Why I'm Not a Football Apologist or Anti-Football Zealot: I'm a Pro-Safety Realist

As I await tonight's advance screening in Boston of Sony Pictures' movie, Concussion, which opens nationwide on Christmas Day, the polarized debate over football has once again reached a fever pitch.

In contrast to recent battles in the now 110-year war over football MomsTEAM Institute of Youth Sports Safety, the non-profit I have headed for the last fifteen years, is not merely an interested spectator this time around.

That's because Sony Pictures chose the Institute as its partner in its Dance or Donate #ForThePlayers social media campaign; an initiative designed not just to publicize the movie but to promote our 15-year effort to make youth football and all sports safer (which is why the Institute is hosting the Boston screening)

Like it or not, I have been drawn directly into the fray.

Not surprisingly, the Institute and I have been taking some pretty savage hits on social media from those who believe that any organization that fails to join the call for an immediate end to football as we know it in America is, by definition, their sworn enemy.

The truth is that I'm not a football apologist, CTE denier, or anti-football zealot. I am, and always have been, a pro-safety pragmatist.

With all due respect to Dr. Bennet Omalu, the hero of Concussion, a courageous and fellow truth-teller who I greatly admire, the reality is that, as terrible, frightening, and real as chronic traumatic encephalopathy, the neurodegenerative disease he discovered in the brains of former NFL players, 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, football is not going away any time in the foreseeable future, and, from all available evidence, is safer than it has ever been.

Personally, I believe kids should probably delay the start of tackle football until middle or high school. If I knew back when I had a son playing middle and high school football - a son who was forced by sports-related concussions to retire from both football and lacrosse before his junior year - what I know now, I would not have let him play. Knowing what I know now about the risks of football, 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.

Or I could tell parents deciding whether to let their child start playing tackle football that, 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, parents, and players about concussions, supplying players properly reconditioned and fitted helmets, 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.

Because millions of athletes, from Pop Warner to the NFL, will continue to play the game, I decided that my job, as it has been for the last 15 plus years, isn't to sit in front of a computer all day, questioning the morals, ethics, or motivations of those involved in the never-ending effort to make sports safer. It is instead, as I like to say, to work in the trenches - to lace up my Asics every morning, talk to youth sports coaches on the sidelines, climb into the stands to talk with moms and dads during practice and games, attend their board meetings, and, above all, to work with top experts in their fields to continue to provide every youth sports stakeholder with the latest and most comprehensive and objective information about the risks of playing contact and collision sports such as football (and soccer, and lacrosse, and hockey).

I have chosen to work to make sports safety through education and grass roots activism: to educate every sports stakeholder about the steps that can be and are being taken to reduce the risks of traumatic brain injury, not just from concussion but the cumulative effect of repetitive head trauma; and how those risks can be further minimized through a comprehensive traumatic brain injury risk management program focusing on early concussion identification, immediate removal from play, appropriate treatment, conservative return to play, and retirement from contact sports when the risk of continued play becomes unacceptably high.

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 - it is hard for anyone like I am who occupies the reasonable, pragmatic, pro-safety middle to be heard above the maddening crowd.

The challenge I face - that all those of us who love, not just the game of football, but all sports and are dedicated to making them safer - is having our message 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 the last 15 years 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 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 fifteen years have looked, and continue to look, to MomsTEAM 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 engaging in the politics of emotion and innuendo, who hide behind dummy Twitter handles, who will prevail. It will be those who discuss the risks and benefits of sports calmly, rationally, and objectively, who work tirelessly to make sports safer, based on science, who will win out.

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



Seven Days In November: Concussions 24/7

It's been a very busy seven days.  Pretty much, all football, all concussions, all the time.

It began with a trip to Washington, D.C. to participate in last Friday's Aspen Institute roundtable on the future of youth and high school football, and back home.

Saturday and Sunday were spent getting the trailer for the new MomsTEAM football documentary, The Smartest Team,  uploaded to a new website.

On Monday morning, after sharing my thoughts on Aspen, I turned my attention to preparing for a quick trip to Austin, Texas on Wednesday, where I was the after-dinner speaker at the end of a symposium on concussions put on by Core Health Systems.

Yesterday, I returned to Boston just in time to attend a lecture by NFL Commissioner Roger Goodell on football safety at the Harvard School of Public Health.

Today (it's Friday, right?), I am finally back at my desk trying to make sense of it all, including catching up on everything that has been written about the Aspen Institute roundtable and on reports about the way in which the concussions suffered by three NFL quarterbacks on Sunday were handled.

One of the Aspen and NFL concussion post-mortems I found particularly provocative was by Mike Wise, a columnist for The Washington Post.  While I am not prone to writing in the somewhat snarky and definitly sarcastic tone Wise employed in his Tuesday column, and although he seemed to mostly align himself with the group at Aspen - led by Dr. Bob Cantu - that views football as too dangerous to be played before the age of 14 (a position with which I respectfully disagree),  I did find myself agreeing with what seemed to be his main point: that whatever measures are instituted to protect player safety will get us nowhere if the culture on NFL fields (and by extension, the high school, middle school, and youth gridiron) doesn't change. If the long-since discredited language of "shake it off'" and "getting dinged" persists; if players aren't willing to self-report concussion symptoms; and, when on rare occasion they actually do, the coaches and medical personnel on the sideline don't take a lot more cautious approach in concussion management and pay more than lip service to the mantra of "When in doubt, sit them out," well, then, football may be in for a world of hurt. 

In reading reports about how the concussion suffered by San Francisco 49er Alex Smith was handled, or, in the view of many, including Wise, mishandled, I was particularly struck by remarks attributed to Coach Jim Harbaugh as to why he allowed his quarterback Alex Smith to take six more snaps (ending, amazingly, in a touchdown pass) after admitting that he was experiencing blurred vision from a head-rattling hit on a quarterback sneak.  "He felt [the blurred vision] would go away. He came over to the sideline and sat down and felt it would go away, and it didn't," said Harbaugh. "He told me he had blurred vision, and that's when we made the move [to sit him out for the remainder of the game]."  

The times they aren't a-changin' 

So let me get this straight: coach Harbaugh allowed Smith to keep playing with a clear symptom of concussion in the hope that his blurred vision would go away.  Trouble is that, even under the three concussion grading systems in most common use in the 1990's and early 2000's (Dr. Bob Cantu's 2001 so-called "evidence-based" guidelines,1 the 1991 Colorado Medical Society (CMS) guidleines,2 and the 1997 American Academy of Neurology (AAN)3 guidelines) - all of which have long since gone the way of the dodo, by the way - and even if Smith's blurred vision had cleared up in less than 15 minutes, which, as it turned out, it didn't, he still would have been considered to have sustained a Grade 1 or mild concussion. That concussion should have ruled out any return to play last Sunday, not just while he was still experiencing symptoms, but even if they had cleared up.  His return to play would have been prohibited by law in the 41 states and the District of Columbia that have put in place - most at the urging and with the support of the NFL - of so-called Zackery Lystedt laws.  

