Narrative

Narrative

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This proposal is submitted to support my request for a Use Permit.  Given 
the urgent need for the services I provide, it seemed appropriate to also 
include some background and context. 
 
 
 
 
The Epidemic of Pediatric Drowning 
Every year that we continue to push the same water safety suggestions, 
stick puddle jumpers on our toddlers, and cross our fingers that maybe THIS 
is the year the statistics magically change, we are failing our kids. Children 
need and deserve to learn the skills necessary to save themselves from 
drowning.

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The Tragedy of Pediatric Drowning: 
  
When my daughter was 8 months old, I willingly handed her to the 
murderer who took her big brother’s life.  
 
And, then I watched as she fought off this killer and learned to live. 
My three-year-old son, Levi, drowned in June 2018, while we were on a 
beach vacation with friends. One moment, he was sitting on the couch, 
watching TV while I cleaned up after dinner. In the next, I pulled his 
lifeless body from the bottom of the pool.  
 
Levi had somehow slipped out of the living room filled with children and 
adults, including myself, my husband, and five other physician friends. 
We weren’t drinking, weren’t on our phones, and the pool was not even 
in our line of vision.  
I was the one who glanced, unsuspectingly, over the balcony and found 
our Levi, my guttural screams bringing a rush of people outside. My

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husband, a cardiothoracic anesthesiologist, was the first to perform 
CPR on his only son. Our older daughters watched in horror from the 
balcony, until our friends gently ushered them inside.  
The confusion of “But, we weren’t even swimming!?” and “Levi was 
just on the couch” hung in the air, as we grappled to make sense of 
the senseless.  
We begged to trade places with this boy who had so much life left 
to live and who we had somehow failed to protect. But, despite 
immediate attention, including being fully intubated before the 
ambulance even arrived, we lost Levi just hours later.  
How did our son drown? How were years of intentional parenting 
canceled out within seconds?  
 
Levi’s death rests on my husband and me. We failed to keep him safe, 
and there is no denying that fact. But, I have since learned that water

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safety goes far beyond the assumed foolproof advice of “watch your 
kids while swimming.”  
Here is the truth: parents only know what they know. I thought I was 
doing everything right to keep Levi safe. I have 16 photos of what 
would be his final day of life, and in 14 of them, he is wearing a life 
jacket or puddle jumper: time-stamped photos of my boy, grinning 
proudly in his puddle jumper, as we unknowingly marched toward the 
end. 
Of course, I will never stop wishing I had not momentarily turned to 
clean up dinner and had seen Levi slip out the door that night. But, 
over the last year and a half of research and advocacy, I have 
realized the most impactful mistake I made that ultimately led 
to my son’s death: I allowed and even encouraged Levi to 
believe that water was fun.  
 
We don’t stand in a busy parking lot and eagerly proclaim to our 
impressionable toddlers: “Come on in!!” We don’t encourage our kids to 
“become comfortable” around guns and tell other parents, “We don’t 
want our kids to be afraid of guns.”  
Yet, this is exactly what we do with water, a substance that is just as 
deadly as parking lots and guns.  
As a society, we brush aside the threat of drowning. “Tsk, tsk,” we say 
from the safety of our iPhones as we casually scroll (often inaccurate, 
sensationalized) news reports on drowning. We almost smugly view 
drowning as some sort of just punishment for the parents too neglectful 
to protect their children. We find the loophole rather than facing the 
fear that this could be us. This stigma around drowning is the greatest 
threat to prevention efforts.  
But, honestly? Here is the real, raw truth that we want to turn our 
heads and ignore: the implications of neglect are irrelevant, because 
drowning isn’t happening to the parents. It is happening to the 
children. It’s the 3 year old who will never get another bedtime kiss,

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the 8 year old who will never again open a Christmas stocking, and 
the teenager who will never graduate high school. Behind the 
statistics are real children and teenagers, with whole lives spread 
before them. Until those lives are taken.  
I’m not just a mom with a broken heart: the statistics back me up. 
Drowning is the #1 cause of death for kids 1-4, a toddler can drown in 
less than one minute, and at least 69% happen when kids aren’t even 
swimming. It remains the #2 cause of death for 5-14 year olds. And, 
then it spikes AGAIN for teens, who are drowning in natural water.  
While advancements in other areas of childhood safety push forward 
each year, drowning prevention watches from the sidelines, ignored, 
wondering why researchers and the medical community continue to turn 
their heads. The statistics have remained stagnant for decades. 
The same water safety tips are casually tossed out each year: Watch 
your kids while swimming! Install a fence! Buy a puddle jumper! Learn 
CPR!  
Well, my son was not swimming; he was wearing khaki shorts and 
sitting on a couch a moment before he drowned. The beach house had 
a fence. Levi wore a puddle jumper while swimming. My son had 6 
physicians by his side within seconds of being pulled out of the water. 
AND NONE OF THESE SAVED HIM.  
We are failing our kids. Every year that we continue to only push the 
same suggestions, stick puddle jumpers on our toddlers, and cross our 
fingers that maybe THIS is the year the statistics magically change, we 
are failing our kids. We are telling thousands of children every year: We 
don’t care enough about you to figure out how to stop this epidemic. 
Your lives are not worth it.  
Then, how do we stop this epidemic? We start by looking 
beyond what we are currently doing and say “WHAT ELSE?”  
We start by treating water as if it can be a lethal environment, because 
it can. I am not advocating that we avoid water; my older girls still love 
swimming, and we even live on a lake. But, our culture has the fun

