{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:08Z","timestamp":1787028668226,"version":"build-2736575974"},"reference-count":61,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Neurodevelopmental disorders such as attention-deficit\/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and Down syndrome (DS) are associated with cognitive, behavioral, motor, and functional impairments that may negatively affect daily functioning and quality of life. Aquatic exercise has emerged as a potential complementary intervention due to its unique physical and sensory characteristics. Objective: To analyze the available evidence regarding aquatic exercise as a complementary intervention for individuals with ADHD, ASD, and DS, considering its potential effects on cognitive, behavioral, motor, and functional outcomes. Methods: A narrative review was conducted using studies identified in PubMed, Scopus, and Web of Science between November 2025 and February 2026. Experimental and quasi-experimental designs, including case studies, evaluating aquatic exercise interventions in individuals with ADHD, ASD, or DS were included. Results: Twenty-two studies were analyzed (ADHD = 7, ASD = 10, DS = 5). In ADHD, aquatic exercise was associated with improvements in inhibitory control, attention, cognitive flexibility, behavioral regulation, academic performance, and cardiorespiratory fitness. In ASD, the main benefits included improvements in balance, motor coordination, aquatic skills, social interaction, communication, adaptive behavior, and behavioral regulation, particularly in Halliwick-based interventions. In DS, positive effects were mainly observed in aerobic capacity, muscular strength, body composition, balance, functional physical fitness, and motor autonomy. Across studies, interventions commonly involved 2\u20133 weekly sessions lasting 30\u201390 min over 6\u201336 weeks. Conclusions: Aquatic exercise appears to be a promising complementary intervention for individuals with ADHD, ASD, and DS, with potential benefits across cognitive, behavioral, motor, and functional domains. Although the available evidence is heterogeneous and methodological limitations remain, aquatic exercise may represent a valuable component of interdisciplinary intervention and adapted physical activity programs.<\/jats:p>","DOI":"10.3390\/jcm15145334","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:27:31Z","timestamp":1783531651000},"page":"5334","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aquatic Exercise as a Complementary Intervention for Cognitive, Behavioral, Motor, and Functional Outcomes in Attention-Deficit\/Hyperactivity Disorder, Autism Spectrum Disorder, and Down Syndrome: A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-3089","authenticated-orcid":false,"given":"Felipe","family":"Montalva-Valenzuela","sequence":"first","affiliation":[{"name":"Escuela de Entrenador en Actividad F\u00edsica y Deporte, Facultad de Ciencias Humanas, Universidad Bernardo O\u2019Higgins, Santiago 8370040, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7001-9004","authenticated-orcid":false,"given":"Eduardo","family":"Guzm\u00e1n-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud, Universidad Santo Tom\u00e1s, Talca 3460000, Chile"},{"name":"Escuela de Fonoaudiolog\u00eda, Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile, Talca 3460000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6190-938X","authenticated-orcid":false,"given":"Exal","family":"Garcia-Carrillo","sequence":"additional","affiliation":[{"name":"Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Cat\u00f3lica del Maule, Talca 3480112, Chile"},{"name":"Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno 5290000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4027-4415","authenticated-orcid":false,"given":"Claudio","family":"Farias-Valenzuela","sequence":"additional","affiliation":[{"name":"Escuela de Ciencias de la Actividad F\u00edsica, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 9170022, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2926-1103","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Gonz\u00e1lez-Aroca","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud, Universidad Santo Tom\u00e1s, La Serena 1720236, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7013-3894","authenticated-orcid":false,"given":"Yeny","family":"Concha-Cisternas","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud, Universidad Santo Tom\u00e1s, Talca 3460000, Chile"},{"name":"Vicerrector\u00eda de Investigaci\u00f3n e Innovaci\u00f3n, Universidad Arturo Prat, Iquique 1100000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6003-5107","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Molina-M\u00e1rquez","sequence":"additional","affiliation":[{"name":"Pedagog\u00eda en Educaci\u00f3n F\u00edsica, Facultad de Educaci\u00f3n, Universidad Adventista de Chile, Chill\u00e1n 3780000, Chile"},{"name":"Programa Doctorado en Ciencias de la Actividad F\u00edsica, Universidad Cat\u00f3lica del Maule, Talca 3460000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-6576","authenticated-orcid":false,"given":"Rodrigo","family":"Ya\u00f1ez-Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Escuela de Ciencias del Deporte, Facultad de Educaci\u00f3n y Humanidades, Universidad Andres Bello, Vi\u00f1a del Mar 2200055, Chile"},{"name":"School of Medicine, Universidad Esp\u00edritu Santo, Samborond\u00f3n 092301, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-960X","authenticated-orcid":false,"given":"Antonio","family":"Castillo-Paredes","sequence":"additional","affiliation":[{"name":"Grupo AFySE, Investigaci\u00f3n en Actividad F\u00edsica y Salud Escolar, Escuela de Pedagog\u00eda en Educaci\u00f3n F\u00edsica, Facultad de Educaci\u00f3n, Universidad de Las Am\u00e9ricas, Santiago 8370040, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.21037\/tp.2020.02.03","article-title":"Neurodevelopmental and neurobehavioral disorders","volume":"9","author":"Patel","year":"2020","journal-title":"Transl. 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