Clearly, Harbaugh's mindset is still the rule not the exception, shared not only by current players and coaches, but former players sitting in the broadcast booth.  As Wise notes in his column, when Bear quarterback Jay Cutler went down after a helmet-to-helmet blow and yet stayed in the game against the Houston Texans (for a photograph of Cutler's Bears teammates helping their stunned and groggy QB to his feet after the hit, click here), NBC analyst Cris Collinsworth "paid him homage, calling Cutler, 'a real Bears quarterback," and "added that a review of the play would give Cutler a chance to 'clear the cobwebs' before action resumed."  

In other words, it was perfectly okay, in the view of Collinsworth, and Harbaugh, and in the macho culture of football, from Pop Warner to the NFL, for a player to suffer a concussion, but, as long as the "cobwebs" (e.g. confusional state) or the blurred vision (a symptom of concussion experienced by 37.5% of concussed high school athletes in a recent study) cleared up, it is somehow okay to send the player right back onto the field.

News flash: It is NOT okay! To Wise, the "only way real change happens is if Jim Harbaugh doesn't leave Alex Smith in that game for six more plays; if Cris Collinsworth skewers the Bears' medical team for not checking on a groggy Jay Cutler; if Ray Lewis tells kids, via a PSA, why hard hits are okay and headhunting isn't; and, yes, if Drew Brees, a son of football-made Texas, has the guts to tell America his kid isn't playing tackle football before age 14."  

I couldn't agree more, even on Wise's last point about Drew Brees.  My position has consistently been and continues to be that it is up to parents to make decisions about their own kids' safety, and that the best thing I, MomsTEAM, the CDC, concussion experts, coaches, athletic trainers, and national governing bodies for football, from Pop Warner to USA Football to the NFL, can do is to (a) continue to do what we can and are doing doing to make the game safer (and that there remains a great deal of work to be done in this area is undeniable); and (b) provide accurate, objective information about the risks so that such decision is an informed one, not one driven by fear.

Biggest challenge 

Which brings me to Roger Goodell's lecture yesterday at the Harvard School of Public Health.  As the Twittersphere and today's Boston Globe reported, and as I was glad to make it back to Boston to hear him say in person, Goodell recognized that changing the culture of the NFL was not only his most important mission as commissioner but also the "biggest challenge" the league, and by extension, football at every level, faces.  Goodell acknowledged that the culture of silence is alive and well; that too many players still hide concussions, and have a "play through, rather than a play safe mentality."    

But, as one who who believes, like an increasing number of concussion experts, that the best way to increase the chances that a concussion will be identified immediately after injury is to utilize a technological "end-around" the problem of chronic under-reporting by players, I was also heartened to hear Commissioner Goodell talk about how the league is testing the use of accelerometers (e.g. hit sensors) in helmets and even in shoulder pads, not to replace self-reporting of symptoms by players or detection of concussion signs by sideline personnel or in the booth, but as another "tool in the concussion toolbox" or another pair of eyes.  

If I have learned anything over the past twelve years of following the advances in our knowledge of concussion, both in terms of reducing the risk and in terms of better identification and post-concussion management and return to play, it is that an "all-of-the-above" strategy is the one that we need to employ because it has the best chance of making the game safer. 


1. Cantu RC. Posttraumatic retrograde and anterograde amnesia, pathophysiology and implications in grading and safe return to play. J Athl Train. 2001;36(1):244-248.

2. Colorado Medical Society. Report of the Sports Medicine Committee: Guidelines for the Management of Concussions in Sport (Revised). Denver, CO: Colorado Medical Society; 1991.

3. American Academy of Neurology. Practice parameter: the management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1997;48(3):581-585.

4. Halstead, M, Walter, K. "Clinical Report - Sport-Related Concussion in Children and Adolescents"  Pediatrics. 2010;126(3):597-615.

Pediatrics Group's Position on Tackling in Youth Football Strikes Right Balance

Last month, the American Academy of Pediatrics (AAP) endorsed efforts to limit contact practices in youth football, but declined to make a clear recommendation in favor of delaying the age at which tackling is introduced. The AAP likewise refused to support those calling for an outright ban on tackling in football for athletes below age 18, unwilling to recommend at this time such a fundamental change in the way the game is played.

Youth football players stretching

Writing for the AAP's Council on Sports Medicine and Fitness, William Meehan, M.D., Director of The Micheli Center for Sports Injury Prevention at Boston Children's Hospital, MomsTEAM concussion expert emeritus, and an expert featured in our PBS documentary, The Smartest Team: Making High School Football Safer, along with co-author, Gregory Landry, M.D., a professor of pediatric and adolescent primary care sports medicine at the University of Wisconsin School of Medicine and Public Health, recognized that head and neck injuries in football have been a topic of "intense interest recently in both the public media and the medical literature."

They acknowledged that safety concerns -- especially about the risk of concussions and catastrophic injuries -- have led to a drop in football participation, and likewise recognized that the potential for adverse long-term health consequences from multiple concussions and repetitive head impacts (RHI) had not only prompted calls for limits on the number of full-contact practices and a delay in the age in which tackling is introduced, but for an outright ban on tackling in football.

Noting that the effect of RHI on long-term cognitive function, the incidence of chronic traumatic encephalopathy (CTE), and other health outcomes remains "unclear," and that further research was needed, the group nevertheless endorsed efforts to reduce the number of impacts to the head in football because, "Repetitive trauma to the head is of no clear benefit to the game of football or the health of football players."

The AAP saw in a delay in the age at which tackling is introduced both benefits (a likely decrease in risk of injury) and potential risks (once tackling was introduced, athletes lacking tackling experience might be exposed to an increased risk of injury). The group therefore decided that no "informed recommendation" could be made until further investigation into the effects of delaying the introduction of tackling until a certain age could be made.

Despite recognizing that an outright ban on tackling would likely lead to fewer injuries of every kind (e.g. overall injuries, severe injuries, catastrophic injuries, and concussions), the AAP decided against recommending a complete ban on tackle football, largely because removing tackling from the game would lead to a "fundamental change in the way the game is played." The group thus left it to "participants" to "decide whether the potential health risks of sustaining these injuries are outweighed by the recreational benefits associated with proper tackling."

Step in right direction

As someone who has been working for 15 years to make youth football safer, I was glad to see the nation's largest and most prestigious pediatrics group support so many of the evidence- and expert consensus-based recommendations MomsTEAM and I have been making to improve the safety of the game, and which were featured in our 2013 PBS documentary.

