Letting Kids Play Football is Not Child Abuse


The last three weeks have witnessed an all-out assault on the game of football, not coincidentally timed with the beginning of NFL training camps. First came a study reporting CTE in 110 of 111 brains of former NFL players. Following closely on the heels of that media circus was the publication last week of a new book by Dr. Bennet Omalu, Truth Doesn't Have a Side, and interviews in which Dr. Omalu, as he has for several years, argues that letting kids play football is the "definition" of child abuse. The not-so-surprising result has been a tsunami of emails in my Inbox asking for my views on the subject.

On the abuse question, the short answer is that, in my view, parents are not engaging in child abuse simply by allowing their kids to play a collision sport like football before middle school.

Personally, I believe kids should probably delay the start of tackle football until middle or high school. One of my three sons began football at the age of 13 and by the age of 16 he was forced by concussions sustained while snowboarding to retire from both football and lacrosse. Knowing all that I know now about the risks of football (and other contact sports) it would be easy to simply tell parents who allow their children to play tackle football that they are committing child abuse by exposing them to the risk of ending up with CTE, and throw up my hands and walk away in disgust when they don't listen. But, I know better. Not all players who play contact sports have or will develop CTE.

That doesn't mean risk can't and shouldn't be minimized wherever possible. It should. One of my principal missions the past seventeen years has been to do what I can to help minimize the risk of injury in youth sports through training and education of sports parents, coaches and administrators, advocating for rule changes, and by urging the use of safer equipment. After working with youth and high school football programs, producing a PBS documentary, The Smartest Team: Making High School Football Safer, starting a comprehensive sports safety program (SmartTeams), and developing an educational intervention designed to increase honest self-reporting by athletes of concussion symptoms, I can say without hesitation that football is safer now than it has ever been. 

Nevertheless, it is a given that all sports, whether collision, contact, individual or team, involve a certain amount of inherent risk. Football can no more be made completely risk-free any more than riding a bike, skiing down a mountain, or running around on a playground can be made injury-proof. Kids can't live in a bubble, nor should they.

Having said that, there are circumstances in which I believe a parent, or for that matter, a coach or athletic trainer, could be deemed guilty of child abuse - as, for instance, if they allowed a child to return to the playing field knowingthey were experiencing concussion symptoms, thus recklessly exposing them to the risk of a longer concussion recovery, a more serious traumatic brain injury, or even, in very rare cases, death from second impact syndrome.

But unless such recklessness is really extreme, unless it rises to the level of a callous and wanton disregard for a child's safety (e.g. reckless endangerment), I believe the degree of risk a parent is willing to have their child take on is really up to them, such that exposing them to that risk does not rise to level of child abuse.

University of Missouri law professor Douglas Abrams, a juvenile law expert and a youth sports coach for more than 40 years, agrees. "There is no room for prosecuting parents merely for allowing their child to play youth-league or school football," says Abrams. "The Constitution guarantees parents broad discretion to raise their children, so the law requires a strong showing to defeat parental decision-making. Football safety concerns are real and safety advocates should continue to speak out to educate, but parents commit no crime when they decide to allow their child to play the nation's most popular professional and amateur sport." But, Abrams cautions, "A child endangerment prosecution might be appropriate if parents expose their football player to specific health or safety consequences during play, such as by coaxing him to play with a concussion or other serious injury."

In the ideal world, of course, a parent's decision about whether to allow a child to start playing or continue playing collision sports before high school under current rules of play (which are evolving in the direction of safety, fortunately, as seen, for instance, in USA Hockey's ban on body checking at the Pee Wee hockey level and below, limits on full-contact practices instituted at every level of football, from Pop Warner, to high school, college, and the NFL, and a ban on heading in soccer before age 12), will be a conscious and informed in which up-to-date information about the inherent risks of the sport, a consideration of risk factors unique to their child, such as pre-existing learning disabilities (e.g. ADHD ), a history of multiple concussions, seizures, or migraines ), or a reckless and overly aggressive style of play - are balanced against the benefits to the child of participating.

Ultimately, our kids have to rely on their parents to make sure they are doing everything they can to minimize injuries by knowing the risks, and by making sure that, if and when they do suffer a sports injury, such as concussion, they receive appropriate treatment. More than that, I think, we cannot expect.

I say all of this knowing that there is a growing body of research which has linked the playing contact or collision sports for a long period of time, at least for some unknown percentage of athletes, with serious adverse health consequences, not just from concussions but from the cumulative effect of sub-concussive blows to the body or head, impacts which athletes in youth football, lacrosse, rugby, and, until recently, Pee Wee hockey and soccer, suffer on an almost constant basis in both games and practices.

With all due respect to Dr. Omalu, who is a courageous fellow truth-teller and whom I greatly admire, the reality is that, as terrible, frightening, and real as CTE is, especially to those who once played or still play professional football and their families and friends, and as gut-wrenching as it is to see, read about, or hear the stories of athletes whose lives have been affected or cut short by CTE, it is by no means clear whether playing football, especially for the vast majority of those who end their careers in high school, inevitably leads to the development of such neurodegenerative diseases as CTE.

In the final analysis, what I tell parents who are deciding whether to let their child start playing tackle football is, if they do let them play - a decision that is theirs, and not mine, to make - that, before they do, they make sure the program puts their child's safety first: by, among other things, educating coaches, officials, parents, and players about concussions, supplying players properly reconditioned and fitted helmets, proving youth players with helmets designed for their heads that are less than 3.5 lbs., teaching players how to tackle without using those helmets, minimizing the amount of full-contract practice time, creating an environment in which players feel safe in honestly reporting concussion symptoms, ensuring that concussions, when they do occur, are managed properly, and prohibiting players from returning to practice and play until a doctor with concussion expertise decides in the exercise of good clinical judgment that their growing brains have been given all the time they need - and then some - to heal.

Admittedly, in an age in which more and more people tend to gravitate towards opposite ends of the spectrum in their opinions on just about anything (in the case of the great debate about football, either urging parents to find another sport for their child to play or extolling its many benefits while minimizing its risks), the challenge I face - that all those of us who love all sports and are dedicated to making them safer face - in occupying the reasonable, pragmatic, pro-safety middle, is being heard.

For the most part, the national media doesn't seem interested in reporting good news - that there are steps being taken to make football and contact and collision sports such as soccer, lacrosse, and hockey, safer - because it is bad news, scary news, sensational news, that sells, and that some in Concussion, Inc. depend for their very existence on promoting.

From my vantage point, having spent countless hours working with youth and football communities around the country, from talking with football parents, coaches, administrators, athletic trainers, clinicians and academicians, and from becoming educated about the actual facts about the safety of football, I believe that, not only is football a sport worth saving, and that it can be saved, but that those who call for it to simply be abolished, represent an extremely loud but vocal minority.

I simply refuse to be cowed into turning my back on the millions of kids who continue to play the game and their parents, and on the thousands of youth and high school football programs around the country which for the past seventeen years have looked, and continue to look, to me and MomsTeam/SmartTeams for advice on how to make the game as safe as it can be.

In the end, I don't believe it will be those who scream the loudest, the trolls on social media engaged in the politics of emotion, intimidation, and innuendo, who will prevail. It will be those who discuss the risks and benefits of sports calmly, rationally, calmly, and objectively, who work tirelessly to make sports safer, based on science, who will win out.

This blog was originally published on Medium.com on August 14, 2017 


Brooke de Lench is a child athlete safeguards and rights advocate and legal consultant. Founding Executive Director of MomsTeam Institute, Inc., Producer/Director/Creator of the documentary, "The Smartest Team: Making High School Football Safer" (PBS). Director of Smart Teams Play Safe, Publisher of MomsTEAM.com, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins). Brooke is also a founding member of the UN International Safeguards of Children in Sports coalition and is an active adviser for the CDC Heads Up brain injury prevention program.

Follow me on Twitter @brookedelench and share your story with me at delench@MomsTeam.com

Note: In the interest of full disclosure, neither I nor MomsTeam Institute, the non-profit of which I am the Founding Executive Director, has ever accepted any donations from the NFL, USA Football, Pop Warner, or any equipment manufacturer. In order to remain fully independent and objective, this has always been our policy.

 

 

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CTE: Is The Media Scaring Young Athletes To Death?

As someone who has been educating sports parents about head trauma in sports for the past seventeen years, and about the very real risk posed by chronic traumatic encephalopathy (CTE) for the last decade, it is not surprising that I receive emails from parents all the time expressing deep concern about stories in the media that have led them - wrongly - to fear that playing contact or collision sports, or suffering a sports-related concussion, especially one slow to heal, makes it inevitable that their child will develop CTE and is at greatly increased risk of committing suicide.

When a recent email prompted me to pick up the phone to talk to one concerned mother, she told me that her son - who had suffered a concussion playing indoor lacrosse, but, seven months later, and after seeing a number of concussion specialists, was still experiencing symptoms - was giving up hope of ever getting better. Most disturbingly, she said he had begun expressing the belief that he might be better off dead, because at least then he would no longer be a burden to his family and community and, if his brain ended up in a jar next to those of other athletes who also had CTE, perhaps he might find a place in medical history.

My reaction was one of sadness, frustration, and worry: sadness that a young athlete simply assumed that he had CTE as a result of a single concussion and considered it to be a death sentence; frustration that, despite concerted efforts by researchers and clinicians, along with some in the media, to set the record straight on CTE, the prevailing media narrative continues to be that concussions or repetitive subconcussive blows "cause" chronic traumatic encephalopathy (CTE), that CTE "causes" former athletes to commit suicide, and that such causal links are proven scientific fact (they're not); and, finally, worry: concern about the consequences of the football=CTE and CTE=suicide memes in the real world.