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aspect of water figured out, and we must add in how to also respect it.  
We start by looking at what worked in the past to change the statistics  
And radical change is exactly what is needed to stop this 
drowning epidemic. We must start treating water with the respect it 
deserves and teaching our children how to SURVIVE in water. The 
missing layer of protection is the one that considers the individual 
child while also simultaneously protecting against multiple bodies of 
water.  
After Levi died, I started researching drowning prevention and 
heard about survival swim lessons everywhere I turned. I was 
admittedly skeptical. “That’s some sort of gimmick,” I remember 
thinking. “It wouldn’t have worked with Levi.”  
I saw the videos circulating on social media of babies floating, even 
had hundreds of parents reach out to me and share their personal 
stories, passionate testimonials of how survival swim lessons saved 
their child.  
My questions and skepticism outweighed my answers. Does this really 
work? Is this traumatic for kids?  
But, as I delved deeper into the statistics and personal stories around 
drowning, I saw consistent common factors: children who drown 
usually loved water, relied on a puddle jumper, and did not know how 
to survive if they reached water alone.  
My perception of water safety shifted dramatically, and this carried 
over to my family. 
And, on the exact day that marked 20 months since we last saw our 
son alive, our 8 month old daughter Willow, Levi’s little sister that he 
will never meet on this Earth, she took her first ISR survival swim 
lesson.

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I was prepared for it to be emotionally challenging. But, ISR took me by 
the hands and said, “Be open minded and watch the process.”  
I handed my baby to the water, and, my heart pounding at every 
lesson, I watched as she learned to roll her tiny body, to find the 
surface, to get air. It has been the most empowering experience I 
have had in my eleven years of parenting.  
 
 
Before her lessons started, part of me still expected it to be a trick or 
just rote training in floating that my baby would soon forget. It is none 
of that. Rather, survival swim lessons are about a behavioral approach 
to water. My daughter was not trained to float; she LEARNED to 
problem-solve and to survive in water.  
She knows where the air is, knows how to get oxygen, understands 
that if she gets to the surface that Mommy will scoop her up. And, I do. 
And, she claps and laughs in delight, proud of the kick-ass job she just 
did in learning to save herself. This experience is beyond just teaching 
her to find the surface and float, though: Willow is developing a respect 
for water, which will continue for her lifetime.

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In the best moments of this lifetime of grief and regret, I know my 
family will survive this tragedy. We are choosing to live purposeful lives 
for our other children. But, in the worst moments, when I feel certain 
this is what the depths of Hell must feel like, I think about Levi’s final 
seconds in the water, and my broken mommy heart cannot help but 
wonder: Was he scared?  
When the layers failed and he reached the water without me, he did not 
have a chance. I was right behind him; I just needed 30 more seconds, 
just needed him to hold his breath. I wish I had known the real truth 
about drowning before June 2018, but I know it now. And, should 
Willow, Levi’s baby sister, ever reach the water alone, she will have a 
fighting chance.  
Watching her learn ISR survival skills and to get to the surface in 
water and breathe, to live, is a gut punch. How did I not know that 
Levi was capable of this skill?

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Traditionally, drowning prevention efforts have utilized and advocated 
three levels of defense: 
         1.      Adult supervision 
         2.      Fencing or other protective barriers, and 
         3.      CPR techniques applied after the fact 
  
Clearly, the mortality rate of more than 4,000 drowning incidents per 
year is a grim testimony to the failure of the traditional approaches 
when the victim had not been effectively trained to survive an aquatic 
accident.