Like the AAP, MomsTEAM has long supported limits on full-contact practices as a way not only to reduce concussion risk but RHI, which likely plays a role in the development of neurodegenerative diseases such as CTE.

Research presented at the AAP's meeting in Washington, D.C. last month shows that such limits actually work to reduce concussion rates at the high school level (where an increasing number of states have followed the 2014 recommendation of the National Federation of State High School Associations in imposing limits), just as an earlier study showed that such limits (adopted by Pop Warner in 2012) -- along with teaching USA Football's Heads Up tackling -- are working to reduce concussion risk in youth football.

That the AAP decided not to join those calling for delaying the age at which tackling is introduced in youth football was not surprising. As one who has been following the debate on this issue for a number of years, and based on my experience working with youth football programs around the country the past two seasons as part of our SmartTeams program, I think there are good arguments on both sides, and that the AAP was right not to call for such a delay in the absence of more research.

Likewise, the AAP's refusal to recommend an outright ban on tackle football at the youth, middle and high school because it would fundamentally change the way the game is played was not in the least surprising. Like the AAP, I have long held the view that the decision about whether a child should play tackle football, and at what age to start, should be left up to parents, in consultation with their child's pediatrician, based on an honest assessment of the risks associated with the sport versus the benefits of participation.

Recent research shows that teaching proper tackling and limits on full-contact practices, along with other safety measures, such as making sure helmets fit properly, and immediately removing players showing any signs or reporting any symptoms of concussion and not allowing them to return until cleared by a medical professional with concussion expertise (all of which are part of the evidence-based Six Pillars approach to concussion risk management featured in The Smartest Team) has made and continues to make the game of football safer.

Still work to do

But there is still a lot we can and should do. Despite the fact that helmet-first tackling was banned in 1976, the sad truth is that the rule is still not adequately enforced. Perhaps adding the AAP's voice to the chorus of those calling for stricter rules enforcement (the NFHS, for one, has strengthened its rules against "targeting" defenseless players, and "spearing") will finally result in concrete action to do just that.

Likewise, working to put athletic trainers on the sidelines at all tackle football games and practices is a goal almost universally shared by the sports safety community. The challenge, as I have found from my experience working the last two years with youth football leagues around the country, is that not all programs can afford the cost of an athletic trainer; even if they could, finding one to provide coverage on weekends (when most are busy staffing high school football games) can be difficult. Simply put, there aren't enough ATs to go around, with access to ATs in rural communities -- where football is almost a way of life -- presenting a particular challenge).

Thus, while a certified athletic trainer at every youth football game and practice is the gold standard which I have long supported, and we have made significant progress in recent years towards the goal of giving every high school athlete access to an AT (a 2015 study published in the Journal of Athletic Training pegs the percentage at around 70%), I believe, from a practical standpoint, that programs for younger football players (those ages 7 to 12), forced to choose between hiring an AT and shutting down the program, can probably get by with game day coverage from volunteer paramedics, RNs and LPNs, or medical doctors (as long as they have received training in the recognition of concussion), and even from parents and coaches who have completed the CDC's Heads Up program (as parents and coaches in our Grand Prairie, TX SmartTeams pilot program are taking, along with a Red Cross first aid, CPR, and AED course).

If an athletic trainer or health care professional with concussion training is not present, however, experts say that there are two essential ground rules which must be followed: first, if a concussion is suspected (in other words if an athlete exhibits any signs of possible concussion (balance problems, confusion, vomiting, dazed look) or reports experiencing any symptoms (e.g. headache, dizziness, memory problems etc.), the player needs to be removed from play, their helmet taken away, and barred from returning to play under any circumstances; and, second, if a concussion is suspected, the athlete must be referred for a full evaluation by a clinician; no layperson is qualified to determine that it is safe for an athlete to return to play, no matter what the results of a sideline test may say, even one marketed for supposed use by non-medical personnel.

The under-reporting of concussions by athletes, as Bill Meehan and fellow MomsTEAM Institute board member, Jim MacDonald, reported at the AAP conference in D.C. in October, continues to defy efforts to persuade more athletes to honestly self-report through education. That culture of resistance, and the win-at-all-costs attitude that is deeply entrenched in our sports culture, represents significant challenges to improving the safety of contact and collision sports. Change is not going to happen overnight.

But efforts, including by MomsTEAM under a NCAA-Department of Defense Mind Matters Challenge grant, are being made to move the culture of sports towards safety by working with the key influencers of an athlete's attitudes and behavior -- parents, teammates, and, above all, coaches -- to create an environment in which athletes feel safe in self-reporting and are confident that they won't be penalized for reporting by a loss of playing time or being viewed as weak.

A multi-pronged approach to football safety, such as advocated by the AAP in its Policy Statement, and by the experts with whom I work on daily basis, is working. We just have to keep not just talking the talk, but walking the walk.

Brooke de Lench is Executive Director of the non-profit MomsTEAM Institute, founder and publisher of MomsTEAM.com, producer of The Smartest Team: Making High School Football Safer (PBS), and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins). You can follow Brooke on Twitter @brookedelench and reach her by email at delench@momsteam.com.

Originally published on October 28, 2015 on Huffington Post.com  



When Bob Cantu Says No Collision Sports Before Age 14, Parents Need to Listen

The blockbuster announcement came across my desk two days ago, but it took me a while to process its full significance.  In fact, it may take me a while longer to fully appreciate all of its implications for youth sports.

Dr. Bob Cantu, MomsTeam's first concussion expert from 2000-2008, and someone I have known and respected for more than a decade, is recommending that kids under the age of 14 not participate in collision sports as currently played.  Youth football players stretching

That's right: Dr. Cantu, one of the nation's pre-eminent concussion experts, co-director of the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine, co-director of the Neurologic Sports Injury Center at Brigham & Women's Hospital, and co-founder, with Chris Nowinski, of the Concussion Legacy Institute (formerly Sports Legacy Institute), will detail in his forthcoming book a recommendation that kids should delay playing collision sports such as football, hockey and lacrosse (or that the rules be changed to reduce or eliminate head contact, such as flag, not tackle, football and no body-checking in hockey), to reduce the risk of developing chronic traumatic encephalopathy  (CTE), a degenerative neurological disease which leads over time to personality changes, memory loss, even dementia.  Early signs of CTE in the brains of 17- and 18-year olds, says Dr. Cantu, have been detected in the brains of kids who showed no symptoms when they were alive.

"The young brains are more vulnerable, they're less myelinated (the protective sheath - myelin - that develops around neurons), the necks are weaker, the heads are bigger proportionately so the forces that accelerate the brain need not be as high to produce higher acceleration," Cantu told Boston's WCVB-TV.

