Swimming Lessons: One Layer of Protection
The re-posting of an opinion article from Slate entitled “Swim Lessons Won’t Keep Your Toddler From Drowning” on the NDPA’s Facebook Page sparked a passionate discussion about the use of swim lessons as a layer of protection to prevent drowning.
The NDPA thanks all of you for taking the time to comment and for your dedication and support of drowning prevention and we encourage respectful commentary. Given the nature of the commentary on this piece and on previous posts, the NDPA felt it important to provide clarity, define our position as the NDPA, and respond to key issues raised.
It is paramount to state first that the NDPA wholeheartedly believes that swimming lessons are an important layer of protection. At many points in the Facebook commentary, the NDPA was accused of attacking swim lessons as an ineffective way of preventing drowning. That is not accurate and it doesn’t not represent our beliefs as an organization.
We do however, believe that we cannot rely solely on one singular layer of protection to prevent drowning. We often cite swim lessons in this context as there have been many incidents in which skilled swimmers have drown. However, we also hold this same belief when it comes to other layers of protection. Pool fences are an important layer, and they can fail. As can self-closing, self-latching gates. One can forget to put a pool cover back on the pool and an alarm’s batteries can expire. Just like skilled swimmers can drown, layers of protection must operate in combination to truly work. This is why the NDPA encourages people to practice all layers of protection, including learning to swim from high quality lessons.
We are confident that many of you would agree, there is no quick and easy solution that will prevent all drowning. This reality is one of the reasons drowning has been so difficult to stop. The polarization and infighting amongst drowning prevention advocates has also played a major role. As an alliance, we represent all areas of water safety and drowning prevention. We support all layers of protection and, as the Alliance, we will not frame our messaging to focus only on one layer.
We appreciate the passion behind the support of learning to swim but if we only focus on the positive effects, we would be doing a disservice to our audience and the public at large. The author of the article in question was making a point that research shows that parents can become overly reliant on swim lessons as a method to protect their children from drowning. The author is not arguing that swimming lessons aren’t a vital part of protecting a child from drowning. Her point was to shed light on the fact that parent’s over estimate their child’s ability and the need for direct supervision after swimming lessons.
An important item we must address is the accusation that the NDPA is not citing research-based studies to support our stance. As the leading organization in drowning prevention and water safety, we firmly believe that research and evidence-based approaches are of paramount importance. While the NDPA did not write the article posted on our Facebook page, we will stand by the fact that the author does cite relevant research in drowning prevention literature. Please see the list of relevant published research studies below that are often used by the NDPA and some of which were discussed in the article in question.
The research published by Dr. Barbara Morrongiello in 2014 that this article cites is an example. The research showed that “as parents perceive their child to be accumulating swim skills, they increasingly believe that children are capable of keeping themselves from drowning, and as a result, that less active parent supervision of the child is necessary.” Obviously, the parent education component of a learn to swim lesson is vital for parents to fully understand the outcomes of swimming lessons. Parents need to appreciate their child’s abilities in the water after swim lessons and that no one of any age or ability level should swim by themselves. We as the NDPA are not insinuating that a swim instructor would claim that their swim lessons will “drown-proof a child”. However, the article points out that parents can make that assumption on their own, given the results of Dr. Morrongiello’s research.
Another example is related to the statistic that learning to swim will reduce the risk of drowning by 88%. This study was not conducted by the American Academy of Pediatrics (AAP), but by Dr. Ruth Brenner and her colleagues at the National Institute of Child Health and Development and published in 2009. We all applaud the AAP’s move to change the age recommendations and push for starting the learn to swim process at younger ages. However, this article points out important components of the research conducted in by Dr. Brenner and her associates that are often overlooked. We often hear the statistic from this study that participation in formal swimming lessons can reduce the risk of drowning by 88%. It is often missed that this research had a small sample size and the 95% confidence intervals regarding the protective effects were 3%-99%. There is no argument that this study is an important step forward and has been cited by the AAP as a key reason why they made their recent modifications. However, it is important to note that the team behind this study points to the limitations of their own research and that “swimming skills alone are insufficient to protect a child from drowning.”
There are several research studies below that we as the NDPA have also used in the past to support our stance on several issues. The insinuation that the NDPA does not support, does not believe in, or does not follow relevant evidence and research-based studies and advancements in drowning prevention and water safety is simply inaccurate, unfounded, and completely false. With all due respect, the comments that state the research cited is outdated and inconsistent, furthers the problem we are facing. An example is that AAP just modified their statement and stance regarding swimming lessons this year. That doesn’t make all previous research invalid or inaccurate. We may need to look at opinions, commentary, and research conducted or produced prior to that with the recent changes made in the front of our minds, however, that doesn’t mean we should toss aside any, and everything published prior to 2019.
Additionally, we never intend to muddy the waters or create inconsistent messages in the drowning prevention space. Our true intent is to advance the discussion by sharing viewpoints, information, and educational content that pushes the drowning prevention and water safety community to have productive discussions addressing the problems we face. This isn’t easy and sometimes can lead to controversy. We are all working to reduce drowning, and as stated before and there is no cure-all to this awful tragedy. We may not always agree on a singular viewpoint. We may disagree with certain people’s opinions. We may find the results of a research study to be unhelpful or in direct contradiction of current messaging. Someone having a differing viewpoint or approach to solving a complex problem (like drowning), doesn’t make them wrong. Having an open discussion and addressing issues where there is disagreement is important and the only action that will advance our shared goals. The NDPA will continue to promote an open and honest discussion about drowning prevention and water safety that is factual, evidence based, and honest as this is our responsibility and role in this space.
