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Swim Instruction - Being The Best You Can Be!
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Code Brown - Oh Crap!
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SWIM SHOP
Special Needs Swimmer Profile
Profile was designed by
Dennis Developmental
Center
*
Indicates required field
Swimmer's Name
*
First
Last
Parent or Guardian Name
*
First
Last
Age
*
Email
*
Phone Number
*
Diagnosis
*
Communication Information
#1 What is your swimmer's expressive communication level?
*
Verbal
Limited Verbal Skills
Non-Verbal
Sign Language
Pictures or PECS to Communicate
Augmentative Device
#2. What is your swimmer's receptive communication level?
*
Follows complex directions verbally
Follows simple directions verbally
Follows written/picture directions
Follows gestures and imitation
#3. How do you best communicate directions to your swimmer, and how do they respond to you?
*
Social Information
#4. How much does your swimmer interact with other children? With other adults?
*
#5. Does your child understand and join in to pretend play? Back and forth reciprocal play?
*
Yes
NO
#6. What is the best way to approach your swimmer to get them comfortable with new people?
*
Fears & Sensory Issues
#7. Are there sensory issues that are particularly difficult for your swimmer? (i.e. smells like chlorine; echo in the pool area; loud sounds, water touching them etc.)
*
#8. Does your swimmer have any fears? (Please list) How do they usually respond?
*
#9. What are the typical causes of any emotional melt-downs for your swimmer?
*
#10. What are the best ways you have found to handle these?
*
Adaptability
#11. How does your swimmer respond to changes in routine?
*
#12. Does your swimmer display any motor mannerisms? If so, what are they trying to tell us? (excited, upset, etc.)
*
Motivation & Best Qualities
#13. What do you use to help motivate and reward your swimmer?
*
#14. What do you think will help us make swimming lessons fun and a good learning experience for your swimmer?
*
#15. What are your swimmer's great qualities?
*
#16. Would you like any specific skills emphasized while we work with your swimmer? If so, please be as specific as possible. (i.e. working on using full sentences; working on asking for more; large motor or small motor skills)
*
Thank you for taking the first step to water safety for your swimmer.
We can't wait to see you at the pool!
Submit
Home
LESSONS
Mobile Lessons - Enroll Now!
Aquatic Fitness & Training
30 Minute Lesson - A La Carte Schedule
Private Recurring Package
Parent & Me Group
Aquatic Attitude for Adults
Club Swim - Group Stroke
PRESCRIPTION PROGRAM
Water Babies 4mths - 3yrs
Safety Consultation
LIFEGUARD/CPR SERVICES
CPR, First Aid & BabySitting
Reserve a Lifeguard For Your Party
Lifeguard Certifications
TRY IT for FREE!
Book An Exchange Lesson
Special Needs
Partnerships & Resources
Special Needs Profile Form
Parent Portal
Parent Information
CPR - Know the Steps, Save a Life
Flotation Devices
COVID19 -Pandemic Plan
Patron Pathway - What you Need to Know Before Swimming
Brain Benefits of Swimming
Cancellation Policy
What to Bring
Separation Anxiety
Water & Food Intake
Hypothermia
Ear Infections
Dry Drowning: Clarifying the Facts
Drown Prevention
Videos
Locations
West Little Rock
Conway
About US
What's Happening & Event Calendar
Contact Us
Client Testimonials
Blog
Photo Gallery
>
SOAR - Water Dragons
Adult Lessons
Club Swim
Private Lesson - Safety Skills
Water Babies
Employment Opportunities
Coaches Corner
Water Smart Babies RX
Safe Coaches & Safe Clients Code of Conduct Agreement Form
Incident Reporting Form
Company Telephone List
From Coach Karen
Swim Instruction - Being The Best You Can Be!
On Deck? Make a Great First Impression!
Code Brown - Oh Crap!
How To's of PIKE13
Advice For New Hires
SWIM SHOP