For the authors of a 2016 editorial in the British Journal of Sports Medicine the tragic case of a former NHL player, Todd Ewen, is Exhibit A of those real-world consequences. Suffering from bouts of depression - which he was convinced were the result of CTE - and terrified at the thought of a future living with an untreatable neurodegenerative disease, Ewen committed suicide at age 49. But before an autopsy could even be performed, the media's verdict was in: his depression and suicide were most likely the result of a career in the NHL, repetitive head trauma, and the inevitable onset of CTE. A subsequent autopsy, however, found no evidence of CTE.

How, asked the authors - three researchers at Vanderbilt and an epidemiologist at the University of North Carolina - Chapel Hill - did an athlete with treatable depression come to believe that he had an untreatable condition and commit suicide? Because, they asserted, the media, ably aided and abetted by Dr. Ann McKee of the Department of Veterans Affairs and Boston University's CTE Center, along with the PBS series, Frontline, had for years been using the results of autopsies of the brains of a small, self-selected group of former athletes to create a "sensationalized state of fear" about CTE.

To make matters worse, they argued that many in the media - most especially, in my personal experience, those active in social media - not only ignore and/or severely criticize research findings that don't fit the football=CTE and CTE=suicide narrative, but label anyone who dares to challenge that narrative or call for further study a ‘CTE denier' or a ‘shill' trying to advance their own vested interests,* confuse the public and conflate the issues, or all the above.

Are cases like Ewen outliers or do they represent an increasingly common and worrisome phenomenon? Unfortunately, it appears to be the latter. Every clinician who routinely treat athletes with post-concussion syndrome (i.e. patients whose symptoms after suffering a sports-related concussion persist for months or years), with whom I spoke for this article expressed variations of the same concern: that their patients, hearing media reports about athletes suffering symptoms associated with CTE (such as depression), were losing hope of a full recovery, to the point of considering suicide.

"As a clinician, I see patients that come to our clinic months and years after they've been diagnosed with a concussion," said Shannon Bauman, MD, director of the Concussion North Clinic in Barrie, Ontario, Canada. It is "very concerning," she said, "when my patients share their story and fears that they will not recover, and are being told by physicians and other health care providers that they trust that they will likely not get better and that living with lingering symptoms was likely to be their ‘new normal.' Without hope, patients begin to believe that they will not recover," Bauman said. "For young athletes, this can be devastating. Without hope, they begin to believe the messaging from media focusing on professional athletes who have died and been found to have CTE. This takes a great toll on the mental health of a patient recovering from a prolonged concussion leading to increased anxiety and depression, and even thoughts of suicide."

The problem, argues Bauman, is that too many media stories focus on professional athletes, CTE, and poor outcomes of prolonged concussion (or sports exposure to repetitive head trauma), and [there are] too few stories about athletes who make full recoveries and improve (even after years of concussion symptoms). This unbalanced media coverage further fuels the mindset of the public and patients who are now believing that they, too, may not recover. We need to restore hope and share positive stories of the many patients who do recover and the importance of having medical treatment and care provided by those who have an interest in managing cases of persistent symptoms."

Likewise, in her practice, Elizabeth Pieroth, Ph.D., Associate Director of North Shore University Health System's Sports Concussion Program, says she has seen a number of youth patients (athletes and non-athletes) who have sustained a concussion and believe they now have or are going to develop CTE. "On too many occasions, I have had young people crying in my office that they were going to ‘die of CTE,' even after just one concussion."

As heartbreaking as such encounters are, said Dr. Pieroth, she saw a silver lining: at least they afforded her the opportunity to educate them on the current state of the science on concussions and CTE. "What worries me," said Dr. Pieroth, "are the countless people who have the same fear but are not being seen by healthcare professionals with the appropriate training and experience to adequately address this issue."

The experience of Rosemarie Scolaro Moser, Ph.D, Director of the Concussion Center of New Jersey, was much the same. "In the past year, we've seen more young athletes at our Center who are overly anxious and worried about CTE," she said. "This worry has become irrational to the point that they are afraid to engage in normal activities for fear of further brain damage, even when it is clear to us that they have recovered. It's as if they have equated the diagnosis of concussion with doom and a sentence of irrevocable brain damage." She pointed to one patient, a high school athlete, who had clearly recovered from his concussion - to the point that he was performing in the superior range on neuropsychological testing and getting As in school - who was nevertheless so worried, anxious, and paranoid about hurting his head again that he thought he'd suffered another concussion when he happened to turn his head quickly from side to side! She wondered whether the media frenzy over CTE was creating a new medical condition she dubbed "Concussion Anxiety Syndrome."

Like Dr. Pieroth, she said that it was the responsibility of concussion specialists to directly address the emotional component of concussions and undo the myths to which athletes and their parents have been exposed as result of the "media hype" about CTE. "It's not always easy undoing the misinformation out there. Now, it is my job not only to help manage the concussion and facilitate recovery, but to challenge the myths and educate athletes and parents about the facts. We still do not have clear, medical, scientific data that indicates that concussion leads to CTE. We still don't know enough about it. We do know that most concussions resolve, that we should expect concussions to resolve, and that there are plenty of athletes who have had multiple concussions who do not have the emotional disturbance, brain damage, and suicidality that may be portrayed in the media

Media reports on the finding by Dr. McKee and her colleagues in a new study reported in the Journal of the American Medical Association that 110 of 111 deceased NFL players her group had autopsied had CTE will undoubtedly take the level of fear among sports parents and present and former athletes in all contact and collision sports alike to even more frenzied heights.

While I was encouraged by the amount of push-back from scientists, clinicians, and researchers objecting to the way in which the media has covered the story, and cautioning that the facts about CTE are far more nuanced and uncertain that many in the media would have us believe, I am concerned that their voices aren't being heard. For every article by a scientist calling for an "end to the media and public hysteria," and for both sides to "stop campaigning for their agenda and to let science take the lead," there are one hundred, or even one thousand, which will do nothing more than repeat the scariest of the study's findings: that 99% of those who played in the NFL whose brains were autopsied had CTE.

I worry that lost amidst the hoopla about the new CTE study is the fact that not every football player whose brain was donated to the CTE Center for pathological scrutiny was found to have the disease, and, that it was not detected in either the brains donated by the families of football players who died before they got to high school, and in only three of fourteen of high school players (and, in those, the disease had not progressed beyond the "mild" stage).

What I found most surprising was, that as far as The New York Times and Dr. McKee were concerned, her study didn't add to the debate about the football=dementia narrative; it ended it. According to the Times - which is widely acknowledged to have originated the football=CTE and CTE=suicide narrative in a January 18, 2007 article - all that was left for scientists to figure out was "how many blows to the head, and at what levels, must occur for C.T.E. to take hold."

Not only was that assertion completely at odds with the uncertain state of the existing science, but it was contradicted by the study itself, in which Dr. McKee and her colleagues acknowledged that several other factors, besides prior participation in football, may influence CTE risk and disease severity, including factors other than cumulative hits to the head, and admitted that it was even "unclear" what roles concussions and repetitive subconcussive hits play in CTE risk, disease severity, and progression.

That the Times didn't report these findings, much less bother to interview anyone for the article other than Dr. McKee, wasn't at all surprising to me (and, I'm sure, to many scientists) for one simple reason: such uncertainty didn't fit the Times' 10-year football=CTE meme.

Educating sports parents and athletes about head injury safety is tough enough without the media's sensationalist reporting, but it does come with its rewards. Recently, I received an email from a mother asking for help for her son, an ice hockey player, who was struggling with post-concussion syndrome to the point he was suicidal. I reached out to the clinicians on our organization's Head Injury Advisory Board to see if anyone could help. One of our members responded immediately, and, working with the athlete and his family, has developed and implemented a treatment plan that is putting him on the road to recovery. I would like to think that I played a part, however small, in that positive outcome.

Now, if only the media could focus its energies on educating the public instead of sensationalizing head injuries in sports, perhaps we could stop creating such a climate of fear that athletes end up literally being scared to death.

Share your story with me at delench@MomsTEAM.com

* In the interest of full disclosure, neither I nor MomsTeam Institute, the non-profit of which I am the Founding Executive Director, has ever accepted any donations from the NFL, USA Football, Pop Warner, or any equipment manufacturer. In order to remain fully independent and objective, this has always been our policy.

This blog was originally published on Huffington Post on August 9, 2017 


Brooke de Lench is a pioneer in child athlete safeguards and rights, a risk reduction in sports and legal consultant. Founding Executive Director of MomsTeam Institute, Inc., Producer/Director/Creator of the documentary, "The Smartest Team: Making High School Football Safer" (PBS). Director of Smart Teams Play Safe, Publisher of MomsTEAM.com, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins), Brooke is also a founding member of the UN International Safeguards of Children in Sports global coalition.

She can be reached by email delench@MomsTeam.com, and you can follow her on Twitter @BrookedeLench.

 

 

 

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Creating A Culture Of Concussion Safety Requires Teamwork All Season Long, Not Just One Day

 

If your child plays a contact or collision sport, whether at the youth, middle school or high school level, chances are they will suffer a concussion at some point in their athletic career. How quickly they recover may depend on how soon after injury - if at all - their concussion is identified so they can be removed from practice or game action. The problem is that concussion signs - still the best way to identify a concussion - are difficult to spot, and athletes often hide their symptoms. The consequences of such unreported and undiagnosed concussions range from a longer recovery up to and including, in rare cases, catastrophic injury and death.Newcastle OK football players

One way to improve the chances that an athlete's brain injury is identified is for teams to employ a "buddy" system in which team members are assigned to watch for signs of concussion in designated teammates and, if they spot signs, or if their teammates tell them they are experiencing symptoms, are encouraged or required to immediately report the possible injury to the athletic trainer or the coach.

While I had been advocating the use of a buddy system for many years in every sport, it was not until five years ago, during the taping of our PBS documentary, "The Smartest Team: Making Football Safer," in Newcastle, Oklahoma that I began to truly appreciate not just how culturally entrenched was an athlete's reluctance to self-report concussion symptoms but also the part a buddy system could play in changing that culture.