It's not just concussions that worries Dr. Cantu, its the accumulation of sub-concussive blows: "In fact, we've had a number [of brains] in our center who have had no recognized concussions at all, so its total brain trauma."

"We have millions of youngsters putting their heads into collision sports right now and we don't really know how safe this is for them," Cantu said.

Hopefully, the recommendation from Dr. Cantu will carry the necessary weight to have some real impact (pardon the pun) on the youth sports community.  MomsTeam and I have long advocated in favor of a delayed start to playing collision sports.  As early as 2006, when my book, Home Team Advantage, was published, I was trumpeting the recommendation of the American Academy of Pediatrics that children wait until middle school to play collision sports like football, and was writing about studies that, even then, showed that a "history of concussions and probably sub-concussive contacts to the head may also be risk factors for late-life memory impairment and mild cognitive impairment."

Tough choice for parents

So what is a parent of a young athlete who has been playing football since he was seven, or who is considering signing up their child for Pee Wee hockey for their child to do? 

Take Dr. Cantu's advice seriously. Seriously consider whether allowing your child to play collision sports at an early age is hazardous to their long-term health. Weigh the rewards and benefits of participation in collision sports against the now undeniable risks.

One thing that Dr. Cantu's recommendation makes clear is the need for better training of youth athletes, a view shared by  Rosemarie Scolaro Moser, Ph.D., sports neuropsychologist, founder of the Sports Concussion Center of New Jersey, and a MomsTeam expert. 

"A big consideration in all high risk sports is that at whatever age the youth transitions to contact or collision, whether 12, 14, 16, or 18 years of age, youth athletes will need to be trained to engage in safe, proper contact," Moser says . "Otherwise, lack of a proper program of training safe contact skill development will essentially defeat the purpose of setting an age designation.

That means we will need educated coaches to teach safe and proper skill contact development in practices, so that when the youth athlete transitions to game contact, he or she will be ready, at any age. We know that kids' brains are vulnerable, that youth concussion is a public health problem, and that the effects of concussion can be devastating. We also know that sports can play an important role in a child's overall development as a person. The question is, Can we provide the resources and support necessary to make all youth sports safer, whether the sport is considered a collision, contact, or noncontact sport?" 

The need for better training of youth and high school football players in proper tackling is a subject I also have been writing about for years. A recent NATA study shows that high school players are at greater risk for concussive events in part because they haven't learned proper tackling techniques. MomsTeam has consistently promoted the efforts of coaches like Bobby Hosea to teach players to use what he calls "Dip n' Rip" (a tackling technique in which a football defender stops the ball carrier with an upward thrust across the chest and shoulders, not by leading with his helmet).

Proper tackling technique needs to be taught at every level, from Pop Warner to high school. At least one concussion expert thinks it might eliminate up to half of football concussions at the youth and high school levels.  Because the risk of concussion triples among younger hockey players in leagues where body checking is allowed, USA Hockey recently banned the practice at the Pee Wee level.  Teaching how to absorb body contact in hockey is also something that expert groups, like the American Academy of Pediatrics, recommend as a way to reduce the risk of brain injury.

What I wrote in that same blog post almost two years ago is worth repeating today:  "Recent news stories have recounted how parents of football players have been torn about whether they should let their kids continue playing and describe the prospect of long-term injury if they keep playing as 'kind of scary.' Some report having decided not to let their kids play football based on the new evidence."

Again, this is something I faced ten years ago. As I  wrote in my book Home Team Advantage and have recounted often on this site, "I ultimately decided to end my son Spencer's football career after his sophomore year in high school because to continue playing, given his history of concussions and learning disabilities, posed, in my view, an unacceptable risk of long-term injury. And this was long before studies began coming out showing just how potentially dangerous football was to a player's long-term mental health."

But as I said then, and say again now, "I am not now and have never suggested that parents simply refuse to let their children play football. But parents do need to make the decision based on complete information; information which they still do not have." (but is rapidly becoming available, as researchers in Boston, at Purdue University, the University of North Carolina and Virginia Tech, find out more and more about the link between sub-concussive blows and short- and long-term brain injury)


"The Smartest Team": Staking Out The Sensible Middle In The Polarized Debate About Football

It has been an exciting week for those of us who worked so hard over the past two years to produce The Smartest Team: Making High School Football Safer.   

After kicking off with our premiere on Oklahoma Educational Television (OETA - PBS) in August, and with stations in North Carolina and Colorado having aired the documentary in September, the beginning of October marks the first full week of broadcasts on PBS stations in more than ten states. 

While we are having a hard time keeping up with all the stations that are airing the documentary, there are stations in twelve additional states that are set to air the documentary during the week of October 7th, including our "home" station, WGBH2 in Boston, where it will run from 3 to 4 p.m. on Sunday, October 13th right before New England football fans click over to CBS's broadcast of the Patriots-Saints game, and right before a rebroadcast of the already controversial Frontline documentary on the National Football League, "League of Denial." (appropriately, many PBS stations are coupling our documentary with "League of Denial," as they make a good pair: one focusing on the past and one looking forward with solutions).  By the time the fall football season is over, most of the nation's PBS stations will have broadcast our documentary.  Taylor Lench filming "The Smartest Team"

It has also been extremely gratifying to hear so many positive comments about "The Smartest Team" from football fans, parents, athletic trainers,  coaches, and players around the country, now that they have had a chance to watch it, and to receive invitations to come speak to their schools or football programs about implementing our Six Pillar approach to comprehensive concussion risk management.

Concussion, Inc.

On the other hand, we know that there are those who are not at all happy that we are taking a pro-active, glass-half-full approach to trying to meeting the challenge concussions and head injuries pose in football.  In an effort to discredit the "The Smartest Team," it appears that powerful interests in the multi-million business that is Concussion, Inc. are working overtime, both in the Twittersphere, through a whisper campaign, and via other even more insidious back-channel means, to cripple our ability to spread the word about our documentary, including trying to convey to the viewing public the impression that MomsTEAM and I are somehow peddling junk science because, to take one example, (spoiler alert!) they claim that the dramatic year-over-year drop in the concussion rate we documented in the Newcastle High football program was not the product of a controlled, qualitative case study or peer-reviewed research, and that our objectivity has somehow been clouded by alleged conflicts of interest, including asserting that we are merely a cipher or football apologist on the payroll of the National Football League.

