Good breathing control is essential for all hydrotherapeutic activity in water including swimming and hot tubing. It is frightening to inhale water and encouraging breathing out, or 'blowing' can prevent this. Such instruction should form the background for all activities. If water comes near the face or the face near water, instruct the child to 'blow'. Breathing control needs to become regular and rhythmical not only when the face is above the surface, but particularly when it is submerged. To assist control in the latter circumstance, the child should be encouraged either to exhale through the nostrils or mouth or to hum. Simply requiring the child to hold the breath can cause tension within the body, and this tension will cause an alteration in the body shape and thus in the balance of the body in water.
Encouragement of breathing control must continue at all times and 'blow' should be the word most frequently heard in the pool. Such an essential skill is nor readily achieved by some disabled children, and frequently advanced skills may have been acquired while breathing control as an automatic and effective action is still lacking. Blowing is also a prerequisite for head control since the blowing action helps bring the head forward.