At a players-only meeting at the beginning of pre-season, and in interviewing athletes in small group and one-on-one, nearly every football player I spoke to freely admitted that they would not self-report concussion symptoms.

"If I can get up and walk away from it, yeah, I'll probably keep playing," one said.

"You see some dots and they go away ... so you just keep playing through it. It's my senior year," said another.

"As long as I can still see and keep my balance, as long as I'm not feeling dizzy, head injuries are all right," acknowledged a third.

Typical was what one player told me: "There was a time that I've gotten a concussion. I didn't think much of it, you know, just a headache, move on with it, keep playing. ... Got hit pretty hard, helmet to helmet, couldn't see, saw stars everywhere, just went back on the field, started playing again. Didn't need to tell anyone. I mean it's not like I was laying down, couldn't get up or anything. But I thought I was fine."

(He wasn't, of course, and should have told someone and removed himself, or been removed, from the game)

My anecdotal experience in Newcastle was that instituting a buddy system - not just players watching teammates but cheerleaders keeping an eye out for players showing signs of concussion - helped, although it's hard to say how much. One of the players recounted how he had noticed a teammate who seemed really "out of it" at practice one day. When he told the coach, his teammate "got really mad." But he said he was undeterred, because he "knew it was going to help [his teammate] in the long run."

Another player told me that, "As far as the buddy system goes, I know that we need to keep each other's backs, like me and Justin have each other's backs as far as like, if I get a concussion or he had gotten a concussion, then you know, make sure he's OK. If he's out of it, you know, can't answer simple questions, go alert the coaches. He got mad at me, but I learned it was the right thing to do."

One of the players recounted how he had noticed a teammate who seemed really "out of it" at practice one day. When he told the coach, his teammate "got really mad." But he said he was undeterred, because he "knew it was going to help [his teammate] in the long run."

Given my experience in Newcastle, I was not surprised when, three years later, a 2015 study suggested that a buddy system, while it does not remove the need for honest self-reporting by athletes themselves or place final responsibility on teammates for each other's health behaviors, may be an important step towards creating a culture of concussion safety on sports teams.

What I learned from working with the Newcastle team, and with youth football programs across the country over the years is that traditional concussion education in which athletes, coaches, and parents are taught the signs and symptoms of concussion, and the health risks of concussion and repetitive head trauma, isn't working to change the concussion reporting behavior of athletes. Between 40 and 60 percent of all concussions - and a much higher percentage of so-called "bell-ringer" events - still go unreported; indeed, a recent study found that four out of 10 athletes with concussion signs or symptoms return to play that same day. It has become increasingly clear that the problem isn't a lack of knowledge. Rather, it is the attitudes and beliefs of athletes about concussion reporting, what they think might happen to them if they report, and what they think are negative attitudes of coaches, teammates, parents, and fans about concussion reporting which combine to create a climate which discourages reporting.

In the age of social media, such negative attitudes by teammates about honest self-reporting can take the form of cyber-bullying and shaming. "As health care providers dealing with concussions, we need to be aware that many concussed patients may be bullied or shamed on social media by friends or teammates who may not believe that they are experiencing concussion symptoms, or that those symptoms are lingering," notes Mark Halstead, M.D., a sports medicine physician and Director of the Washington University Sports Concussion Clinic & Young Athlete Center.

The answer, then, is to work to change attitudes about concussion symptom reporting so that honest reporting is viewed as a valued team behavior and a hallmark of a good teammate. Like the Centers for Disease Control and an increasing number of concussion experts, I believe that the best way to increase the rate at which athletes report concussion symptoms, either their own or their teammates, is for coaches, parents, medical staff to work as a team to change reporting behavior - to reshape the culture around concussion reporting - by changing individual and team reporting attitudes and norms and by creating a climate in which athletes feel comfortable reporting their symptoms.

Available free of charge on MomsTEAM's new SmartTeams concussion website, the #TeamUp4ConcussionSafetyTM program, developed by MomsTEAM Institute as part of its SmartTeams Play SafeTM initiative with a Mind Matters Educational Challenge Grant from the National Collegiate Athletic Association and Department of Defense, is designed to do just that: to increase reporting by athletes of concussion symptoms by engaging coaches, athletes, parents, and health care providers in a season-long, indeed career-long program which emphasizes that immediate reporting of concussion symptoms - not just by athletes themselves but by their teammate "buddies" - not only reduces the risk the athlete will suffer a more serious brain injury - or, in rare cases, even death - but is actually helps the team's chances of winning, not just in that game, but, by giving athletes the best chance to return as quickly as possible from concussion, the rest of the season, and by teaching that honest reporting is a valued team behavior and a hallmark of a good teammate.

The rate at which student-athletes immediately and honestly report experiencing concussion symptoms, both their own and their teammates, will only begin to increase if all stakeholders first understand how much they know about concussions, and about their own attitudes towards and beliefs about symptom reporting. Our five-part program begins by asking coaches, athletes, athletic trainers, and parents to take a series of quizzes designed to test their concussion knowledge, and, more importantly, whether they view concussion symptom reporting in a positive or negative light.

While knowledge and awareness of concussion has increased substantially over the seventeen years that MomsTEAM/SmartTeamsTM has been engaged in concussion education, research shows that there are still important gaps that need to be filled. To fill them, coaches, parents, and athletes will be encouraged in Step Two in the #TeamUp4ConcussionSafety program to continue learning about concussions by taking our online concussion education course.

Because studies show that one-off concussion education isn't enough to change concussion symptom reporting behavior, Step Three in the SmartTeams Play SafeTM #TeamUp4 ConcussionSafetyTM game plan calls for coaches, athletes, athletic trainers, team doctors (and, at the youth and high school level, parents) to attend a mandatoryconcussion safety meeting before every sports season to learn in detail about the importance of immediate concussion symptom reporting, not just in minimizing the risks concussions pose to an athlete's short- and long-term health, but in increasing the chances for individual and team success. (As I have learned from long experience with youth and high school sports programs, making attendance at a concussion safety meeting voluntary virtually guarantees a lot of no-shows.)

Anecdotal evidence from NCAA Division I football programs suggests that the signing by athletes of pledges acknowledging their responsibility to report concussion symptoms increases the rate of reporting by athletes, both of their own symptoms and those of teammates. Because improving concussion safety requires a team effort, we believe that all those with a stake in concussion safety should sign pledges, not just athletes. Step Four of our concussion safety game plan thus calls for athletes, coaches, parents, and medical staff to demonstrate in a tangible way their commitment to creating a culture in which immediate reporting of concussion symptoms by athletes is a valued team behavior and the sign of a good teammate by signing a concussion safety pledge at or shortly after the pre-season concussion safety meeting,

And, finally, because prevailing attitudes towards concussion symptom reporting and reporting behavior are deeply entrenched in our sports culture, we encourage, as Step Five, that coaches, athletes, athletic trainers, team doctors, and parents continue working over the course of the sports season to create and maintain an environment in which athletes feel safe in immediately reporting concussion symptoms (both their own and their teammates) by sharing and reinforcing positive messages about the importance of immediate concussion symptom reporting via social media, by maintaining open lines of communication and an ongoing dialog about concussion safety among and between and among coaches, athletes, medical staff and parents.

With consistent messaging and constant reinforcement of the value of immediate concussion reporting in achieving your team's performance goals, and by making athletes feel comfortable in reporting, we believe that, not only will attitudes and beliefs about concussion reporting begin to change, but the concussion reporting behavior of your athletes will start to change as well, and that, over time, the culture of resistance to concussion symptom reporting will be replaced by a sports culture of concussion safety.

First published on Huffington Post on September 11, 2017 


Brooke de Lench is a pioneer in child athlete safeguards and rights, a risk reduction in sports and legal consultant.  She is Founding Executive Director of MomsTeam Institute, Inc., Producer/Director/Creator of the documentary, "The Smartest Team: Making High School Football Safer" (PBS). Director of Smart Teams Play Safe, Publisher of MomsTEAM.com, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins), and Brooke is also a founding member of the UN International Safeguards of Children in Sports global coalition.

She can be reached by email delench@MomsTeam.com, and you can follow her on Twitter @BrookedeLench.

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Are Parents Who Allow Young Athletes To Play Contact or Collision Sports Guilty of Child Abuse?

As long-time visitors to MomsTeam or readers of my blog and 2006 book, Home Team Advantage, know, I have always taken a somewhat expansive view of what constitutes child abuse in the context of sports. 

Among other things, I have long advocated for adoption by the United States of the protections against abuse contained in the U.N. Convention on the Rights of the Child [Update: as of December 11, 2015, the U.S. was the only country in the world that has not signed the convention] and believe that a parent or coach who knowingly allows a child to continue to play while injured, or recklessly exposes a child to an unreasonable risk of sports injury, is engaging in child abuse.

So, when I was asked in a recent radio interview, whether I viewed parents who allow their children - particularly elementary school age-children  - to participate in collision sports as committing child abuse, I had to stop for a moment to think.  

On the one hand, there appears to be a growing body of research suggesting that playing contact or collision sports for a long period of time likely has, at least for some unknown percentage of athletes, serious adverse health consequences, not just from concussions but from the cumulative effect of sub-concussive blows to the head, blows which athletes in youth football, lacrosse, and, until recently, hockey, suffer on an almost constant basis in both games and practices.  Such evidence. while far from conclusive, has raised alarm bells among some in the youth sports community and prompted at least one leading concussion expert, Dr. Robert Cantu, MomsTeam's concussion expert emeritus, to recently recommend that kids not play such sports until middle or high school, at least under current rules.

On the other hand, while I personally think Dr. Cantu's recommendation is worthy of serious consideration, I don't believe parents who allow their kids to start or continue to play collision sports before middle school are engaging in child abuse.