Backed by science

We have never claimed that "The Smartest Team" is anything but what it is: a documentary showing how a single high school football team, based on the recommendations of a world-class team of concussion experts, implemented a concussion risk management program that we believe represents the current "gold standard," from teaching players how to tackle without using their heads to strengthening their necks so as they are better able to withstand the forces that cause concussion, from encouraging players to honestly report concussion symptoms to utilizing cutting edge technology in the form of impact sensors to give sideline personnel another tool in their toolbox to employ in identifying athletes who may - emphasis on the word "may" - have sustained impacts of sufficient magnitude that may have resulted in some cases in concussions, so that they may be monitored for signs of concussion or may be asked to undergo a balance, vision, and/or neurocognitive test on the sidelines, the results of which may suggest a removal from play for the remainder of the game and referral to a concussion specialist for formal evaluation away from the sports sideline, which may result in a clinical diagnosis of concussion.

We don't claim that we conducted a controlled study.  I am not an epidemiologist, medical doctor, athletic trainer, neuropsychologist or an expert in biomechanics. I am a journalist and youth sports safety advocate and expert. I made "The Smartest Team" to get people to look at football in a new and more pro-active way.

Does The Smartest Team advance a particular point of view? Absolutely. Does it marshal facts in support of that point of view? You bet. But in expressing the view that, as two-time Super Bowl winning running back Howard Griffith says in the narration introducing the last section of the documentary, there are steps that can be taken now to make the sport of football at the high school and youth level safer, we are doing no more than documenting recommendations that, in every single instance, have already been made by leading experts in the field, including medical doctors, physical therapists, strength trainers, athletic trainers, neuropsychologists, equipment manufacturers, and biomechanical experts.

To some extent, one concussion journalist was right when he noted in a recent Tweet that The Smartest Team isn't "bombshell" material, because there is really nothing we say in the documentary that hasn't been said before.  What is refreshingly different about our documentary is that, instead of focusing exclusively on, and sensationalizing, the concussion problem, we emphasize solutions.

The challenge we face - that all those who, like us, want to strengthen and preserve the great game of football - is having our message heard.  For the most part, the national media doesn't seem interested (surprise) in reporting good news - that there are ways to make football 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.

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 (extremely well documented, by the way, in Daniel J. Flynn's powerful new book, The War on Football: Saving America's Game) while minimizing its risks, it is hard to be heard above the maddening crowd when one occupies the reasonable, pragmatic, pro-active, middle.

From my vantage point, having spent a lot of time with the wonderful football community in Newcastle, Oklahoma, from talking to football parents across the country, and from becoming educated about the actual facts about the safety of football, I believe that, not only is football a sport worth saving, but that those who call for radical changes in the way it is played, and by whom, or for it to simply be abolished, represent a small, but extremely vocal and influential minority. It is therefore essential that what Flynn calls the "tired media narrative that accentuates the negative and ignores the positive" be balanced by the facts about football, which are "overwhelmingly positive, if well hidden."  That is precisely what The Smartest Team seeks to accomplish. 



Concussion Bill of Rights # 4: An Athletic Trainer Should Be On Staff

Among the things which increase the anxiety level of parents of children playing contact sports is the fact that many high school programs don't employ athletic trainers who have received training in recognizing the often subtle signs of a concussion. Only 42 percent of U.S. high schools, according to the National Athletic Trainers' Association, have access to an AT.* In some states, the number is much lower (Over three-quarters of Nebraska high schools, for instance, are without ATs).

Thus, the fourth point in the Parent's Bill of Rights on Concussions is the right to expect that a certified athletic trainer (AT) is on staff. An AT is so important that she should be the next hire after the head coach. An AT is an essential member of the concussion management team because:

  • The AT often sees the athlete on a daily basis, and thus has the opportunity to establish a trusting relationship. This trust is a vital part of the process of evaluating and managing a concussion.
  • Athletes may be more comfortable reporting symptoms to an AT, who they see on a regular basis, than to a physician they do not see regularly, or to their coach.  
  • An AT may also be better able to identify subtle signs that an athlete has suffered a concussion because he or she knows the athlete's usual behavior and demeanor. 
  • An AT is also in best position to perform daily follow-up examinations that allow the AT and team physician to determine when the athlete is symptom-free and determine when he or she may return to play.

Because physicians are present at relatively few youth sports contests and never at practices, an AT is essential and we should work towards the goal of having a certified athletic trainer on staff at every high school in this country.

* October 25, 2015 update:  In 2014, the National Athletic Trainers' Association released preliminary data showing that approximately two thirds of U.S. secondary schools with an ongoing athletic program now have access to athletic trainers (ATs), whether full-time or part-time, a significant improvement from its 2005 estimate that only about 40-45% had such access. indeed, according to a survey by the Korey Stringer  Institute, certified athletic trainers now provide coverage to fully 85-90% of all high school athletes in the U.S.  In some states, however, the percentages are much lower. (Over three-quarters of Nebraska high schools, for instance, are without ATs)  

Average: 5 (1 vote)

Improving Football Safety: Is It Up To Parents?

Now that the concussion lawsuit filed by retired National Football League players has apparently been settled (remember: the judge still has to give her approval), it's time to focus on the upcoming football season, and working to make the sport safer at every level of the game. Missy Womack

Sincerest form of flattery

We could sit back and wait for the N.F.L., National Federation of High School Associations (NFHS), USA Football and Pop Warner to lead the way on football safety.

From personal experience over the years, I believe that waiting for national organizations to act and adopting a complete top-down approach would be mistake.

In 2002, after USA Football was formed, I wrote to the organization encouraging it to put safety first by requiring, among other things, that all its coaches have appropriate safety training, and by adopting a concussion policy. I was met by silence.

Seven years later, USA Football finally got back to me, asking me to put together a proposal on ways that MomsTEAM could help the organization make the sport safer. I again recommended that USA Football do more than it was doing on concussion safety, such as by training coaches to teach youth football players Coach Bobby Hosea's "Heads Up" tackling and doing more concussion education of coaches, parents, and players.

Finally, in late 2011, USA Football began adopting some of what we had been recommending for ten years.

I had a similar experience in trying to work with the N.F.L. During my 2008 keynote speech at the National Sports Concussion Symposium, I gave the league a long list it could use to help make the sport safer at the youth level (a list I have been constantly updating; for the most recent checklist, click here). I remember being chided for having the temerity to suggest that the N.F.L. was not doing all it could be doing to improve football safety.

Yet it wasn't too long after that I saw that the league implementing some of my suggestions (such as my recommendation that they join with MomsTeam in sponsoring public service announcements about the dangers of concussions in sports, although the PSAs that ultimately aired were, of course, sponsored solely by the league).

In the fall of 2012, the N.F.L. invited me to its New York City headquarters to present a proposal to the league on ways that I thought MomsTEAM could help them preserve and strengthen the sport of youth football, in part by educating parents, and especially safety-conscious moms, about the dangers of concussions and ways in which the risk of concussion could be reduced.