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 Certainly, appropriate adult supervision and effective physical barriers 
(i.e., pool fencing) are helpful.  Yet, at the same time, they are subject 
to human error.  CPR, the recommended “last line of defense” is, at 
best, an after the fact, emergency management procedure with a highly 
uncertain outcome. Per American Heart Association data, even with 
effective CPR, survival of a prehospital cardiac arrest is only around 
14%. Of the victims who do survive the initial submersion incident, 
thousands suffer severe and permanent neurological damage. It is 
estimated that for every child who drowns another four will suffer 
permanent brain damage.   
 
 The need for an effective defense, after adult supervision and pool 
barriers have failed, is self-evident.  A moment’s inattention does not 
have to cost a baby his life. A baby or toddler who has the physical 
strength and motor skills to escape adult supervision, defeat a pool 
barrier, and enter the water can, with effective instruction, be trained to 
float on his/her back to breathe and survive.   
 
Infant Swimming Resource (ISR)-The Program (infantswim.com) 
 
ISR is the safest provider of infant and toddler survival swimming 
lessons worldwide.  With over 50 years of ongoing research and 
development behind this program, ISR teaches each child aquatic self-
rescue skills, and progresses to basic swimming lessons that give them 
the competence required to safely enjoy the water.  To date, ISR 
Instructors have safely delivered more than 8,000,000 ISR self-rescue 
lessons and saved more than 800 lives. 
 
As a Certified ISR Instructor, I have spent the past 12 years working to 
prevent as many water-related tragedies as possible.  Every year I hear 
numerous stories from parents sharing how this program saved their 
child when he or she accidentally reached the water alone.    
 
ISR- The Lessons 
 
Lessons are offered to children ages 6 months - 6 years.  They are one 
on one, for up to 10 minutes each day, five days per week for 3-6 
weeks.

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Children 6-12 months learn to roll onto their backs to float, rest, and 
breathe.  They learn to maintain this position until help arrives.   
 
Children 1-6 years of age learn the ISR self-rescue sequence of 
swimming until they need air, rotation onto the back to float, then 
rolling back over to continue swimming.  ISR students are taught to 
repeat this sequence until they reach the safety of the steps, side of the 
pool, or the shoreline 
 
Specific Business Details Requested… 
-Heated pool 
-Parking is in driveway 
-Hours    
 
April-July = max 5 hours   
 
August max 2 hours 
 
No teaching during the other months! 
-Entrance is through the RV Gate that is propped open during business 
hours.  
-Teach Monday-Friday only 
-One parent allowed per child 
-No other employees

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General Safety/COVID-19 
According to the Arizona Republic (August 8, 2020) child drownings 
spiked in Maricopa and Pinal Counties as Covid-19.  Drownings nearly 
tripled from the previous year. Families quarantined at home and public 
pools shut down were certainly contributing factors.  ISR already had so 
many safety protocols in place before enhancing them with additional 
COVID-19 precautions.  
  
-Registration Review: A medical questionnaire is completed online for all 
students prior to scheduling lessons.  The Registration Evaluation Team 
(RET), staffed by Registered Nurses who are also ISR trained 
Instructors, evaluates each registration to ensure that lessons and 
protocols are modified where needed to provide the safest lesson 
experience for each child.  
  
-BUDS: Monitoring of the child’s Bowel, Urine, Diet, and Sleep which is 
important to make modifications to the lesson based on the specific 
needs of each child. 
 
-Lesson/Pool Environment:  Pool entrance and deck area is inspected to 
ensure a clean and accessible area.  The chlorine, PH levels are 
monitored daily to ensure chemically balanced water.  Pool water is 
always free of algae and debris.   
 
-Water/Air Temperature:  Water temperature is maintained between 82-
86.  Temperatures above and below this range do not allow for adequate 
safety monitoring.  I do have a pool heat pump and it is checked 
regularly.  Sunscreen is recommended and umbrellas cover my pool 
area.  
  
-Weather:  Lessons will not be conducted when lightning, heavy rain, 
high winds, or other potentially dangerous conditions have been 
reported in the area within a minimum of 30 minutes of the lesson time.  
Parents and Instructors observe for sudden changes in weather 
throughout the lesson.  Lessons must be stopped if there is 
thunderstorm or lightning.

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-Instructor/student Health:  Lessons will not be conducted if the 
Instructor is ill or injured.  Students that experience fever, diarrhea, 
vomiting, open skin lesions, new rashes, or other obvious signs of illness 
or injury will be asked to stop lessons until the condition can be 
evaluated by physician and by the RET.  
  
-Medical Lesson Update (MLU):  Students who miss 3 or more lessons in 
a row due to a medical condition OR visit a doctor OR start a new 
medication OR who have changes to the health information questions in 
the online registration form will need to complete a MLU online prior to 
resuming lessons.  The RET will respond to these requests within 24 
hours.  An email indication clearance and any applicable safety protocols 
will be sent to the parent together with a new registration form. 
   