Here's why:

  • All sports, whether collision, contact, individual or team, involves a certain amount of risk. Risk of injury is inherent to sport, and sport cannot be made completely risk free any more than riding around on a bike or running around on a playground can be made injury-proof.1  Kids can't live in a bubble, nor should they.
  • That doesn't mean risk can't and shouldn't be minimized wherever possible.  It should.  One of my principal missions, from even before MomsTeam was launched in 2000, has been to minimize the risk of injury in youth sports through training and education of sports parents, coaches and administrators, advocating for rule changes, and by urging the use of safer equipment.
  • While there is a level of risk at which a parent could be deemed guilty of child abuse - say, for instance, by allowing their child to return to the playing field knowing that they are still experiencing concussion symptoms, and thus recklessly exposing them to the risk of a further delay in concussion recovery, long-term brain injury, or even death from second impact syndrome - unless their recklessness is really that extreme, I believe the degree of risk they are willing to have their child take on is really up to them, such that exposing them to that risk is not, in my view, child abuse.

 

Knowledge is power

In the end, it all comes back to education: In the ideal world, a parent's decision about whether to allow a child to start playing or continue playing collision sports before high school under current rules of play (which are evolving in the direction of safety, fortunately, as seen, for instance, in USA Hockey's ban on body checking at the Pee Wee hockey level and below, and limits on full-contact practices instituted at every level of football, from Pop Warner, to high school, college, and the NFL), will be a conscious one; a decision in which the risks of participating in a particular sport - provided it is based on the most up-to-date information about those risks and a consideration of other risk factors that might come into play for their child, such as pre-existing learning disabilities (e.g. ADHD), chronic health conditions (e.g., a history of history of multiple concussions or seizures, history of migraines), or a reckless and overly aggressive style of play - are balanced against the  benefits to the child of participating.

Ultimately, our kids have to rely on their parents to make sure they are doing everything they can to minimize injuries by knowing the risks, and by making sure that, if and when they do suffer a sports injury, such as concussion, they receive appropriate treatment. More than that, I think, we cannot expect.  


Brooke de Lench is Executive Director of MomsTEAM Youth Sports Safety Institute, Founder and Publisher of MomsTEAM.com, producer/director of the PBS documentary, The Smartest Team: Making High School Football Safer, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins)  

1. The Centers for Disease Control's study on traumatic brain injuries in youth and high school sports and recreational activities agrees.  "Risk for TBI," it says, "is inherent to physical activity and can occur during any activity at any age."   Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR). Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged ≤ 19 Years -- United States, 2001-2009; 2011; 60(39):1337-1342 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6039a1.htm?s_cid=mm6039a1_e&s...)(accessed October 7, 2011).  Interestingly, riding a bike and playground were number one and number three on the list of activities resulting in emergency room visits for traumatic brain injury overall (8.1% and 7.9% respectively), second and third among males under age 19 (16.5%, 7.8%), second and first among girls (11.8%, 14.2%), and number one and two for boys and girls aged 9 or younger.   

MomsTEAM Institute of Youth Sports Safety, Inc. is a registered 501(c)(3) tax-exempt organization which relies on donations from readers like you. Help us continue to provide the best in youth sports safety and parenting information by making a donation today.  

 

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Chronic Under-Reporting Of Concussion: Is Changing The Culture A Realistic Solution?

 

If your child plays a contact or collision sport, whether at the youth, middle school or high school level, odds are that at some point in their athletic career they will suffer a concussion. How well they recover depends a lot on how quickly their concussion is identified so they can be removed from practice or game action. 

A lot of student-athletes - a declining percentage, fortunately - don't appreciate precisely when they have suffered a concussion. There are a lot of reasons:

  • the symptoms may not appear right away (as one recent study of college athletes  (1) found, 23% of diagnosed concussions were delayed, on average, 17 hours, and another 27% had unspecified onset (1,2), or  
  • they don't know the symptoms, or
  • they are not functioning at their cognitive baselines and do not recognize they have suffered an injury (2) or 
  • because they don't appreciate that concussions, however mild, are traumatic brain injuries (3,4,5), or 
  • because they still believe that a  loss of consciousness (LOC) is required for a concussion (again, the message that a concussion doesn't require LOC, and that, in fact, the vast majority of concussions - 90-95% of all concussions in high school sports - do not involve LOC, seems to be sinking in). (6)

Code of silence

Unfortunately, the problem is that, even for athletes who realize that they have suffered a concussion, there is still a very good chance (more than 50% in one oft-cited 2004 study (4) but probably much higher) they won't self-report symptoms to sideline personnel, much less voluntarily remove themselves from the game.  

Why?

For a variety of reasons, it seems, but mostly, I think, because the very culture of the contact or collision sport they are playing, and their own self-concept as invincible, strong adolescents, encourages them to remain silent:

  • to avoid jeopardizing their spot in the starting lineup or letting their teammates down; (3)
  • to avoid being seen as weak or cowardly by their coach or teammates, or even their parents; (3)
  • to demonstrate to the coach and their teammates that they can "take a hit like a man,"
  • to show that they can be as tough as their professional heroes;
  • because they fear they will be held out of play; (7
  • because they want to win the game at all costs; orThe Smartest Team
  • because they believe that the glory of individual and team success, the promise of a college scholarship, or the lure of a lucrative professional career, is somehow worth the risk of lifetime impairment from continuing to play with concussion symptoms.

That all of these forces conspire to prompt kids to be reluctant, indeed, unwilling to self-report concussion symptoms was driven home to me during the filming of MomsTEAM's PBS documentary, The Smartest Team.  Nearly every football player I interviewed for the film freely admitted that they would not self-report concussion symptoms.  Here is just a sampling of what they told me:

  • "If I can get up and walk away from it, yeah, I'll probably keep playing."
  • "You see some dots and they go away ... so you just keep playing through it. It's my senior year."
  • "As long as I can still see and keep my balance, as long as I'm not feelin dizzy, head injuries are all right."

I have been hearing and reading a lot lately about how we need to "change the culture" of football and encourage honest self-reporting by athletes of concussion.  It is seems clear from the research that if players don't tell anyone that they or a teammate are experiencing concussion symptoms and continue to play, they are increasing the chances their recovery will take longer, and, worse, expose them to increased risk of an even more serious brain injury, or, in very rare circumstances, catastrophic injury or even death from second impact syndrome.

Several years ago, HBO's Real Sports did a segment on high school sports concussions featuring the tragic story of Ryne Dougherty, a Montclair, New Jersey football player who died in 2008, likely from second impact syndrome, when he suffered a blow to the head when he returned to play, despite having confided to teammates that he was still experiencing headaches from an earlier concussion.

As needless as Ryan's death was, even more shocking was that his teammates, when asked if, knowing what they knew now about the dangers of playing with concussion symptoms, they would still hide their concussion symptoms in order to play, they still all answered without equivocation, "Yes."

Indeed, an ESPN poll of players, coaches, parents and athletic trainers in 23 states (8) found that players  - the ones whose brains are being rattled and who are putting themselves at risk of adverse long-term health consequences from concussions - are still the group least concerned about concussions. (Again, it's not surprising: teenagers all think they are invincible, which leads them to engage in a lot of risky behaviors)

When asked whether, if a star player got a concussion, they would rather lose the state title game as he sat out than win it because he chose to play with a concussion, more than half (54.1%) of the 300 players in the ESPN survey said they would play the star compared to 9% of athletic trainers, 6.1% of parents, and 2.1% of coaches. A majority of players (55.4%) also felt that a headache - far and away the the number one reported symptom of concussion - shouldn't disqualify them from returning to the same game.

The survey results were consistent with my anecdotal experience in talking to players for The Smartest Team.  Typical was what one player told me: "There was a time that I've gotten a concussion. I didn't think much of it, you know, just a headache, move on with it, keep playing. ... Got hit pretty hard, helmet to helmet, couldn't see, saw stars everywhere, just went back on the field, started playing again. Didn't, didn't need to tell anyone. I mean it's not like I was laying down, couldn't get up or anything. But I thought I was fine."   (He wasn't, of course, and should have told someone and removed himself, or been removed, from the game)

Yes, it is critically important that all athletes playing a contact or collision sport (including not only football, hockey and lacrosse, but soccer, basketball, cheer, and baseball), understand the symptoms of a concussion (things they feel) and appreciate the range of damaging health consequences they can suffer if they don't report them and keep playing, from making another concussion much more likely to long-term cognitive (concentration, memory, reasoning) and emotional difficulties (e.g. depression) to, in rare instances, catastrophic injury or death (e.g. second impact syndrome).  We should do everything we can to encourage honest self-reporting.  

We also need to encourage reporting by players about concussion symptoms being experienced by their teammates (One of the things I stressed at the players meeting back in June 2012 before the season began was the need for a "buddy system.")  My experience in Oklahoma gave me some reason to be cautiously optimistic that, by educating players and parents, and by enlisting the help of coaches, we can increase the number of athletes who are willing to self-report and use the buddy system.  

One of the players on the Oklahoma team we followed in the fall of 2012 appears in the documentary telling me that he had a friend on the line who seemed really "out of it" at practice one day.  When he told the coach, his teammate "got really mad."  But he was undeterred, because he "knew it was going to help [his teammate] in the long run." Another player told me that, "As far as the buddy system goes, I know that we need to keep each other's backs, like me and Matt have each other's backs as far as like, if I get a concussion or he had gotten a concussion, then you know, make sure he's OK. If he's out of it, you know, can't answer simple questions, go alert the coaches."

But while I saw some progress in terms of self-reporting and use of the buddy system during my time in Oklahoma, I don't think we can count on changing overnight a deeply entrenched culture as a panacea in solving the chronic problem of under-reporting.

