the water, enabling them to feel as well as hear the music.
Appropriately themed acoustical wall and ceiling panels dramatically add appeal and versatility to the aquatic-therapy and wellness programming. Engineered of marine-grade materials, plasma flat-screens and surround-sound for DVD capabilities will withstand natatorium elements.
Aromatherapy has also been shown to psychologically enhance therapy settings for children. Soothing scents can augment the relaxation response; thus, these systems supplement the water’s natural therapeutics. Also, built-in features can dispense scents that will not adversely affect water chemistry.
Well-Being And Mobility
When designing a children’s therapeutic aquatic environment, the designer must include well-being amenities.
The first component to welcome kids is easy access into the facility, including for those who can walk, be carried, or wheeled through the front doors. Non-sloped parking lots in close proximity will enable parents to easily transport their child from the car into locker and changing rooms, and onto the pool deck (helpful if all are on the same level).
Shower and changing rooms must be designed to be large enough for wheelchairs, therapists, and accompanying family members. Doorknobs, lockers, showers, toilets, and fixtures must be at child-wheelchair height and easy to operate with limited hand functions.
Additionally, at Children’s Specialized Hospital, there are separate changing areas for boys and girls. Each area is approximately 100 square feet, and offers a large bench. An adjacent shower/bathroom can be accessed from the changing area.
The Americans with Disability Act Accessibility Guidelines (ADAAG) state that at least one accessible means of entry shall be provided for each public-use and common-use swimming pool less than 300 lineal feet, and two accessible means provided for pools over 300 lineal feet.
A pool lift or a sloped ramp is required for the pool’s primary mode of entry.
The secondary entrance must be separate from the primary means of access, and can be a pool lift, sloped ramp entry, transfer system, transfer walls, or stair entry, thus meeting the requirements set forth in the ADAAG for Buildings and Facilities/Recreation Facilities.
Children’s Specialized Hospital is equipped with an ARJO Lift. This versatile track-layout solution not only can transfer a bather from the pool deck to the pool, but from changing areas to the pool deck to the pool. The modular-track system enables flexible solutions, whereby a track layout can be optimized for design needs specific to its working space.
For therapeutic, teaching, and transfer purposes, mobility is another factor when designing comfort. A movable floor increases the pool’s programming capabilities where deep- and shallow-water therapy can be utilized.
Movable floors provide for deep-water exercise and transition to zero depth for easy access and use. Water depths range from 3 feet to 4 feet, 6 inches since aquatic-therapy methods are performed in an array of depths for maximizing flexion of various-sized children.
The pool walls and floor must be designed to insulate against heat loss to maintain therapeutic temperatures of 87° F to 95° F. The size of the pool must be large enough for several children and their therapists at one time. About 50 square feet of water surface per child/therapist provides enough space for dedicated aquatic-therapy programs.
Other amenities particularly useful for children include perimeter railings near the water’s surface, offering stabilization to pool users. Another consideration is adjustable and movable parallel bars for attaining user balance for assorted exercise movements.
The Children’s Specialized Hospital therapy pool provides underwater benches (submerged seating/resting platforms) where hydrotherapy jets provide directed sprays to tension-filled areas of the child, such as the neck and shoulders, the spine, or the legs and feet.
Aerobic steppers, underwater treadmills, and even current channels provide resistance-therapy exercise, while dedicated lap lanes can add an important strength and fitness component. Dedicated lap lanes greatly add to the overall size of the pool, but unlike competition pools, the length of the fitness lap lanes can be shorter than 25 yards or meters.
Treating The Water
The subsequent increase in organic loading due to oils, sweat, skin, urine, and occasional fecal matter (swim diapers should be used as a precaution) will increase the levels of combined chlorine or chloramines.
This off-gassing of chlorine can be irritating to children’s sensitive lungs and eyes, and destructive to metal items in the pool building and HVAC/DH system. As with all indoor aquatic facilities, an appropriately designed HVAC/DH system will maintain comfortable temperatures and humidity levels in the natatorium, while purging chloramines from the pool area.
In addition to a programmable chemical automation system at Children’s Specialized Hospital, the pool water is routinely monitored and treated by UV sterilization to kill bacteria, viruses, and mold spores, and continuously remove chloramines.
Filtration systems should be designed based on a two-hour turnover rate (in comparison to a six-hour turnover rate for indoor competition pools), providing the inclusion of an automated chemistry controller to govern the addition of the pool sanitizer and buffer.
A dual sanitization system, such as the ultraviolet light sanitization system, will greatly aid in keeping the water chemistry in balance. Although it has a higher first cost, benefits of a UV system include improvement of air quality, effectiveness against micro-organisms, improvement of water quality with fewer chloramines (combined chlorine reduced to below 0.2 parts per million), treatment of total water flow, and reduction or elimination of the need to superchlorinate. It is not hazardous, and is simple and reliable with minimal space requirements.
The successful and welcoming aquatic-therapy center cradles young people and their families like warm water cradles the mind and body in a relaxing, soothing, and peaceful way. Designing a balance between inspiration, innovation, and accommodation of children’s needs, where aesthetics and function merge, the end result allows children’s rehabilitative needs to be a truly uplifting and safe aquatic experience.
Matt Cappello is a professional engineer with the aquatic engineering, planning and design firm Counsilman-Hunsaker. In his role as a Studio Director, Matt oversees engineers, architects, and CAD design support on a broad range of aquatic facilities including waterparks, resorts, community aquatic facilities, therapeutic, K-12, hospitality, and collegiate-level facilities.
Michelle Schwartz is a contract writer for the Counsilman-Hunsaker team. She focuses on research and writing feasibility studies, master plans, strategic plans, marketing narratives and assisting engineers and architects in writing articles for publication.
For more information, visit www.chh2o.com.