WHEN I BECAME A PADI INSTRUCTOR in 2010, I didn’t anticipate that my teaching would diversify into helping those people with mental or physical challenges to enjoy the aquatic element.
Working with seriously injured British Armed Forces personnel and US Marines, I have found that they often want to qualify as PADI Open Water Divers and beyond.
Disabled Divers International (DDI) is a not-for-profit organisation that seeks to make scuba-diving accessible to those who are mentally or physically challenged.
It aims to provide a framework for PADI and equivalent Dive Masters and Instructors to qualify as DDI Instructors and Assistant Divers.
Understanding individual disabilities is essential. This keeps divers safe and allows those who might otherwise fail to qualify because of their disabilities to dive under various levels of supervision.
PADI Vice-President Mark Caney says he is keen that when adapting standards for disabled individuals, instructors should “think out of the box and be innovative”.
Far from suggesting any relaxation in PADI standards, this is about understanding what each standard requires and how, for instance, a student missing both legs might achieve “mastery” of a particular skill.

WHEN YOU START TEACHING a mentally or physically challenged person to dive, the level of disability may seem overwhelming.
You will have instinctive feelings of sorrow and sometimes pity, especially when dealing with the young, or those who have suffered life-changing injuries, for whom the pernicious effects of Post-Traumatic Stress Disorder may also be present.
Whatever your feelings, you have to hide them. “The worst thing you can do is show us pity,” says Owen Pick, a 19-year-old soldier who lost his right leg below the knee in a bomb explosion.
You need to understand the nature of the injury/disability as it relates to the individual’s ability to dive, but no more. This is where a DDI Professional programme can help Instructors or DMs.

CASE STUDY 1
RICHARD AND CHRIS BOTH CAME through the Deptherapy programme, wishing to go on to become qualified PADI divers. Richard has both legs amputated below the knee, while Chris has one amputated above the knee and one below.
Before the confined-water sessions, I went through each PADI standard and considered the adaptations I needed to make.
For instance, the standard for the Confined Water CESA is: “Simulate a controlled emergency swimming ascent by swimming horizontally for at least 9m while emitting a continuous sound.”
We normally teach students this skill by asking them to make themselves neutrally buoyant through a fin pivot, count three breaths and on the third fin towards a marker, holding their inflator hose in the left hand to simulate releasing air and their right arm extended as if heading towards the surface.
But without legs to propel himself forward, how can a bi-lateral amputee achieve this?
Once neutrally buoyant, he needs to propel himself using his right arm only, because he must still simulate the release of air using his left.
Yet it takes a number of arm-strokes to gain any forward propulsion, so the diver will be expending his held breath even before he moves.
He can only cross his legs and propel himself using his right arm only. PADI Course Director and UK Regional Manager John Carlin tried this skill, and said on surfacing: “I thought I was going to die.”
It took Richard and Chris well over an hour to achieve the PADI standard, including repeated visits to the surface, breathing practice and calming of doubts as to their ability.
They needed to take their final breath as soon as they had forward propulsion, but it took a massive physical effort to swim the 9m without the use of their legs.
Similarly, it was no use kneeling in front of them to demonstrate regulator recovery. They had to sit down, and performing this skill seated is completely different, and far harder, than when kneeling.

CASE STUDY 2
I WAS TEACHING BRITISH A-level students to dive in Cuba. Several had Asperger’s syndrome, but one was very high on the autism scale. I had learned about the need for routine when teaching those suffering from autism on my DDI Pros course, so I was prepared for the challenge.
Fortunately I was working with another instructor, and I was able to pass the rest of the group (none challenged in any way) to him and concentrated on the young man with autism.
Every skill had to be explained in detail, and under water the work was intense. The other five in the group would all complete a particular skill ahead of him.
Everything was challenged, and he would become uncomfortable if things were taken too quickly, so skills had to be demonstrated and re-demonstrated and re-demonstrated.
The never-ending question was “Why” His teachers doubted his ability to complete the course, but although his progress was slow, he was completing the skills.
One day, something happened that stunned me. My student was kneeling on the sand on his third open-water dive. One of the other students lost buoyancy and kicked the young man’s mask off and knocked the regulator from his mouth.
I deployed my octopus but, like a professional, he grasped his mask as it floated away, and at the same time leaned to his right, swept his right arm back, recovered his regulator, replaced it in his mouth, cleared it and proceeded to replace and clear his mask. He then gave me the OK signal.
When we arrived at the surface I said: “Well done!” His response was “Why That is what you taught me to do.” So to him it was a matter of repeating what he had learned as a routine.

CASE STUDY 3
DAN IS A THROUGH-THE-SHOULDER amputee – a very rare amputation. Without a prosthetic shoulder, he would not be able to wear a BC or a wing.
His right arm is affected, so kit configuration presents problems. His primary regulator is on a left-sided port from the first stage, and the second stage needed to be converted to a left-hand breathe.
The octopus remains on the right side, attached in the normal triangular area. If he had it on the left side the hoses would be congested.
Fortunately Apeks/Aqua-Lung provided us with one of its i3 BCs, on which there is no inflator hose to get in the way of his primary regulator (which is itself secured by a technical-diving regulator necklace). Dan needed to complete the skill of regulator recovery left-handed.
For mask-clearance he can use only the heel of his left hand, as the two-handed method is not an option. Mask removal and replacement offers a real challenge, however – try it yourself one-handed.
But the instructor has to demonstrate the skill, and it’s no use doing so using two hands. It look me nine attempts to find a way to do it with one hand effectively, and many more to master the skill.

CASE STUDY 4
DAVE IS A SINGLE-BELOW-THE-KNEE AMPUTEE, and probably the best entry-level diver I have ever taught. He does not wear a prosthetic, but quickly developed amazing buoyancy skills.
One problem he, like so many other amputees, experienced was one of balance. The leg below the knee weighs a considerable amount, so you need to compensate for a missing limb by adding extra weight.
Integrated weight-pockets are great for this, or small clip-on weights such as Bright Weights.
Daves balance required precise weighting, and initially he would roll towards the side of his amputation. Again in common with many leg amputees, he had little sense of where his amputated leg was sitting in the water.
Rather than the weight of the bottom part of the leg pulling it down, the stump floated
upward to put him into what was almost a sitting position.
By moving Daves leg to its correct position at the surface, he was able to understand where it needed to be.

There are many examples, but these help to illustrate why adapting standards requires innovation and practice on the part of the instructor.
We know from experience many of the adaptations that are necessary for individual disabilities, but there is still often the need to think outside the box.
Any instructors and DMs who would like to get involved in working with those with physical or mental challenges are welcome to contact me.
You can complete the DDI Pros course, or I can put you in touch with other scuba bodies that provide help to those with disabilities.
And if divers already involved in this area of training are having any problems I’m happy to offer any advice I can. Contact me at uk@ddivers.org

6 tips for instructors

* See the individual, not the injury.
* Do not stereotype.
* Over-assisting is worse than under-assisting.
* Think through whether the individual can be included with other student-divers who are not physically or mentally challenged.
* Prepare and rehearse the adaptation and practise the skills you will teach.
* Seek professional advice where appropriate about the well-being of an individual and the nature of any prescription medication that could be contra-indicative to diving.