In fact, the evidence continues to be that athletes are resistant to such culture change, despite increased education.  Two studies [reported after this blog originally appeared] (13,14)  by researchers at Cincinnati Children's Hospital (2) of 120 high school football players, 30 of whom had suffered a concussion,  found that, while three-quarters had received concussion education, and 9 out of 10 recognized the risk of serious injury if they returned to play too quickly:

  • an astounding 91 percent felt that it was okay for an athlete to play with a concussion
  • 75 percent said they would play through any injury to win a game
  • 53 percent said they would "always or sometimes continue to play with a headache sustained from an injury,"
  • Only 54 percent would "always or sometimes report symptoms of a concussion to their coach," and
  • Only 4 in 10 would tell their coach immediately if they had concussion symptoms. 
Were the athletes with more concussion education more likely to self-report? Sadly, no. Researchers found that athletes with higher concussion knowledge scores were not significantly more likely to have a better attitude about self-reporting than those with lower concussion knowledge scores.

Are impact sensors the solution? 

One possible way around the problem: to avoid relying on athletes themselves, game officials and/or sideline observers to call for a concussion assessment, but to instead employ real-time monitoring of head impact exposure (e.g. number, severity, location, and cumulative impact) at all levels of football, and other helmeted and non-helmeted contact and collision sports where practical, to allow for early recognition and management of brain injury. (9,11,12)  

"The identification of a potentially injurious impact or series of impacts via real-time monitoring of head impact exposure in athletes may [not only] facilitate the early recognition and management of brain injury in helmeted sports," argues Richard M. Greenwald, PhD of the Thayer School of Engineering at Dartmouth College, lead author of an editorial in the March 2012 Clinical Journal of Sports Medicine (9) but "permit early intervention, potentially in advance of an injury, rather than simply as a management tool post injury."

Benefits of real-time hit monitoring  

While monitoring will not eliminate brain injuries altogether, the benefits of early identification and prevention of further injury are numerous:

  • Sideline personnel will benefit from objective data that might inform their medical decisions; [9,11,12]
  • Parents will benefit from reduced reliance on honest self-reporting of concussion symptoms by athletes and of the observational skills of sideline management in spotting signs of concussion;
  • Teams will benefit by having healthy, unimpaired athletes on the field more often; and
  • The student-athlete and professional athlete will benefit the most from reduced exposure to potentially injurious blows and from the "conundrum of having to self-report an injury that they may not recognize as being potentially injurious or dangerous in the moment of competition."  

As co-founder of Simbex, LLC, the Lebanon, New Hampshire company that makes the HITS (Head Impact Telemetry System) - a peer-reviewed, scientifically-validated technology used by researchers in biomechanical studies to measure head impacts on the playing field - Greenwald knows a thing or two about the technology of head impact exposure monitoring.  That his company might benefit from the widespread monitoring he and his colleagues at Simbex propose in the editorial, however, does not make their recommendation any less important. 

Writing about head impact sensors in the March 2013 issue of the British Journal of Sports Medicine (11) Jeffrey S. Kutcher, MD, of the Department of Neurology and Michigan Neurosport at the University of Michigan, observes that the "development of easily deployable sport equipment-based accelerometer systems ... provide[s] two unique and potentially useful, clinical opportunities:

The first is the ability to monitor impacts during the course of an athletic event for the purpose of screening for potential injury. Although many researchers have analyzed impact counts and characteristics across a variety of settings in the hopes of establishing force 'thresholds' for injury, no such threshold has been discovered.  As efforts to improve impact-monitoring accuracy continue, however, so will the search for the 'concussion threshold.'  At the same time, there may be a separate, but similar role for the real-time tracking of impact forces.  Although an on-board accelerometer system may not be able to accurately predict injury, it may have utility as a screening device by alerting sideline personnel of an impact that has occurred above a predetermined magnitude that triggers either observation or clinical evaluation of an athlete.  Although there are currently no published studies to support the use of impact sensor systems in this manner, and a 'concussion threshold' is unknown, the potential clinical utility should be carefully considered.

The second potential clinical benefit of impact monitoring systems stems not from the idea of monitoring impacts for the presence of an acute injury-generating hit, but from the potential advantage of acruately cataloguing the number of hits and post-impact head acceleration being experienced by an athlete over time.  Some have suggested that the idea of a 'hit count' that is kept for athletes over the course of a game, practice, week, month, season or career.  This concept is fairly new and, as yet does not have published data to suggest that any particular level or number of hits has significant clinical meaning for any particular sport or position.  Nonetheless, individual athletes may feel there is a benefit to having an estimate of forces their brain experiences over time. 

Head impact monitoring systems 

The day when monitoring of head impact exposure in football and other helmeted sports becomes commonplace may be closer at hand than one might think, as a number of helmet sensor products are already on, or about to come on, the market designed to capture the kind of data that not only Greenwald and his colleagues, but other concussion experts say is needed as a way around the underreporting/under-identification problem.

Watch this space. 

October 24, 2015 update: While the number of impact sensor products on the market or in development has grown exponentially since I wrote this blog back in February 2013, my direct, first-hand experience working with a host of sensor manufacturers and teams at both the high school, and for the past two years, at the youth football level, leads me to believe that, cost, reliability, specificity and sensitivity hurdles have pushed the day when widespread use of impact sensors as what one sensor company CEO called another "tool" in the concussion toolbox, or "another set of eyes" for an athletic trainer on the sports sideline to help him or her spot athletes who should be checked out for possible concussion, can be realistically achieved.  

While MomsTEAM and I continue to see sensors as holding out the promise of a technological solution to chronic under-reporting (which preliminary data collected during the 2014 season and presented to the American Academy of Pediatrics' 2015 Annual Meeting in Washington, D.C. suggests has not gotten better over the past ten years), our primary focus in the coming months and years to develop, under a NCAA-Department of Defense "Mind Matters Challenge" grant, a multi-media program designed to change the culture of sports from one of resistance to one of safety, and fight chronic under-reporting by working with coaches, athletic trainers, parents, and players to create an environment in which athletes feel safe in honestly self-reporting concussion symptoms.


1.  Duhaime A, Beckwith J, Maerlender A, McAllister T, Crisco J, Duma S, et. al. Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets. J Neurosurg. 2012; 117(6):1092-1099 (epub ahead of print October 2, 2012. DOI: 10.3171/2012.8.JNS112298).

2.  Ellenborgen R. Sports and Concussion. J. Neurosurg. 2012;117:1089-191.

3. McGrath N. Supporting the Student-Athlete's Return to the Classroom After a Sport-Related Concussion. J Ath. Tr. 2010:45(5):492-498.

4. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players - Implications for prevention. Clin J Sport Med 2004;14:13-17.

5. Tomei KL, Doe C, Prestigiacomo CJ, Gandhi CD. Comparative analysis of state-level concussion legislation and review of current practices in concussion. Neurosurg Focus 2012; 33 (6):E11 (published online ahead of print)(accessed December 10, 2012).

6. Meehan W, d'Hemecourt P, Comstock D, High School Concussions in the 2008-2009 Academic Year: Mechanism, Symptoms, and Management. Am. J. Sports. Med. 2010; 38(12): 2405-2409 (accessed December 2, 2010 at http://ajs.sagepub.com/content/38/12/2405.abstract?etoc)

7. Echlin PS, Skopelja EN, Worsley R et al. A prospective study of physician-observed concussion during a varsity university ice hockey season: incidence and neuropsychological changes. Part 2 of 4. Neurosurg Focus 2012;33(6):E2. 

8. "Concussion Confidential"ESPN The Magazine (http://sports.espn.go.com/espn/news/story?id=5925876)(accessed December 21, 2010).

9. Greenwald R, Chu J, Beckwith J, Crisco J.  A Proposed Method to Reduce Underreporting of Brain Injury in Sports.  Clin J Sport Med2012; 22(2):83-85.

10. Kaut KP, DePompei R, Kerr J. Congeni J. Reports of head injury and symptom knowledge among college athletes: implications for assessment and educational intervention.  Clin J Sport Med 2003;13:213-221. 

11. Kutcher J, McCrory, Davis G, et al.  What evidence exists for new strategies or technologies in the diagnosis of sports concussion and assessment of recovery?  Br J Sports Med 2013;47:299-303. 

12. Broglio SP, Eckner JT, Surma T, Kutcher JS. Post-Concussion Cognitive Declines and Symptomatology Are Not Related To Concussion Biomechanics in High School Football Players.  J Neurotrauma 2011;28:1-8. 

13. Anderson B, Pomerantz W, Mann J, Gittelman M. "I Can't Miss the Big Game": High School (HS) Football Players' Knowledge and Attitudes about Concussions. Paper presented at the Annual meeting of the Pediatric Academic Societies, Washington, D.C. May 6, 2013.

14. Wall Street Journal (2013). Study Raises Concerns That Teen Athletes Continue to Play with Concussion Symptoms (http://online.wsj.com/article/PR-CO-20130506-904595.html)(accessed May 7, 2013)  

Note: this blog was updated on May 9, 2013 to reflect the new Cincinnati Children's Hospital study and to include information about impact sensors as a technological end-around the problem of chronic under-reporting.

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17th Annual Mother's Day Wish List

It's Mothers Day once again. Time for spring sports, warmer weather, longer days, planting gardens, and, of course, watching kids play sports. Each year for the past seventeen years, MomsTEAM has published my Mother's Day Wish list. As you will see, many of the wishes on this year's list will look very familiar to long-time visitors. 

More moms: I wish that ... instead of being a "No-Mom's Land" in which a mother's only job is to chauffeur the kids to and from practices, support their kids from the bleachers, and run concession stands, youth sports could be a place where as many mothers as fathers are invited to be coaches, administrators, and members of boards of directors of youth sports organizations locally and nationally. This has

 been on my wish list forever.  My anecdotal experience over the years is that youth  sports organizations with equal or close to equal numbers of women and men in leadership roles actually provide a safer youth sports experience to our kids in just about every aspect: physically, sexually, psychologically and emotionally. Unfortunately, the evidence suggests that, if we are making progress in this area, it is painfully slow.  The fact is that men pretty much continue to run the show.

