Children have been participating in recreational scuba diving since the pioneering years when training was handed down by the practitioners. There were no training standards, no certified or licensed instructors, and no formal training materials. The results were generally acceptable, and safety was not a major concern. Children tended to be trained by skilled parents, who were competent at the requisite diving skills, knew their own children, were experienced in bringing them up, and accepted responsibility for their actions.
Diver training organisations later took over the instruction and certification of divers, but until 1987 there were no broadly recognised minimum age standards for scuba diving, and certification depended only on satisfying the performance standards.
The Confédération Mondiale des Activités Subaquatiques (CMAS) had standards for training from 8 years old with a good safety record. In 2000, after reviewing the industry-wide safety records, the US Recreational Scuba Training Council (RSTC) returned to its pre-1987 performance-based standard. It again accepts people younger than 15 to learn to dive and to dive under adult supervision, with a minimum age of 10 years for Junior Scuba Diver with professional supervision and Junior Open Water Diver with parental supervision, to a maximum depth of . Younger participants can take part in Professional Association of Diving Instructors (PADI) Seal Team and Bubble-maker events under professional supervision in confined water only.
History Jacques Cousteau, Lloyd Bridges, and others from the pioneering years of recreational scuba diving, introduced their own children to scuba diving, usually with satisfactory results.
Since training agencies took over the training and certification of divers, for-profit agencies have tended to gradually reduce the minimum ages based on their recorded experience as that increases the market size, whereas not for profit training agencies appear to have a more conservative and cautious approach. Overall, the age at which children have been allowed to start scuba training has decreased, as the training agencies made courses available specifically targeting children. Official recommendations from specialist medical groups generally tend to be precautionary and conservative in the absence of data from targeted studies.
PADI reduced its minimum age from 12 to 10 years based on 30 years of data from their own experience and from other training agencies. CMAS has a junior programme stating at 8 years old, and American agencies start at ages from 8 to 12.
Safety record Not many safety statistics are available, but there is also no history of a high accident rate during training. Although there are few cases of severe injury or death following scuba incidents involving children, the number of child divers, how often they dive, and the dive profiles used are also not reported.
Policy Little scientific evidence is available regarding a minimum age limit for scuba diving. In 1999 the South Pacific Underwater Medicine Society (SPUMS) Committee on Medical Standards for Recreational Diving recommended a minimum age of 16 years based on factors relating to diver safety. The more recent 2010 SPUMS guidance suggests a minimum age of 14 years based on an opinion that children below that age do not have the emotional maturity to safely deal with diving emergencies.
In 2003 the Dutch Society of Diving and Hyperbaric Medicine (DSDHM) issued a national guideline specifying a minimum age of 14 years for scuba diving, but it is recognised that younger children also dive and it is in their interests to be examined and assessed by diving physicians for fitness to dive. The DSDHM set up a task group to review the available literature on the topic and provide updated guidelines, which were officially accepted by the DSDHM in around 2020.
There are differences in agency policy on professionally supervised introductory experience compared with training for actual certification, and differences between the policies of the various agencies.
Following standard industry practice, legal responsibility of the instructor and the training agency is limited as far as possible by waivers, with parents and legal guardians assuming responsibility where the minor cannot. The text of the waiver is likely to mention the hazards and possible consequences, and thereby serves to demonstrate that the client was made aware of the risks. Further protection is by adherence to standards, keeping adequate records and sufficient liability insurance cover.
Risk There are always risks in scuba diving, including risks of death and permanent disablement, but there are also risks associated with many other necessary and desirable activities. Most of the risks associated with scuba diving are relevant to all ages, but some hazards may be more of a risk to younger divers. Existing guidelines and recommendations for adults do not necessarily transfer adequately to children, and scientific evidence in this regard is generally lacking.
Younger divers may be at greater risk because of variations in physical, physiological and psychological factors linked to age. Acceptance of risk for a minor has legal and ethical aspects. A parent or guardian may legally accept risk for a minor, but ethically, they should have an adequate understanding of the risk, which raises the question of if and how the diving instructor and school ensure that this understanding is in place.
Medical concerns
Not much data has been published about medical aspects of exposure of children to the stressors of diving; consequently a large part of the criticism is based on hypotheses and speculation. These concerns should be considered in the context of potential benefits to the children of learning to rationally evaluate risk.
