FAST Skills™ are a 2025 clinical framework in skilled aquatic therapy under development by Andrea Salzman, MS, PT and others through Aquatic Therapy University.
Why? Today, many children with disabilities do not learn to swim through traditional pathways. For them, aquatic therapy may be their first — and sometimes only — meaningful experience in water.
FAST Skills™ (a working name) are being created to intentionally overlap therapeutic goals with foundational water-safety capacities, so that medically necessary aquatic therapy also supports reduced panic, improved orientation, and increased survivability in water.
FAST Skills™ are not swimming skills.
They are not stroke instruction.
And they are not taught as lessons.
Instead, FAST Skills™ are embedded outcomes that emerge naturally through skilled aquatic techniques, when clinicians are trained to recognize and intentionally leverage the overlap between therapy and safety.
The FAST Skills™ Framework (A Working Document)
F — Floating & Buoyancy Awareness
The ability to tolerate buoyancy, horizontal positioning, and body support in water.
A — Airway Control
The ability to regulate breathing, tolerate facial immersion or splash, and maintain calm respiratory control.
S — Spatial Orientation
The ability to orient the body in water, understand position, and manage rotational movement.
T — Transitions & Recovery
The ability to initiate movement toward safer positions, including rolling, surface recovery, and vertical transitions.
These capacities align with well-established aquatic therapy frameworks such as the Halliwick Concept and reflect skills already used instinctively by experienced clinicians.
The FAST Skills framework simply names them, organizes them, and makes them teachable as skilled aquatic therapy interventions — so novice clinicians can apply them intentionally and ethically within medically necessary therapy.
1. FAST Skills™ Definition
FAST Skills™: Functional Aquatic Safety Threshold Skills are foundational water-safety capacities that can be embedded into skilled aquatic therapy.
F — Floating & Buoyancy Awareness“
I can trust the water to hold me.”
A — Airway Control“
I can breathe calmly and manage my airway.”
S — Spatial Orientation“
I know where my body is in the water.”
T — Transitions & Recovery“
I can move toward a safer position.”
FAST Skills™: Functional Aquatic Safety Threshold Skills are foundational water-safety capacities that can be embedded into skilled aquatic therapy.
F — Floating & Buoyancy Awareness“
I can trust the water to hold me.”
A — Airway Control“
I can breathe calmly and manage my airway.”
S — Spatial Orientation“
I know where my body is in the water.”
T — Transitions & Recovery“
I can move toward a safer position.”
FAST Skills are not taught as lessons — they emerge through skilled therapeutic movement.
2. FAST Skills Mapped to the Halliwick Concept
FAST Skills align closely with the early and middle phases of established swimming and water-competency frameworks, including the Halliwick Concept. They emphasize orientation, control, and recovery in the water — rather than propulsion, stroke mechanics, or formal swimming instruction.
In that sense, FAST Skills are not a new idea.
Rather, they are a system: one that codifies correct aquatic handling and therapeutic techniques and makes these skills teachable, repeatable, and clinically intuitive for aquatic therapy providers.
The goal is simple — so that even novice aquatic clinicians instinctively use these skills as dual tools: to achieve therapy goals and, without additional time or effort, to reduce drowning risk for the children they serve.
In that sense, FAST Skills are not a new idea.
Rather, they are a system: one that codifies correct aquatic handling and therapeutic techniques and makes these skills teachable, repeatable, and clinically intuitive for aquatic therapy providers.
The goal is simple — so that even novice aquatic clinicians instinctively use these skills as dual tools: to achieve therapy goals and, without additional time or effort, to reduce drowning risk for the children they serve.
3. FAST Skills Are Designed to Align (or to Nest Within) with Skilled Aquatic Therapy Goals
F — Floating & Buoyancy Awareness
Therapeutic overlap:
Trunk control
Postural endurance
Balance reactions
Core stability
Corresponding PT/OT language:
Improves postural control and tolerance to varied base-of-support demands.
A — Airway Control
Therapeutic overlap:
Breath coordination
Sensory modulation
Autonomic regulation
Oral-motor control
Corresponding PT/OT language:
Supports respiratory coordination and self-regulation during functional tasks.
S — Spatial Orientation
Therapeutic overlap:
Motor planning
Vestibular processing
Righting reactions
Bilateral integration
Corresponding PT/OT language:
Enhances body awareness and orientation during dynamic movement.
T — Transitions & Recovery
Therapeutic overlap:
Transitional movements
Balance recovery strategies
Sequencing and initiation
Functional mobility
Corresponding PT/OT language:
Facilitates safe transitions and recovery responses during functional movement.
FAST Skills are not a new service line or teaching model. They are a clinical lens — one that allows aquatic therapists to deliver medically necessary care while ethically supporting water-safety outcomes within their scope of practice.
When applied intentionally, FAST Skills strengthen clinical reasoning, protect professional boundaries, and improve outcomes that matter both in — and beyond — the pool.
Interested in helping develop this concept. Let us know!
When applied intentionally, FAST Skills strengthen clinical reasoning, protect professional boundaries, and improve outcomes that matter both in — and beyond — the pool.
Interested in helping develop this concept. Let us know!