Mom with a team of kids

Redefine competition: I wish that ... instead of defining competition solely in terms of winning and losing, youth sports could also reflect a mother's belief that, while competition is healthy and necessary, a successful competition is one where all players do their best and respect their teammates, opponents, and the rules.  This used to be almost universally true in sports for kids in elementary school, but now? Not so much. To say that it is a disturbing trend that needs to be not just stopped but reversed is an understatement.   

Sports for all: I wish that ... when a mother signed a child up to play sports, she knew that her child would be given a chance to continue playing right through high school, regardless of ability, not excluded by a youth sports system designed to cater to the elite few. Again, if anything, things on this front are getting worse, not better, with more and more intense competition for roster spots for elite or travel teams at ever earlier ages. 

Stop the abuse: I wish that ... youth sports were a place that provided the kind of nurturing, caring, and inclusive environment mothers know intuitively their children need to grow into confident, competent, empathetic, and emotionally and psychologically healthy adults, instead of a place where physical, emotional and even sexual abuse of children is too often viewed as the price children have to pay in order to play.  

Listen to moms: I wish that ... mothers could feel safe in challenging the status quo by registering their concerns about safety issues, an abusive coach, an unfair team selection process, the lack of women leaders, or the unhealthy overemphasis on competition, aggressiveness and winning instead of being afraid that, if they speak up, their children will be ostracized.

Restore balance: I wish that ... more mothers felt empowered to just say no, to reject the all too common belief that more (more teams, more practices, more intense and competitive games) and earlier (travel teams at age seven) are better, and instead to trust their intuition that, when it comes to youth sports, less is more.

I wish that ... so many mothers didn't get sucked into the crazy vortex of competitive youth sports, where survival virtually requires that they become overly focused on and invested in their children's athletic success, and were able to find a healthy balance between sports and family life.

Again, I'm not sure things are getting any better on the sports/family balance front, but we'll keep on trying to help parents keep sports in a proper perspective. 

Better injury prevention: I wish that ... youth sports organizations did more to reduce the risk of catastrophic injury or death so that fewer mothers have to spend Mother's Day remembering a child who died because proper safety precautions such as anchoring soccer goal posts, strictly adhering to concussion return-to-play guidelines, and having an automatic external defibrillator at every game and practice, were not taken. Some signs of progress, but the overuse injury epidemic seems to be getting worse, not better.

Doing more

For the past 17 years, MomsTEAM has been providing sports parents, coaches, athletic trainers, and all youth sports stakeholders comprehensive and practical advice on how to make youth sports safer, saner, less stressful and more inclusive. But there is more, much more, we can and must do to improve youth sports safety.

To that end, we have been working with some of the top experts in sports injury prevention, diagnosis, and treatment, as well as experts in nutrition, heat illness and hydration, strength and conditioning, and coaching, and with leading academic institutions around the country, to develop a comprehensive set of best practices for youth sports programs called SmartTeams.  We piloted the SmartTeam program in the fall of 2014 with eight communities, and in 2015 returned for a second year to one of the eight (Grand Prairie, TX), and hope to roll out the full program in the fall/winter of 2017-2018.

Instead of highlighting all the problems that youth sports faces in the 21st century, our goal will be to celebrate programs, like the high school football program in Newcastle, Oklahoma featured in our PBS documentary, The Smartest Team: Making High School Football Safer, that are not just talking the talk, but walking the walk, by adopting best safety, nutrition, hydration, and organizational best practices.  Our goal is to provide sports parents with something akin to an "Angie's List" for youth sports; a way to know, when they register their child, that the program to which they are entrusting their child is one in which safety never takes a back seat to winning.

Two final wishes 

Which leads me to make two, new, wishes:

The first is that you share this blog, and spread the word about MomsTEAM, with all of the mothers in your life, because it will only be as a team of moms (and dads) that we can make the wishes we all have as safety-conscious parents come true.

And the second is that, if you believe that MomsTEAM has helped you as sports parent, if you have found the information and advice we have been providing free of charge these past 17  years useful, you consider making a donation in any amount, large or small, to The MomsTEAM Institute, the non-profit organization we established in 2013 to run MomsTEAM.com and the Smart Team program.  Your donations will not just allow us to continue to act as an independent, trusted source of objective information and advice on youth sports, but to do much more to keep our kids safe playing sports, so that next year, on Mother's Day, I can hopefully say that some of the wishes in my annual list have come true!

Thanks to all of you for supporting MomsTEAM, and remember this Mother's Day, as you watch your child play soccer, baseball, lacrosse, tennis, softball, or whatever sport they are playing this spring, that they need to Play Smart To Be Safe. 

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17th Annual Mother's Day Wish List from Brooke de Lench

It's Mothers Day once again. Time for spring sports, warmer weather, longer days, planting gardens, and, of course, watching kids play sports. Each year for the past seventeen years, MomsTEAM has published my Mother's Day Wish list. As you will see, many of the wishes on this year's list will look very familiar to long-time visitors. But a couple are brand spanking new:

More moms: I wish that ... instead of being a "No-Mom's Land" in which a mother's only job is to chauffeur the kids to and from practices, support their kids from the bleachers, and run concession stands, youth sports could be a place where as many mothers as fathers are invited to be coaches, administrators, and members of boards of directors of youth sports organizations locally and nationally. This has been on my wish list forever.  My anecdotal experience over the years is that youth  sports organizations with equal or close to equal numbers of women and men in leadership roles actually provide a safer youth sports experience to our kids in just about every aspect: physically, sexually, psychologically and emotionally. Unfortunately, the evidence suggests that, if we are making progress in this area, it is painfully slow.  The fact is that men pretty much continue to run the show.

Mom with a team of kids

Redefine competition: I wish that ... instead of defining competition solely in terms of winning and losing, youth sports could also reflect a mother's belief that, while competition is healthy and necessary, a successful competition is one where all players do their best and respect their teammates, opponents, and the rules.  This used to be almost universally true in sports for kids in elementary school, but now? Not so much. To say that it is a disturbing trend that needs to be not just stopped but reversed is an understatement.   

Sports for all: I wish that ... when a mother signed a child up to play sports, she knew that her child would be given a chance to continue playing right through high school, regardless of ability, not excluded by a youth sports system designed to cater to the elite few. Again, if anything, things on this front are getting worse, not better, with more and more intense competition for roster spots for elite or travel teams at ever earlier ages. 

Stop the abuse: I wish that ... youth sports were a place that provided the kind of nurturing, caring, and inclusive environment mothers know intuitively their children need to grow into confident, competent, empathetic, and emotionally and psychologically healthy adults, instead of a place where physical, emotional and even sexual abuse of children is too often viewed as the price children have to pay in order to play.  

Listen to moms: I wish that ... mothers could feel safe in challenging the status quo by registering their concerns about safety issues, an abusive coach, an unfair team selection process, the lack of women leaders, or the unhealthy overemphasis on competition, aggressiveness and winning instead of being afraid that, if they speak up, their children will be ostracized.

Restore balance: I wish that ... more mothers felt empowered to just say no, to reject the all too common belief that more (more teams, more practices, more intense and competitive games) and earlier (travel teams at age seven) are better, and instead to trust their intuition that, when it comes to youth sports, less is more.

I wish that ... so many mothers didn't get sucked into the crazy vortex of competitive youth sports, where survival virtually requires that they become overly focused on and invested in their children's athletic success, and were able to find a healthy balance between sports and family life.

Again, I'm not sure things are getting any better on the sports/family balance front, but we'll keep on trying to help parents keep sports in a proper perspective. 

Better injury prevention: I wish that ... youth sports organizations did more to reduce the risk of catastrophic injury or death so that fewer mothers have to spend Mother's Day remembering a child who died because proper safety precautions such as anchoring soccer goal posts, strictly adhering to concussion return-to-play guidelines, and having an automatic external defibrillator at every game and practice, were not taken. Some signs of progress, but the overuse injury epidemic seems to be getting worse, not better.

Doing more

For the past 17 years, MomsTEAM has been providing sports parents, coaches, athletic trainers, and all youth sports stakeholders comprehensive and practical advice on how to make youth sports safer, saner, less stressful and more inclusive. But there is more, much more, we can and must do to improve youth sports safety.

To that end, we have been working with some of the top experts in sports injury prevention, diagnosis, and treatment, as well as experts in nutrition, heat illness and hydration, strength and conditioning, and coaching, and with leading academic institutions around the country, to develop a comprehensive set of best practices for youth sports programs called SmartTeams.  We piloted the SmartTeam program in the fall of 2014 with eight communities, and in 2015 returned for a second year to one of the eight (Grand Prairie, TX), and hope to roll out the full program in the fall/winter of 2017-2018.

Instead of highlighting all the problems that youth sports faces in the 21st century, our goal will be to celebrate programs, like the high school football program in Newcastle, Oklahoma featured in our PBS documentary, The Smartest Team: Making High School Football Safer, that are not just talking the talk, but walking the walk, by adopting best safety, nutrition, hydration, and organizational best practices.  Our goal is to provide sports parents with something akin to an "Angie's List" for youth sports; a way to know, when they register their child, that the program to which they are entrusting their child is one in which safety never takes a back seat to winning.

Two final wishes 

Which leads me to make two, new, wishes:

The first is that you share this blog, and spread the word about MomsTEAM, with all of the mothers in your life, because it will only be as a team of moms (and dads) that we can make the wishes we all have as safety-conscious parents come true.