Our goal by writing this blog article today is to inform our audience of our decision-making process and the NDPA’s stance on layers of protection as well as our role in the drowning prevention space. It is not to further any arguments or criticism that the NDPA received in relation to this opinion article and in many other instances when sharing various information on our Facebook page. We fully understand and appreciate how highly emotional this topic can be. Our goal is to reduce the number of awful tragedies that causes this to be such an emotional topic. While many disagree with the author or the opinion piece’s tone; we did not share this to support her tone. We shared this work to again shed light on the fact that we can’t be overly reliant on one layer of protection.
The nature of the NDPA as an “alliance” organization means that we, as an alliance, are all in this together. That does not mean its easy and we all agree on everything. But we all can agree drowning is preventable and that the use of multiple layers of protection save lives. With a complex issue such as drowning; the discussion, refinement, and education of the preventative measures will sometimes lead to situations where we find ourselves disagreeing with approaches, messaging, and each other. In these cases, we all need to remind ourselves and others that we share the same goal, to prevent drowning and to save lives.
List of Relevant Research Studies
Blitivich, J. D., Moran, K., Petrass, L. A., McElroy, G. K., & Stanley, T. (2012). Swim instructor beliefs about toddler and preschool swimming and water safety education. International Journal of Aquatic Research and Education, 6(2), 110-121.
Brenner, R. A., Taneja, G. S., Haynie, D. L., Trumble, A. C., Qian, C., Kliner, R. M., & Klebanoff, M. A. (2009). Association between swimming lessons and drowning in childhood. Archives of Pediatric & Adolescent Medicine, 163(3), 203-210. doi: 10.1001/archpediatrics.2008.563.
Golob, M. I., Giles, A. R., & Rich, K. M. (2013). Enhancing the relevance and effectiveness of water safety education for ethnic and racial minorities. International Journal of Aquatic Research and Education, 7(1), 39-55.
Irwin, C. C., Irwin, R. L., Ryan, T. D., & Drayer, J. (2009). The mythology of swimming: Are myths impacting minority youth participation? International Journal of Aquatic Research and Education, 3(1), 10-23.
Irwin, C. C., Irwin, R. L., Ryan, T. D., & Drayer, J. (2009). Urban minority youth swimming (in)ability in the United States and associated demographic characteristics: Towards and drowning prevention plan. Injury Prevention, 15(4), 234-239.
Katchmarchi, A. B., Taliaferro, A. R., & Kipfer, H. J., (2017). Document analysis in drowning prevention education, International Journal of Injury Prevention & Safety Promotion. doi: 10.1080/17457300.2017.1341932
Lynch, T. J. (2012). Swimming and water safety: Reaching all children in Australian primary schools. Can you swim? An exploration of measuring real and perceived water competency. International Journal of Aquatic Research and Education, 6(2), 267-278.
Martin, N. T., & Witman, D. (2010). Factors affecting minority drowning. International Journal of Aquatic Research and Education, 4(1), 9-18.
Moran, K., Stallman, R. K., Kjendlie, P., Dahl, D., Blitvich, J. D., Petrass, L. A., … & Shimongata, S. (2012). Can you swim? An exploration of measuring real and perceived water competency. International Journal of Aquatic Research and Education, 6(2), 122-135.
Moran, K. (2008). Will they sink or swim? New Zealand youth water safety knowledge and skills. International Journal of Aquatic Research and Education, 2(2), 114-127.
Moran, K. (2008). Youth aquatic recreation: The pleasures and pitfalls of an aquatic lifestyle in New Zealand. In N.P. Beaulieu (Ed.), Physical activity and children: New research (pp. 35–63). Hauppauge, NY: Nova Science Publishers.
Moran, K. (2009). Parent/caregiver perception and practice of child water safety at the beach. International Journal of Injury Control and Safety Promotion, 16(4), 215-221. doi: 10.1080/17457300903307045
Moran, K. (2009). Parents, pals, or pedagogues? How youth learn about water safety. International Journal of Aquatic Research and Education, 3(2), 121-134
Moran, K., & Stanley T. (2006). Toddler drowning prevention: Teaching parents about water safety in conjunction with their child’s in-water lessons. International Journal of Injury Control and Safety Promotion, 13(4), 254-256.
Morrongiello, B.A, Sandomierski, M., & Spence, J. R. (2013). Changes over swim lessons in parents’ perceptions of children’s supervision needs in drowning risk situations: “His swimming has improved so now he can keep himself safe.” Health Psychology 32(9), 1-8. doi: 10.1037/a0033881
Ramos, W., Beale, A., Chamber, P., Dalke, S., Fielding, R., Kublick, L, … Wernicki, P. (2015). Primary and secondary drowning interventions: The American Red Cross circle of drowning prevention and chain of drowning survival, International Journal of Aquatic Research and Education, 9, 89-101. doi: 10.1123/ijare.2014-0045
Sbarbaro, V. S., & Enyeart Smith, T. M. (2011). An analysis of water safety behaviors among migrant and economically/educationally disadvantage middle school students. The Health Educator, 43(1), 21-28.
Stallman, R. K., Junge, M., & Blixt, T. (2008). The teaching of swimming based on a model derived from the cause of drowning. International Journal of Aquatic Research and Education, 2(4), 372-382.
Yang, L., Nong, Q.M., Li, C., Feng, Q.M., Lo, & S.K. (2007). Risk factors for childhood drowning in rural regions of a developing country; A case-control study. Injury Prevention, 13(3), 178-182. doi: 10.1136/ip.2006.013409
