There’s not a lot of research on the effects of diving on children and we cannot presume guidelines for adults directly transfer. Therefore, it can be difficult to find health information when it comes to getting your child certified. In 2015, researchers published a paper entitled “Scuba diving in children: Physiology, risks and recommendations,” wherein they compiled a summary of current research as well as explored some of the risks and recommendations for child divers.
Risks for kids
The researchers found a number of anatomical and physiological characteristics that we should consider when it comes to certifying children.
The increased pressures we experience while diving can affect the respiratory system, and using compressed-air tanks increases the effort we must expend as we breathe large amounts of higher-density air. Both inhaling and exhaling becomes active instead of being autonomic. Children have smaller airways, which means they’re expending more effort when breathing compressed air. This could lead to slower gas exchange and put them at a higher risk of airway collapse. Children are also more prone to getting respiratory infections, which leads to higher risks of airway obstruction or trapped air during ascent.
Patent foramen ovale (PFO), or a hole in the heart that didn’t close properly after birth, also occurs more frequently in children. PFO can lead to nitrogen bubbles entering the circulation system. While there is little research available on PFO and child-divers, adults with PFO are at a higher risk of developing decompression illness. The researchers note that due to these increased risk factors, children should stay shallower than 33 feet (10 m) as micro-bubbles are unlikely to form in shallower depths.
The most common diving accidents in children involve their ears. Children’s eustachian tubes are narrower, shorter and more horizontal. They are also more prone to inner-ear infections. This could hinder proper equalizing.
Furthermore, the articular cartilage (the white tissue found between bones in your joints) in children could increase the risk of developing gas micro-embolisms. Although the researchers state that there is no researched evidence for this, they argue that higher metabolism and the forming of capillaries in these areas in children contributes to this increased risk.
Diving not only increases the body’s energy consumption, it also exposes divers’ bodies to higher amounts of heat loss. Children are especially vulnerable to this as they generally have a lower body-fat percentage than adults.
Most common types of accidents and their causes
According to Divers Alert Network (DAN), 3 percent of diving fatalities involve children. While most fatalities involve drowning and gas embolisms, other causes include children or adolescents who had not received training and participated in higher-risk dives like deeper dives in caves and wrecks. Fifty percent of child-related diving accidents involved children with asthma who also had a history of anxiety or ADHD, or children who made rapid ascents caused by panic or oxygen exhaustion. Other causes of accidents include loss of consciousness due to hypoxia (too little oxygen) due to a cessation of breathing while ascending, lunge over-expansion injuries, gas toxicity, otic (ear) and dental barotrauma, and decompression illness. It is important to note that decompression illness can occur on the very first dive, during shallow dives and even in swimming pools.
Recommendations for scuba diving in children
There are very few studies focusing specifically on children and scuba diving. Thus, many of the recommendations are based on experts’ opinions. Generally, any condition that could increase the risk of barotrauma, disorientation, anxiety, or the increase or development of co-morbid conditions should be assessed beforehand.
Medical conditions that should be considered include ear, nose and throat health, respiratory system health, PFO and epilepsy. While diabetes mellitus does not necessarily increase risks in diving, children should have it under adequate glycemic control and dive with someone familiar with the disease.
Researchers list the following medical conditions as absolute contraindications for diving in children: sinusitis, acute and chronic otitis media, acute tubal ventilation disorders, asthma (in those under 12) and diseases that involve the narrowing of airways.
From a psychological point of view, experts agree that the youngest age to start diving activities is 8 years old. Generally, children will have developed the ability to cooperate, concentrate, control themselves, have logical thoughts, take responsibility and exhibit risk awareness at this age. Parents should thoroughly consider whether their child is ready to dive before they proceed. Here are a few factors to consider:
- Children are more easily distracted than adults. This could lead them to increase their depth to see something interesting.
- Children can excite easily and are generally less aware of risks. This makes them less predictable, requiring more attentive supervision.
- Children are less able to react to novel and new situations and might find it difficult to handle a situation different from those their instructors describe.
- A psychological evaluation should be done at every training stage to ensure that the child is fit to dive.
- ADHD increases the risks of decompression illness and ear and sinus problems. It is advised that children with ADHD do not dive.
- The child should express a desire to dive, not just be fulfilling the wishes of their parents or friends.
Parents should also have dive equipment checked regularly to ensure that it is the correct size. Regulators should be light and flexible and kids should use lightweight tanks.
Appropriate dives for kids
Children should only participate in low-risk dives. Thus, they shouldn’t participate in night dives, cave dives, or wreck dives. Shorter dives are best in order to prevent hypothermia, and the recommended maximum depth is 33 feet (10 m). Children should also be accompanied by at least one, preferably two, experienced adult divers.
Is your child ready to dive?
It is important to individually assess the risk/benefit ratio.
- Does the child want to go diving, or do their parents or peers want them to?
- Does the child fulfil the medical requirements?
- Can the child swim at least 80 feet (25 m) without equipment?
- Can the child listen to and understand directions?
- Is the child capable of following rules?
- Can he or she identify and interpret fear?
- Is the child capable of interpreting hypothetical situations?
- Can the child react adequately when stressed, scared or frustrated?
- Can the child communicate problems, ask for help and offer help?
- Is the child responsible?
Children often make excellent divers, sometimes even better students than adults. It is important, however to ensure that your child is both medically and psychologically fit and ready to dive before introducing them to the sport.