Like USA Football, the N.F.L. went ahead on its own to implement some of our recommendations (witness N.F.L. Commissioner Roger Goodell's recent visit to Columbus, Ohio, where he co-hosted, with Ohio State football coach Urban Meyer, a safety clinic for 600 mothers of youth football players).

This past June I was invited to a press event at the NFL headquarters, where representatives from a group of national governing bodies for team sports talked about their safety initiatives, which showed just how far behind the NFL and its youth football arm, USA Football, had been until recently. To their credit, they pulled together this meeting to learn from the other national organizations whom I have been advising since 2002 such as US Lacrosse, which has been a leader in making its sport safer.

I say until recently, because I believe that, over the past two years, the NFL, USA Football and Pop Warner have done yeoman's work to catch up on the safety front, to the point where they are now making strides in their safety outreach efforts. The additional $10 million earmarked in the concussion litigation settlement for research is a step in the right direction, albeit a fraction of the money that will be needed to be devoted to concussion research to make the sport safer.

Wanted: Pro-Active Parents

But, as far as the N.F.L., NFHS, USA Football and Pop Warner have come in recent years in their efforts to improve football safety, I still believe, in the final analysis, that football safety is largely up to parents, working in their local communities with all those with a stake in making football safer, including independent football organizations, school boards, school superintendents, athletic directors, coaches, school nurses and psychologists, and other health care providers, and networking with other parents, coaches, administrators and medical professionals at the local, state, regional and national levels to share ideas on what works and what doesn't.

It is up to parents to make sure that football programs adopt best practices based on the latest medical research and technological advances in the identification and treatment of concussions;

It is up to parents to insist that coaches be part of the concussion solution, not continue to be part of the concussion problem. Recent qualitative and quantitative studies have confirmed MomsTEAM's longstanding belief that, more than education about concussion signs and symptoms, it is changing the negative attitude of too many coaches towards reporting and creating a safe concussion-reporting environment that may be the best ways to improve the low rates of self-reporting found in study after study.

It is up to parents to do whatever they can to make sure that their child's coach does not continue to convey the message to athletes that there will be negative consequences to concussion reporting by removing them from a starting position, reducing future playing time, or inferring that reporting concussive symptoms made them "weak", but, instead, creates an environment in which athletes feel safe in honestly self-reporting experiencing concussion symptoms or reporting that a teammate is displaying signs of concussion (and reinforcing that message at home)

It is up to parents to be advocates in their community for creating a culture of safety at all levels of the game, instilling in kids when they first start playing sports positive attitudes about sports safety and concussion that they can carry with them throughout their lives.

It is up to parents, whether it be individually or as members of a booster club, "Friends of Football," or PTA, to raise money to (a) fund the hiring of a certified athletic trainer (who, as we always say, should be the first hire after the head football coach); (b) consider equipping players with impact sensors (whether in or on helmets, in mouth guards, skullcaps, earbuds, or chinstraps); (c) purchase concussion education videos (which a new study shows players want and which they remember better); (d) to bring in speakers, including former athletes, to speak about concussion (another effective way to impress on young athletes the dangers of concussion); and (e) to pay for instructors to teach about proper tackling and neck strengthening;

It is up to parents to make sure that the helmet their child wears fits properly, maintains that fit over the course of a season, and has been properly reconditioned, and, if the football program does not buy impact sensors for the whole team, to consider buying one on their own, weighing the benefits of knowing the magnitude and frequency of the hits that their child is taking to the head against the risk that adding a two-ounce piece of plastic to the inside or outside of their helmet may void the manufacturer's warranty and NOCSAE certification or increase the risk that the protection the helmet's polycarbonate shell provides against skull fractures will be compromised;

It is up to parents to decide for their family whether to allow their child to start, or continue, playing football, not some present or former player, journalist or scientist who takes the position that football is either too dangerous to be played by anyone or safe enough to be played by all (October 25, 2015 update: this is exactly the position adopted by the American Academy of Pediatrics in its 2015 Policy Statement on Tackling in Youth Football in which it leaves parents - presumably in consultation with their child's pediatrician - to "decide whether the potential health risks of sustaining ... injuries [in tackle football] are outweighed by the recreational benefits associated with proper tackling"); and

It is up to parents, when a child sustains a concussion playing the sport, to know what to do to help the child recover, including the need for cognitive and physical rest in the first few days after concussion, when it is safe to return to school and everyday social and home activity, whether their child's school day should be modified to take into account cognitive difficulties experienced after concussion and, in consultation with their child's health care providers, including the athletic trainer, if there is one, to sports.

Call to action

Finally, it is up to football parents like you, if you value MomsTEAM as a trusted source of youth sports parenting, nutrition, hydration, and safety information, to help us spread the word about MomsTEAM, about our PBS The Smartest Team posterdocumentary, The Smartest Team: Making High School Football Safer, and about our newSmartTeams initiative

You can help in three ways:

First, you can help make football safer by sending a note to the programming director at your local PBS station encouraging them to find a slot in their fall schedule to air THE SMARTEST TEAM. If they are skeptical about the value of airing yet another concussion documentary, tell them that this one is different: it starts where other concussion documentaries like "Head Games" and "United States of Football" leave off: not just scaring or documenting the concussion problem but showing ways the sport can be made safer right now.

Second, you can help make football safer in your community by suggesting to your school or its PTA that it purchase a DVD of the documentary from our educational distributor, Films For The Humanities (most schools are subscribers already, or it can be purchased a la carte).  Why not Invite some former athletes and concussion experts from your community to lead a discussion about concussions after the film.

Third, you can help make football safer by sharing links to MomsTEAM concussion articles with other football parents, coaches, athletic trainers, and PTA presidents, or by distributing copies of key articles, some of which are listed here:

  1. Concussion Safety Checklist for Parents: 12 ways parents can help protect their kids in contact/collision sport
  2. Concussions: Parents Are Critical Participants in Recognition, Treatment, Recovery
  3. Gradual Return to Play After Concussions Recommended
  4. Coaches: Improve Concussion Safety By Creating Safe Environment For Athlete Self-Reporting
  5. Honest Self-Reporting Of Concussion Symptoms Critical

I am as convinced as ever that, together, we can preserve and strengthen that uniquely American game: the game of football. It will take work, it will take commitment, it will take dedication, but it CAN and MUST be done.

Brooke de Lench is the producer/director of THE SMARTEST TEAM: MAKING HIGH SCHOOL FOOTBALL SAFER, Founder and Publisher of MomsTEAM.com, and the author of "Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins).


Average: 5 (1 vote)

MomsTeam Awarded NCAA-DOD Mind Matters Challenge Educational Grant

On July 15, the NCAA and Department of Defense (DOD) announced the selection of MomsTeam Youth Sports Safety Institute as a recipient of a Mind Matters Challenge grant for our application, Creating a Safe Concussion Reporting Environment: A Multi-Media Approach.

