New research recommends expansion of supervision techniques to prevent child drownings

In his newest research, Schwebel suggests that a fourth dimension be added to the current drowning prevention model.

Happy family in swimming pool. Smiling child in goggles swim, dive in pool with fun - jump deep down underwater. Healthy lifestyle, people water sport activity, swimming lessons on holidays with kidsIn his newest research, Schwebel suggests that a fourth dimension be added to the current drowning prevention model.According to the Centers for Disease Control and Prevention, there are an estimated 4,000 drownings every year in the United States, an average of 11 deaths per day. With drowning being the leading cause of deaths in children ages 1-4, a researcher from the University of Alabama at Birmingham has published a module on how caregivers can prevent drownings.

Traditionally, successful drowning prevention is thought to have three dimensions: attention, proximity and continuity. In his newest research, published in Pediatrics, lead author David Schwebel, Ph.D., associate vice president for Research Facilities and Infrastructure at UAB, says that in most cases, there is a decreased risk of drowning when all three are utilized. However, he and his co-authors propose that a fourth measurement be added — competency.

“Competency means knowing how to save a child’s life,” Schwebel said. “Driving provides a simple example: If a parent is competent to drive, they do not crash their car and a child sitting in a car seat will stay safe. Near water, competency is more complicated.”

When young children are around bodies of water, competency includes details like caregivers who know how to swim, how to rescue a drowning child and, when needed, how to administer CPR. In emergency circumstances, competency can add valuable, lifesaving seconds in the event of a drowning.

Schwebel, director of the UAB Youth Safety Lab in the College of Arts and Sciences and author of “Raising Kids Who Choose Safety,” says that competency also includes a caregiver’s knowledge of the Drowning Chain of Survival — especially in environments where a lifeguard is not present. Steps of the chain are: 

  • recognize distress
  • safely rescue distressed swimmers by providing means of flotation either from waterside or, if necessary, by swimming to the child
  • remove the child from water
  • provide initial care, which includes CPR if the child is not breathing
  • call for emergency medical services 

If an in-water rescue is required, the new fourth dimension is vital to prevent a multi-victim drowning, as young children have the ability to pull adults underwater during rescue attempts.

“In the injury prevention field, we have always focused on supervision of children by thinking about three dimensions: attention — how attentively are you watching the child; proximity — how close are you to the child; and continuity — are you watching the child constantly, intermittently or not at all,” Schwebel said. “These dimensions are still important, and they work well for locations like the playground; but near water, we also need to think about the fourth dimension of competency.” 

Schwebel Inside ImageDavid Schwebel, UAB associate vice president for Research Facilities and Infrastructure
Photography: Lexi Coon
Going forward

Schwebel and his co-authors suggest a five-step implementation plan for the new four-dimension supervision model. The plan includes:

  • aquatic swim programs’ incorporating training for adult supervisors
  • health care providers’ supplying a more robust water safety guide to families
  • caregivers’ expanding their knowledge by attending first aid and CPR trainings
  • traditional and social media campaigns’ disseminating important drowning prevention strategies
  • insurance providers’ providing incentives and resources for attending drowning prevention programs

“We hope parents recognize the importance of gaining basic knowledge to keep their children safe from drowning,” Schwebel said. “If those who are supervising children do not know how to swim or how to provide CPR, then they can seek basic training to be more prepared. Parent training for child safety can save lives.”

Co-authors of the study include William Ramos, Ph.D., Department of Health and Wellness Design, Indiana University-Bloomington; Julie Gilchrist, M.D., U.S. Public Health Service, Centers for Disease Control and Prevention; and Cinnamon Dixon, D.O., Eunice Kennedy Shriver National Institute of Child Health and Human Development.