Factors influencing fitness to dive for adults are equally relevant to younger people, but there are some factors that are more relevant to bodies that are still growing. Some of these characteristics change gradually with age along a continuum, and adult characteristics are reached at different ages in different individuals, making it difficult to make valid generalisations.
Physical differences Stature and strength affect the ability to carry heavy objects like scuba sets, and how well and comfortably they fit on the diver. Motor skills: Coordination and dexterity and in some cases, physical strength, affect the effectiveness and efficiency of skill performance, which influences safety, where the immediate and effective performance of a procedure can be critical. Thermal concerns: Heat loss and insulation are influenced by physical bulk, ratio of surface area to mass, and thickness of the subcutaneous fat layer, as well as effective insulating clothing.
Physiological differences Bone growth — It has been suggested that the articular cartilage in adolescents and children may be vulnerable to gas micro-embolism, but there is no evidence available either way. Equalization – In young children the Eustachian tubes are relatively narrow and more horizontal, with softer cartilage. The ability to equalise the middle ear is known to be reduced before the age of eight, and children are more susceptible to ear disorders than adults. Middle ear squeeze is the most common dive medical problem in young divers. A careful assessment of ear health by the medical examiner can reduce risk of injury. Small and slender people have an increased rate of heat loss due to body surface area to weight ratio, which increases the hypothermia risk.
Pathophysiological differences Patent foramen ovale (PFO) is more likely to persist in children. The rate of occurrence is estimated at around 40%. In adults with PFA, the risk of cerebral ischaemia is higher, so it has been assumed that the risk in children is proportionately higher. A shallower maximum depth has been suggested to reduce the risk of microbubble formation.
Bone development. Although there has been concern voiced about decompression stress affecting long bone development in children, there is no evidence showing that there is a problem. The epiphyseal plates close in late adolescence and there have been large enough numbers of teenagers diving that growth inhibition due to decompression sickness would be apparent, but there are no cases reported. Hyperbaric oxygen treatment is not known to have deleterious effects on healthy bone of any age.
Lung development. The lungs develop rapidly before the age of eight, at which stage the number of alveoli reaches its maximum but the lungs are still relatively small, so the diameter of the airways is also small, requiring greater breathing effort and resulting in more airway restriction at the end of exhalation than in adults. Until about 16, a child's alveoli and bronchioles are smaller than an adult's and can collapse at a relatively large pulmonary closing volume. They are theoretically more vulnerable to air trapping in the airways and at higher risk of pulmonary barotrauma. The developing lung can also be more sensitive to stimuli like cold dry air that cause bronchoconstriction.
Psychological differences Executive dysfunction is more prevalent in children who have been diagnosed with attention deficit hyperactivity disorder (ADHD), attention deficit disorder (ADD), autism or dyslexia. The deficit in attention and focus could adversely affect situation awareness and timely and appropriate response to adverse events, which may deteriorate into emergencies. These attributes can constitute a relative contraindication to diving. A child may lack emotional maturity and the ability to objectively assess risks. An analysis of DAN emergency call records suggested that psychological immaturity, poor management of adverse events and inadequate supervision may have led to panic and severe injuries among minor divers. The most common injuries were to the ears and sinuses, but 15% of dive-related injuries in minors had a final diagnosis of pulmonary barotrauma. Impetuosity
Learning differences Adult learners are expected to be self-motivated and behave responsibly in a voluntary learning environment, and if they are not, it is their choice. This is not always the case with children, and the duty of care from an instructor is consequently different. A higher level of cooperation and communication is needed between instructor, parent, and child learner to ensure that necessary learning occurs, and that it occurs reasonably efficiently.
How children learn at various stages and ages
The cognitive processes that help to regulate, control and manage thoughts and actions, also known as executive functioning, is only fully developed in the late teens.
Situations where routine behavioural response is not normally adequate include: planning or decision-making; error-correction; responding to novel difficult and dangerous situations; and situations that require overcoming habitual responses.
Some factors to be considered when evaluating suitability of a minor for scuba diver training include: How effectively is the person likely to handle any given problem. Can the person understand level of risk, possible and likely consequences of an associated incident, and can they make a rational informed acceptance of that risk Are they able to assess a developing risk during a dive and reasonably mitigate it by adjusting the dive profile in time to avoid escalation.
Preparation for diving training Swimming: For safety and developing comfort and confidence in the water. Foundational learning: Reading, mathematics, physics, physiology of diving. Physical fitness. Strength and endurance as appropriate and necessary.
Readiness for diver training