And the second is that, if you believe that MomsTEAM has helped you as sports parent, if you have found the information and advice we have been providing free of charge these past 14 plus years useful, you consider making a donation in any amount, large or small, to The MomsTEAM Institute, the non-profit organization we established in 2013 to run MomsTEAM.com and the Smart Team program.  Your donations will not just allow us to continue to act as an independent, trusted source of objective information and advice on youth sports, but to do much more to keep our kids safe playing sports, so that next year, on Mother's Day, I can hopefully say that some of the wishes in my annual list have come true!

Thanks to all of you for supporting MomsTEAM, and remember this Mother's Day, as you watch your child play soccer, baseball, lacrosse, tennis, softball, or whatever sport they are playing this spring, that they need to Play Smart To Be Safe. 

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Let's Celebrate Mother's Day By Recognizing Critical Role of Sports Moms

 

Ask the average person what special day is celebrated in May, and most will say Mother's Day. Ask sports fans who athletes most often thank when they are interviewed on television after a big win, and they are most are likely to say their moms. Now, ask someone in what month does the country celebrate National Sports Moms Month, and I bet you would be met with a lot of quizzical looks.

Fact is that there hasn't been such a month, at least one that I could find. So, in 2012, I decided to declare May to be Sports Moms Month.

Why? Because ever since I started MomsTEAM and began writing about youth sports seventeen years ago, I have made it one of my primary missions not only to recognize and celebrate the critical role that sports moms play in keeping our kids safe, in fighting to make sure they are treated fairly, and to helping sports mothers juggle the many 'hats' they don every day - as chauffeur, child psychologist, safety officer, nutritionist, or what one survey aptly put it, the "Chief Everything Officer" - but to encourage and empower mothers to take a more active role in youth sports.

Woman coach talking to T-ball players

While the sports landscape has changed dramatically over the past 40 years, with the sandlots of yesteryear replaced by multi-million dollar youth sports complexes and highly organized programs, what has not changed is the hardwired instinct of mothers to want to nurture and protect their children from harm.

But instead of continuing to serve as the primary guardians of our children at play - hanging out a city window to check on their kids playing stick-ball or kickball in the street below, or looking out into the backyard to monitor a group of ten-year old kids playing touch football - today's sports mothers are still found, far more often than not, sitting in the stands, working behind the concession counter selling snacks and raffle tickets, working as team administrators, or chauffeuring their kids to and from practice and games.

Although youth sports organizations say they want more women involved, the simple fact is that far fewer women coach youth sports than men. While the numbers vary, available research suggests that between 75% and 85% of volunteer youth sport coaches are still male, that nearly all of the team parent positions are held by women, and that very few head coaches of boys' teams (around 5% in one study) are female. The percentage of women on the boards of national sports organizations, with a few notable exceptions, is similarly paltry.

What I said ten years ago in my book, Home Team Advantage: The Critical Role of Mothers in Youth Sports, remains true today: "The low numbers of women coaches at the youth level [persist] despite factors that would otherwise suggest a greater number, including the greatly expanded opportunities for girls in sports, the fact that ... today's women came of age in a post-Title IX world in which many of them played sports, and that women vastly outnumber men in every other volunteer activity involving their kids (PTA, Scouts, special events at school etc.)."

Persistent gender gap

What explains this persistent gender gap? I argued in Home Team Advantage that the "absence of women coaches and administrators is a vestige of the sex-segregated sports system that existed before the passage of Title IX. The old-boy network in sports is still very much alive and well. ... Too many men still hew to the gender stereotype that males are more competent and authoritative."

In a 2009 study, researchers at the University of Southern California, led by sociologist Michael Messner, essentially agreed with what I, and no doubt many mothers, know from our own experience: that it is simply the "natural extension of gendered divisions of labor in families and workplaces, ... not simply from an accumulation of individual choices; rather, [but] produced ... and shaped by gendered language and belief systems [that] are seen by many coaches as natural extensions of gendered divisions of labor in families and workplaces."

As Messner and his USC colleagues observed, sports are framed as a "realm in which girls are empowered to exercise individual choice (rehearsing choices they will later face in straddling the demands of careers and family labor), while continuing to view boys as naturally 'hard-wired' to play sports (and ultimately, to have public careers).... In short, [youth sports] initiates kids into an adult world that has been only partially transformed by feminism, where many of the burdens of bridging and balancing work and family strains are still primarily on women's shoulders. Men coaches and 'team moms' symbolize and exemplify these tensions."

I have been arguing for years that the dearth of women coaches in youth sports is problematic because it translates into fewer role models for female athletes and fewer future coaches. The problem is compounded by the fact that female athletes, having become used to being coached by men and having only rarely been coached by women, seem to favor male coaches and perceive them as more competent and authoritative.

Not surprisingly, the USC study reported that many of the men surveyed scoffed at the thought of women coaching youth sports teams and simply assumed that it was the job of men to coach and take leadership positions and for women to work behind the scenes in a supporting role as team moms. (This is precisely what I experienced when I offered to coach a boys' soccer team).

Writing in the April 2015 online edition of the Canadian Journal for Women in Coaching, Nicole LaVoie, Associate Director of the Tucker Center for Research on Girls & Women in Sport at the University of Minnesota, and Sarah Leberman, a professor at the Massey University in New Zealand, echo these same themes. The "lack of gender balance in the youth coaching ranks," they say:

sends the wrong message to children and youth about power, gender, and leadership and reinforces the notion that sport is male-dominated, male-run, and male-centered. For children, who are impressionable, seeing mostly men in positions of power in a context that matters a great deal to them, does little to challenge and change the status quo. A lack of women coaches also means girls have few, if any, active female role models, therefore making it less likely that girls will view coaching as a viable and available career pathway.

Missing piece of puzzle 

I have long argued that mothers are the missing piece in the youth sports puzzle, and advocated in favor, not only of more women as coaches, but more women on the boards of youth sports organizations, from national governing bodies all the way down to the local level, even in such boy's sports as football, baseball and hockey. I continue to believe that it will only be when gender parity is achieved in positions of power in youth sports that its full potential will be realized for all our children.

It is long past the time for such change. As I wrote in Home Team Advantage:

"The ... million[s] of mothers of kids in sports represent an incredible resource. [They need] to reclaim their natural role as guardians of [their] children at play and confidently step onto the out-of-control playground of today's youth sports to assume whatever role they choose, whether it be as parent, coach, team administrator, member of the board of directors of the local youth soccer club, or community activist. ... The ... climate in sports will inevitably change for the better when more women take an active role in youth sports and roll up our sleeves to work for change. From my work deep in the trenches of youth sports, I know that there is a solution-oriented community of mothers in this country ready and eager to take a much more active role in youth sports."

So, as the nation celebrates Mother's Day this year, we should give a special thanks to all the mothers who play such a critical role in youth sports, and commit to valuing their contributions, not just for one day or one month but all year long, and to working to create a youth sports environment that is more inclusive and welcoming of women, particularly mothers, and gives them the opportunities to take leadership and coaching roles. 


Brooke de Lench is Executive Director of MomsTEAM Youth Sports Safety Institute, Founder and Publisher of MomsTEAM.com, Producer/Director of The Smartest Team: Making High School Football Safer, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins). You can follow Brooke on Twitter @brookedelench.

Originally published on Huffington Post on Friday, May 1, 2015. 

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Texas Youth Football and Cheer Program: Ten Ways It Is Walking The Talk On Safety

Participation in youth sports in general, and in youth football in particular, is on the decline in some parts of the nation.  One of the biggest factors driving the decline is a concern about injuries. 

Lots of youth sports programs say they want to improve safety, but how many are actually making the effort to implement best health and safety practices?

I can't speak for every program, but I know one that is definitely walking the talk: the youth tackle and flag football and cheer program in Grand Prairie, Texas, where I spent the first week of August in 100 degree heat (the first thing I did when I arrived was to buy a pallet of water at a local big box store!) working with a group of leading experts I invited in to help educate and train 2,500 young tackle, flag and cheer athletes, parents, coaches, and administrators in the program on ways to make football and cheer safer as part of our MomsTEAM Institute of Youth Sports Safety's SmartTeamsTM | UNICEF International Safeguards of Children in Sports project. 

What are some of the ways to make youth football safer? Here are ten specific steps I encouraged the Grand Prairie program, as an independent youth football program not affiliated with USA Football or Pop Warner, to take to provide a safer and more enjoyable experience for its players:

  1. Adopt and periodically practice a comprehensive Emergency Action Plan: As I emphasized in my meetings with the Grand Prairie board, one of the most important steps it could take to protect the safety of athletes, spectators, coaches, and officials in case of a medical (serious head, neck or spine injuryheat stroke\ or weather emergency (e.g. lightningexcessive heat) was to develop, implement, and practice an emergency action plan (EAP). To emphasize the point, we ran a mock emergency drill my last day in Texas.  Because many youth sports programs, such as Grand Prairie, lack the resources of school-based programs to pay a certified athletic trainer to be at games and practices, I emphasized the need for Grand Prairie to look for volunteers such as school nurses, RN's, LPN's, EMTs, or nurse practitioners or  medical doctors (either parents with kids in the program or from the community) to help fill the gap.Brooke de Lench with Grand Prairie Texas youth football players
  2. Strongly encourage parents to make sure their child has a pre-participation physical evaluation.  In his presentation to the Grand Prairie parents, Dr. Jim McDonald, a pediatric sports medicine medical doctor at Nationwide Children's Hospital and  Ohio State, encouraged them to make sure their child had a pre-participation physical examination, including the taking of detailed cardiac and concussion histories, even though a PPE is usually not required for participation in community-based sports.  Experts agree that a PPE is the primary means of identifying athletes at risk of sports injury and initiating preventative measures.
  3. Teaches  proper tackling and limit player-to-player contact during practices. As I did in 2012 while I was working with the high school football program in Newcastle, Oklahoma during the filming of my PBS documentary, The Smartest Team: Making High School Football Safer, I flew in Coach Bobby Hosea, the inventor of a revolutionary heads-free tackle training system now being used at all levels of the game, to teach safe tackling to the Grand Prairie players.  To the naysayers who believe teaching kids to tackle without using their heads, or that sensible limits on full-contact practices at the youth level, can't make the game safer, a new study in the Orthopaedic Journal of Sports Medicine shows that they can significantly reduce the number of concussions, not just in practices (where, in contrast to other levels of football, most concussions occur at the youth level), but also in games. 
  4. Makes sure that all helmets fit properly, and that used helmets have been properly reconditioned. An important part of my week in Grand Prairie, as was the case in 2012 in Newcastle, was a helmet fitting session in which an expert made sure that every player in the Grand Prairie youth football program started the pre-season with a properly fitted helmet and reminded coaches to check helmet fit periodically during the season.  I also made sure that all helmets were reconditioned prior to the season in accordance with the helmet manufacturers' recommendations, and also supplied thirty of the younger, smaller players with brand new, lightweight helmets to  evaluate  (citing a lack of data, the National Operating Committee on Standards for Athletic Equipment ("Nocsae") said in June 2015 that it had no current plans to issue a separate performance standard for youth football helmets; look for a future blog on that subject).Brooke de Lench and Grand Prairie youth football players
  5. Requires safety training. Most youth sports coaches are parent volunteers with little or no safety training.  To fill that safety gap, I arranged for an instructor from the local chapter of the Red Cross to hold training sessions for Grand Prairie parents and coaches in first-aid, CPR and the use of an AED
  6. Mandates comprehensive concussion education.  As I discussed in a previous blog, state laws requiring concussion education do not always cover community- based and independent sports programs.  I encouraged parents and coaches to take the free 30-minute online CDC Heads Up Concussion training courses, which MomsTeam Institute has endorsed. As a longtime advocate for mandatory concussion education meetings before every sports season, I walked the talk by flying in from Chicago a top sports concussion neuropsychologist. Dr Elizabeth Pieroth, to talk to the Grand Prairie parents and coaches about concussions, not just knowing the signs and symptoms but the importance of creating an environment in which players feel safe in reporting concussion symptoms to increase the likelihood that they will be immediately removed from games and practices.
  7. Has adopted conservative return to play guidelines.  As required by law in every state for school-based sports, independent and community-based programs should require players to obtain written clearance by a medical professional with concussion training and expertise before returning to play.  Many experts recommend that, because their brains are still developing, younger players should be held out of play longer than older athletes, some suggesting a minimum of three weeks after a concussion before returning to sports.
  8. Regularly inspects practice and game facilities. All programs should designate a parent or coach to regularly inspect practice and game facilities to make sure they are safe, including the cleaning of locker rooms to minimize the risk of communicable diseases (such as community-acquired MRSA.  Athletes, parents, and officials should be encouraged to immediately report any unsafe conditions.
  9. Conducts detailed background checks of all volunteers and paid staff. It is every parent's nightmare that their child might be a victim of a sexual predator while participating in youth sports. Unfortunately sexual abuse of young players has occurred in youth sports leagues of all kinds, as well as with individual coaches in individual youth sports.  Performing background checks on all volunteers is a powerful tool for protecting each player in your league. This safety measure is so important it needs to be required in all youth sports leagues.
  10. Follows the International Safeguards for Children in Sport. Adopted at the Beyond Sport summit in South Africa in 2014, the Safeguards are designed to help create a safe sporting environment for children wherever they participate and at whatever level, provide a benchmark to assist youth sports organizations and sports stakeholders to make informed decisions about safety, promote best practices and challenge practices that are harmful to children, and provide clarity on safeguarding children to all involved in sport.  As the head of a pioneer organization designated by UNICEF UK to help implement the Safeguards in the U.S, I will be working with the Board of Directors of the Grand Prairie youth football and cheer program on an ongoing basis to implement the holistic and process-oriented approach to youth sport safety the Safeguards recommend. 

I firmly believe that the best way to protect our children in sports is for an independent non-profit serving the interests of all youth sports stakeholders, not any special interest or group, to develop a program, such as we are doing with SmartTeamsTM,  free to incorporate best practice recommendations from a wide variety of sources, including UNICEF, leading medical societies, and governmental agencies such as the CDC, adapted, where appropriate, for use by youth sports programs that lack the resources of school-based programs.

If more sports programs, like Grand Prairie, were to implement these kinds of safety measures, I am convinced that the safety concerns of parents would be assuaged and the decline in youth sports participation could be stemmed, even reversed.

During the next few weeks I will have more to say about youth sports best safety practices and what weare doing with SmartTeams , but, in the meantime, remember that to play safe, we need to be smart!

 


Brooke de Lench is Founding Executive Director of MomsTEAM Institute, Inc., Director of Smart Teams Play Safe, Publisher of MomsTEAM.com, author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins), and Producer/Director/Creator of the PBS documentary, "The Smartest Team: Making High School Football Safer." Brooke is also a founding member of the UN International Safeguards of Children in Sports coalition.
She can be reached by email delench@MomsTeam.com, and you can follow her on Twitter @brookedelench. and email her at delench@momsteam.com

Note: This blog was first published on Huffington Post 

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U.S. Failure To Ratify UN Convention on Rights of the Child Is Embarrassing and Unacceptable

ORIGINALLY POSTED IN HUFFINGTON POST 10/9/15 

Ten days ago, as I was flying 30,000 feet above Jonesboro, Arkansas on my way back to Boston  from Dallas, I read about a statement issued by UN Secretary-General Ban Ki-Moon praising the ratification by the Government of Somalia of the United Nations Convention on the Rights of the Child. Noting that 196 countries had ratified the Convention, making it the most widely-ratified human rights convention in history, the Secretary-General went on to encourage the United States, as the only holdout, "to join the global movement and help the world reach the objective of universal ratification."

The Convention spells out the basic human rights that children everywhere should enjoy, among them the right to survival, to develop to the fullest, and to protection from harmful influences, abuse and exploitation. While its most obvious application is in combating such abhorrent practices as the 'recruitment' of child soldiers and the sexual slavery of teenage girls, and in protecting the rights of the thousands of children fleeing to Europe to escape war-torn Middle Eastern nations, the Convention also provides, in the words of a 2010 Unicef report, "the overarching framework that can guide those who provide and supervise sport for children," with application to such abusive practices as forcing children to train excessively and to engage in unhealthy and illegal behavior, such as the use of performance-enhancing drugs (Articles 3, 6, 19 and 24), ensuring that a child's right to an education is not overshadowed by considerations concerning a sporting career (Articles 3 and 28), and the economic exploitation of child athletes (Article 32).

UN Convention On The Rights of The Child 

As someone who has been advocating for ratification That I was reading the Secretary-General's statement after having just wound up four days of intensive work with a league of 1,200 youth football players and cheerleaders to implement the International Safeguards as part of my organization's SmartTeam program, and during National Bullying Prevention Awareness Month, made me feel that much worse.  

 

There has been a strong focus in recent years in this country on concussion safety in youth sports, much of it media-driven (all 50 states and the District of Columbia now have concussion safety laws).

Brooke with kids from Grand Prairie in SmarTeams program

Sadly, no similar, sustained effort has been made in this country to enact laws to protect children playing sports from abuse -- whether it be physical, emotional, psychological or sexual -- at the hands of coaches, parents and other athletes.

When reports, such as the 2010 Unicef study on violence and abuse in sports, are issued finding a troubling lack of awareness of and education on child protection issues among youth sports coaches, parents and other stakeholders, they receive absolutely no media attention in this country.

Why not?

It can't be because children playing sports in this country are immune from abuse, because they are not. The sad fact is that youth athletes are victims of violence and abuse in their myriad forms every day. Young athletes across the country are still forced to participate in physically injurious or sexually degrading hazing rituals; they're required to run punishment laps in 102 degree heat for being late to practice; and allowed, or often encouraged, to play hurt or return to the playing field too soon after a concussion.

Too many are victims of bullying, not just by other players but by coaches; sexually assaulted by their coaches; psychologically degraded or humiliated based on their gender, sexual orientation, body shape or performance; or required or encouraged to follow nutrition and weight loss regimens that lead to eating disorders and the abuse of appearance- and performance-enhancing drugs such as anabolic-androgenic steroids.

The kinds of abuse we see in youth sports would not be tolerated in the classroom or in the workplace. Yet there are no laws that specifically address such abuse in the context of sports, and no sustained lobbying efforts to enact such protections.

The lack of media attention and legislative action also can't be because youth sports organizations, whether they be at the national, regional or local level, are doing all they can to protect children against such violence and abuse. As the 2010 UNICEF study reports, while some other countries (most notably, the United Kingdom) have enacted child protection programs in sport, they are virtually non-existent in the United States.

A major part of the problem is that instead of defining youth athletes in a way appropriate to their needs -- as children first and athletes second -- organized youth sports in the United States and other industrialized countries all too often treat children as miniature adults, with potentially serious adverse consequences to their physical and emotional health. More and more parents seem to accept abuse as the inevitable price their children must pay to succeed in our winner-take-all-society.

Child abuse is the most preventable youth sport injury. Physical, emotional and sexual abuse should not be the price children have to pay to play competitive sports. The status quo should and must be changed. The United States should ratify the Convention on the Rights of the Child. Laws against child abuse should be strengthened in every state to protect against abuse, not just at home, but on the playing field, courts, diamonds and rinks of America. It is time for the abuse to stop. We owe the children of America nothing less.


Brooke de Lench is Founding Executive Director of MomsTEAM Institute, Inc., Director of Smart Teams Play Safe, Publisher of MomsTEAM.com, author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins), and Producer/Director/Creator of the PBS documentary, "The Smartest Team: Making High School Football Safer." Brooke is also a founding member of the UN International Safeguards of Children in Sports coalition.

She can be reached by email delench@MomsTeam.com, and you can follow her on Twitter @brookedelench.  

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