-Getting in the Pool:  Each parent will hand the child to the Instructor 
who is already in the pool.  The child will not walk down steps, jump in, 
or enter the pool without hands-on assistance from the parent.   
 
During the Lesson:  
 
-Seven Second Rule:  No student will be submerged for more than 7 
seconds.  Seven seconds is 1/3 of the time period that defines apnea by 
the American Academy of Pediatrics. 
 
-Swim Diapers:  Students who are not potty trained must wear a swim 
diaper that has elastic waist and leg openings plus an additional layer of 
protection such as plastic pants to prevent accidental fecal 
contamination of the pool water.  (I always request parents have two 
layers of protective reusable plastic swim diapers that fit securely on 
their child).   
 
-Bowel/Vomiting Accidents:  If there should be an incident where fecal 
material leaks from the swim diaper into the pool water or where the 
child vomits into the water, the lesson must end immediately.  Pool is 
sanitized and filtered for a minimum of 12 hours prior to resuming 
lessons.

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After the Lesson: 
 
-The 3 Towel Rule:  Parents bring 3 towels to each lesson for placement 
on my mat where the students have the left-side recovery.  Towel 1 is a 
barrier to prevent person to person contact on the pool deck and allows 
for the prevention of disease transmission.  Towel 2 is for absorption of 
pool water and any stomach contents that may be expelled during the 
recovery process.  Towel 3 is for drying and warming after the lesson, 
paying special attention to the head first as heat loss occurs most 
rapidly from the child’s head.   
 
-Refresher/Maintenance Lessons:  Students return to the pool from time 
to time throughout the year/years to review skills and make 
adjustments as the child grows and develops.   
 
As previously mentioned, ISR lessons are the safest lessons provided 
and all of these safety precautions were already in place on a daily 
basis.  Once COVID-19 became a widespread pandemic, I knew that I 
still needed to reach children - now more than ever with so many at 
home!  Although my season was postponed while waiting to see what 
added safety precautions were needed as well as finding out more about 
COVID-19, ISR was able to provide the best safety measures to put in 
place to safely be able to offer lessons yet once again!   
 
COVID-19 Precautions: 
 
-BUDS:  All BUDS interviews now are filled out by myself so that no one 
is sharing a pen or touching anything poolside.  Also, every parent and 
child has to take their temperature before lessons and let me know what 
it is before lessons.   
 
-Parents now need to wait in their car until 1 min before their time slot 
before coming out of their vehicle and around to the backyard.  Each 
parent is required to wear a mask.

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-Water proof facial covering needs to be worn while I teach and I 
maintain at least a 6ft distance from any parent poolside.   
 
-Students need to arrive in swim attire as before and once they have 
rested they must exit promptly, no changing student poolside or in the 
backyard.   
 
-Parents must dispose of any swim diapers, diapers or any other trash 
should be placed in a bag and taken home by the parents.   
 
-Any shared surface (such as the mat that children lay on with the 3 
towels) is sanitized before and after each child! 
 
-My hands are sanitized between students. 
 
My husband, Trevor, of almost 25 years has been a Chandler Fire 
Fighter for 23 years.  We share the passion of drowning prevention and 
know first-hand the importance of children learning aquatic survival 
skills.  Trevor has seen, first-hand, the tragic consequences for unskilled 
children who reach the water unsupervised.   Drowning is very real and 
it is preventable.   
 
Below, please find some additional supporting documentation regarding 
both the ISR program and threat that drowning poses to our youngest 
and most vulnerable of citizens...Our Children. 
 
Thank you for your consideration. 
 
Therace Pollard 
ISR Certified Master Instructor

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Pediatric Support:  
   
February 29, 2020 
  
To whom it may concern:  
  
My name is Dr. Todd Porter and I am a pediatrician at Denver Health Medical 
Center in Denver, Colorado. I am also the father of 3 children aged 10 years, 
8 years and 6 years. Since completing my residency in pediatrics, I have 
always been passionate about pediatric injury prevention. From 2003-2009 I 
was actively involved in our local Safe Kids Coalition especially in the area of 
child passenger safety. In 2009 my wife and I started our family and from 
this point on my primary role has been attempting to figure out how to keep 
my children safe in a world full of dangers and unexpected hazards. Yet 
despite being a former competitive swimmer as well as a community 
pediatrician, I really had no insightful anticipatory guidance on how best to 
teach my own children how to swim nor advise my patient’s parents on what 
to do with their children. Being passionate about injury prevention I was 
familiar with the statistics about drowning, but it was easier to talk about car 
seats to families than how best to reduce the child’s risk about drowning.  
  