Mind Matters Challenge

joint NCAA-DOD initiative announced in November 2014, the Mind Matters Challenge focuses on two important areas related to concussion: Changing Attitudes about Concussions in Young and Emerging Adults (a research challenge); and Educational Programs Targeting Young and Emerging Adults (an educational programs challenge).

The Institute was one of just six winners (of a possible ten) in Phase One of the Educational Programs Challenge, for which it was awarded a $25,000 cash prize for its proposal to create a multi-media concussion education intervention designed to create an environment in which student-athletes are not penalized, ostracized, or criticized for honestly reporting their own concussion symptoms as well as those of teammates but are actually encouraged to do so.

In Phase Two, which will begin in August, the Institute will be awarded an additional $75,000 to work with the NCAA and DOD to actually design a prototype educational program to increase understanding of the critical importance of honest and early self-reporting by student-athletes of concussion symptoms in the diagnosis and management of concussions.

We are truly honored to have been selected to participate in this prestigious program by a stellar panel of judges, including, among others, , Jim Whitehead, Executive Vice President of the American College of Sports Medicine, and Kelly Sarmiento of the Centers for Disease Control and Prevention's Heads Up Program.

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



Bullying: An Ongoing Problem In Youth Sports

Recently, I received the following letter from a mother who had attended one of my talks to a group of sports moms.

"My daughter has just signed up for a 3rd grade travel soccer team after having never played soccer before.  But last week, she told me that her teammates were teasing and bullying her (telling her she's not a good soccer player) and telling secrets about her. I have stayed and watched all her practices and all her games except one. She is completely devoted in her practices, and seems to work at least as hard if not harder than the other girls. She pays attention and does what the coach (or trainer) says. She seems to be one of the more mature girls on the team, and has made amazing progress from the first practice, to now (practice #5). I am not sure she fully understands the game, nor the nuances of each position, but she is definitely participating in earnest.

My question really is what I should expect out of the coach in this regard? I have already sent him an email telling him about the behavior of the other girls, and I borrowed some language from your handout to say that I expected the girls to show respect to each other (i.e. no teasing or bullying). Should I really expect this situation to change? Should I pull her out in the middle of the season? She is telling me now that she never wants to play soccer again. I think that, other than the behavior of the other girls, she enjoys it. I have told her she needs to finish out the season. Help!"

Bullying is violent behavior

The subject of bullying in sports is one that is near and dear to me.  According to an about-to-be- released book from the United Nations titled Violence Against Children In Sport - The Right To Play Safe (a book to which I was honored to contribute) and Article 1 of the UN Convention on the Rights of the Child, what her daughter's teammates were doing to her daughter actually constituted emotional abuse/violence.

It is sad, but true, that some kids think that one way to keep moving up the sports pyramid is to eliminate the competition and drive kids to quit, especially if they perceive them as competitive threats, through bullying or teasing that makes them so unhappy they see quitting as a better alternative than being abused.  In extreme cases, teasing in youth sports can even lead to tragic results, such as the teasing that led a thirteen-year-old California boy to beat a fifteen-year-old boy to death in April 2005.

Common problem

A recent study revealed that there is a high probability on most teams that one or more of the lesser skilled players will be bullied or teased by a more skilled teammate.  Good coaches are alert to the possibility of bullying and proactively seek ways to reduce it.

If the coach allows the bullying to go unchecked, the player being bullied may end up deciding that quitting the team is the only way to get the abuse to stop. I remember when my son, Taylor, was on a youth basketball team.  He had just gone through a big growth spurt and towered above the other boys on his team.  He was still trying to get used to his new body, but showed real potential as a basketball player, especially given his height (he is now close to 6 feet 6 inches tall).  One of the players on the team, who actually happened to be one of his closest friends, decided that the best way to eliminate Taylor as his competition was to tease him and so he did did everything he could to undermine his self-confidence by teasing him about his skills, especially at the offensive end of the court where, despite Taylor's height, he had trouble scoring over smaller opponents.  Unfortunately, because the coach did nothing to stop the bullying, the strategy worked: Taylor finished the season but decided not to sign up again.  There is no way of knowing how good Taylor could have been as a basketball player (he was definitely a late bloomer), but I would like to think that he would grown into his body and been pretty good.

Given my experience with my own son and thousands of emails on this subject spanning the tens years I have been running MomsTeam, I thought there was a pretty good chance that the daughter of the mother who wrote me was  being bullied because, despite having just started off in soccer, she was already showing real potential and was therefore viewed by her teammates as a competitive threat.  I wondered whether the coach's child was one of the bullies and when/where was the bullying actually taking place.

The bottom line, I told her, was that the her daughter's coach should have a zero tolerance for bullying and needed to do whatever it took to get it to stop. Easier said than done, though.

Here is what I suggest to parents who find their child is being bullied by his teammates:

  1. Find articles and information on bullying on MomsTeam, especially in sports, such as Quitting Sports: A Difficult Decision and Good Youth Sports Coaches Teach, Model and Demand Sportsmanship, Fairness and Respectful Behavior ;
  2. Print the articles and when handing them to the coach demand that he or she put an end to the bullying and teasing, because it is a violent activity, because teaching respect for teammates, officials and opponents is critical part of a coach's job, and because bullying is damaging to team spirit; and
  3. Teach their child to look directly at the kids who are teasing or bullying her and in a loud, assertive voice say something like, "I have had enough of your bullying. I just want to have fun. Stop it now!" (Repeat as necessary to get it to stop).
  4. Ask your child's coach to make a quick announcement prior to each practice or game along the lines of  "There will be NO bullying or hazing or teasing and anyone on the team who does will sit on the bench! This was something I did before each practice when I was coaching and there were no problems-ever!

November 4, 2013 update: As the sad story of alleged bullying of Miami Dolphin offensive tackle Jonathan Martin by teammate Richie Incognito, which led Martin to take an indefinite leave of absence and to the indefinite suspension of Incognito while the NFL investigates, bullying can happen on teams at every level of sports.   

Has your child ever been bullied? Please add your comments below--I am very interested in what worked to eliminate the bullying of your child. 

Brooke de Lench is Executive Director of the 501(c)(3) non-profit MomsTEAM Institute of Youth Sports Safety, author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (Harper Collins), founder of MomsTeam.com, and producer/editor of the PBS documentary, The Smartest Team: Making High School Football Safer. You can contact Brooke at delench@momsteam.com


Female Coaches At FIFA Women's World Cup: Do They Have Natural Advantages Over Men?

If you've been watching the FIFA Women's World Cup, you may have noticed that the head coaches of most of the 24 national teams competing in Canada are men. In fact, only seven teams (the USA, Ecuador, Germany, Costa Rica, Switzerland, Sweden, and Ivory Coast) are led by female head coaches.