Then in 2013 at the recommendation of a friend and neighbor, we enrolled 
our then 3-year-old daughter and 22-month-old son in this lesson program 
called ISR. As a pediatrician, I had never really heard about it and still 
around that time the guidance from the American Academy of Pediatrics 
(AAP) did not seem to have any strong recommendations for swim lessons in 
the 0-4 age group. Over the next 6 weeks I watched in awe and wonder as 
my daughter and son learned how to problem-solve in the water and rotate 
and float on their back with eventual ability to float-swim-float. Fast forward 
to 2014 when we enrolled our third child at the age of 10 months in ISR and 
he accomplished the same survival skill of independent floating in the water 
proving at least to me that an infant of his age was developmentally ready 
to learn this skill.  
  
After witnessing the success of the ISR program I did start to recommend it 
verbally to my patient families during anticipatory guidance on drowning 
prevention in the 0-4 age group my personal experience with ISR and my

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growing friendship with Nicole Hughes that I have come to better understand 
the gross deficit that continues to exist in our national drowning prevention 
efforts as well as our society’s misperception on how we should introduce 
water activities to our children.  
  
Some facts and graphics about drowning: 
•       children 0-4 years drown at 3 times the rate of 5-17 year olds 
•       children < 2 years are more likely to drown in a bathtub while 1-4 
year olds drown more often in swimming pools where child death review 
investigations showed lack of supervision and failure of physical barriers 
to be key factors.  
•       it is estimated that for every death, 5 children visit the emergency 
room for non fatal drowning  
•       Current supported drowning prevention approach consists of Layers 
of Protection that include Barriers around pools, adult supervision, water 
safety education (may include swim lessons) and CPR  
•       2004-2014 Child Death Review data on Pool Drownings found that 
“breaches in these layers of protection ranged from 7-91% of cases 
meaning that at least one layer was breached in 9 out of 10 fatal 
drownings reviewed…Barriers failed 47% of the time, supervision was 
missing in 49% of the time, and only 2% of children < 5 yrs reported to 
be able to swim”. (Dangerous Waters - SKWW)

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Child Death Review Data 2005-2014 on Swimming Ability by Age 
  
 
 
 
 
 
  
 CDC data on Fatal Drownings age 0-4 years from 2002 to 2016

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Contrast to reduction in death rate for children 0-4 years of age in 
Motor Vehicle Crashes 2002 to 2016 — CDC Data. 
  
 
  
  
 
 
 
  
CDC Wonder Data 2004 - 2013 on lack of reduction in Child Pool 
Drowning Deaths by Age

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CDC 2017 Data showing drowning now tied for #1 cause of deaths in 
1-4 year olds 
 
 
  
The above graphics clearly display the lack of meaningful reduction in child 
drowning deaths specifically in the 0-4 year age group over the past 15 
years. So much emphasis has been placed on layers of protection and 
despite having great potential to reduce drownings (pool fences / covers / 
PFDs / supervision), data has shown that all of these have the potential to 
fail and they all depend on placing responsibility on something and someone 
else external to the child.  
 
The one layer of protection that travels with the child wherever 
he/she goes is the child’s own learned survival skills when faced 
with an unexpected interaction with the water. However, unlike car 
seats which are crash tested and heavily regulated and have lead to a 
significant reduction in motor vehicle occupant fatalities in the 0-4 age group 
over the last 20 years, swim lessons are not regulated and therefore are 
quite variable with what, if anything, the child learns during the swim lesson 
program. Because of this, leading pediatric injury prevention advocates have 
been prudent in their recommendations on when a child is developmentally 
ready to start swim lessons in this age group. Therefore, unlike motor 
vehicle occupant fatalities, we have not observed any substantial reduction 
in drowning deaths in the 0-4 year age group over the last several decades.

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Regardless of the layers of protection external to the child that are enacted, 
they will never be absolute or ubiquitous around the child. Because 69% of 
drownings in the 0-4 age group occur with unplanned interactions with 
water, we must elevate the priority of individual swim lessons, specifically 
lessons with the intent of teaching self-survival skills of floating 
independently.  
 
Sincerely, 
  
  
  
Todd Porter, MD, MSPH, FAAP 
 
.    
 
 
The statistics on drowning have remained stagnant for decades. How many more 
thousands of children must drown? How many more parents, brothers and sisters, 
aunts and uncles, and grandparents will have to sit on the front row of a funeral for 
precious children who had full lives snatched away from them in seconds.

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We must teach our children how to survive in water before we teach 
them that it is fun. They are counting on us. The next generation of 
parents should never have to say, “I just wish I had known.”