While that number is five more than when I watched from the stands at Giants Stadium as the U.S. played Mexico in the 1999 Women's World Cup, it is still a distressingly low number.

Unfortunately, women's elite soccer has plenty of company: women head coaches are also few and far between in professional sports (which a recent article in Time Magazine not only characterized as unfair, but bad business) and at the college level, where the disparity has gone from bad to worse (As USA Today recently reported, the percentage of women coaches at the college level has dropped precipitously, from 90 percent when Title IX was enacted in 1972 to 40 percent today, with only a minuscule 2 percent of men's teams being coached by women).

Many reasons have been offered to explain the under-representation of women in the coaching ranks, not only at the professional and collegiate level, but at the high school and youth level as well. But what really sticks in my craw is that such gender inequality persists even though, I believe, women, far from being ill-equipped to be good coaches (as some continue to claim), may actually enjoy some natural advantages over men, especially when it comes to coaching at the youth level.

While making generalizations based on gender is tricky business, here's a list of eleven reasons why, as I first wrote in my book, Home Team Advantage: The Critical Role of Mothers in Youth Sports, I think women are so well-suited to coach youth sports:

1. Women are safety conscious and risk averse. Studies show that serotonin levels in the brain are inversely related to risk-taking behavior. Evolutionary biologists believe that a woman's higher levels of serotonin, combined with her instinct to survive by avoiding risk, prompt women to be more careful about safety so as to avoid exposing children to an unreasonable risk of injury.

What I have found from consulting with youth sports programs across the country over the last fifteen years is that programs in which women, usually mothers, are actively involved - not just as team moms, but as coaches and administrators - tend to put a higher premium on safety. Exhibit A is the football program in Newcastle, Oklahoma featured in my concussion documentary, The Smartest Team: Making High School Football Safer (PBS). I would never have assembled a team of world-class experts to parachute into the town in the summer of 2012 to help the program implement a comprehensive concussion risk management program called The Six Pillars had it not been for an email I got from a Newcastle mother of one of the players - who was also a school board member - reaching out to me for help in reducing the alarming number of concussions players had suffered the previous season.

2. Women are natural teachers. While there are exceptions to every rule, of course, I believe that women coaches tend to be more organized and prepared to provide a quality experience to all kids involved. I coached that way, and remember that parents constantly remarked on my organizational skills, and told me that my attention to detail had made them more organized sports parents as well.

3. Women tend to be less authoritarian leaders. Women tend to lead by consensus, a leadership style that even boys prefer, rather than employing a more authoritarian form of leadership. Women tend to connect by empathizing and establishing relationships. A mother's instinct to be a calming influence and peacemaker, and to want to emphasize how all players are alike, not different, serve her well as a youth sports coach, where playing favorites or allowing teammates to bully or tease other teammates can create a hostile psychological climate.

4. Women are natural nurturers. Science has shown that women are generally more adept than men at detecting mood from facial expression, body posture, and gestures, and thus knowing if a child is unhappy. Because they tend to be emotionally open and have good communication skills, women are able to motivate and relate well to players, which is essential if a child is to have an enjoyable sports experience.

5. Women tend to want to find a balance between competition and cooperation. I have found that a woman's focus tends to be more on teamwork, arising out of her belief that the best result comes when everyone contributes and the most is gotten from everyone's individual talents. Women tend to reject the common supposition that competition must consist of winning and losing and of displays of power, dominance, and control, for better or worse. "What we need to be teaching our daughters and sons," said Alfie Kohn, author of No Contest, "is that it's possible to have a good time - a better time - without turning the playing field into a battlefield."

6. Women care about all children, not just their own. More than 9 in 10 mothers surveyed in a landmark study of mothers agreed with the statement, "After I became a mother, I found myself caring more about the well-being of all children, just not my own." As co-authors Martha Farrell Erickson and Enola Aird observed, mothers have a "special sense of responsibility for children in general."

7. Women are process- rather than result-oriented. This is what youth sports should be all about: an emphasis on the process (developing skills, both physical and social, and having fun) not solely on the result (wins and losses).

8. Mothers want to protect children from the pressures of the adult world. Nine out of ten mothers questioned in the Motherhood Study - and most child psychologists agree - that exposing kids too fast to the pressures of the adult world is a bad thing; that childhood should be a time when children are protected from, not intentionally exposed, to large parts of the adult world. Many mothers are concerned about the "disappearance of childhood" as the late author, media critic, and NYU professor Neil Postman, called it, and see themselves, in a sense, as what Postman called the "overseers" of children. As coaches, mothers tend to resist the concept, increasingly prevalent in today's youth sports, that intentionally exposing children to the harsh realities of the adult world (cut-throat competition, sorting out of winners and losers), even before they have reached puberty and grown into their bodies, is somehow a good idea.

9. Women have been socialized to place a high value on sportsmanship. One of the most important lessons a youth sports coach can teach players is the value and importance of good sportsmanship. A landmark study by the Josephson Institute of Ethics found an ethical and moral gulf between female and male high school athletes in terms of their tolerance for poor sportsmanship. Some research suggests that the ways in which girls are socialized may promote a lower tolerance for poor sports behavior.

10. Women are good at teaching boys healthy masculinity. Female coaches can teach male athletes that they don't have to conform to society's male gender stereotype by hiding their emotions, pain and injuries; that it is possible to be emotionally open and still be a man. Canadian professor Alexis Peters, an expert on masculinity, violence and ethics in sports, argued in an article in the Calgary Herald, that "the root of the problem is not men, athletes or sport themselves ... The issue is adults who forget what it is like to be a child and impose 'real man' values into youth sport." The presence of women as coaches of boys raises, wrote Drexel University professor Ellen Staurowsky in Sport, Men, and the Gender Order: Critical Feminist Perspectives, "profound questions about male supremacy and directly challenges the patriarchal notion that maleness is a key prerequisite for coaching and for leadership." In other words, more woman coaching boys could, by changing the way men think about masculinity, drive one more nail into the coffin of the myth that women are somehow lacking the qualities to be leaders in society.

11. Women coaches are role models for girls and teach them to celebrate being a female athlete. Women coaches break down gender stereotypes by proving that women can be just as competent and tough as men. As Professor Staurowsky told me, the presence of woman in large numbers as coaches at the youth sport level would help boys and girls see that "women can coach, thus affecting their vision of how sports systems operate."

While participation by girls in sports has increased at all levels (Olympic, professional, college, high school, and youth) and society is more accepting than ever of female athleticism, the fact that women are still so woefully under-represented in the coaching ranks, and that girls drop out of sports at six times the rate of boys are indications that we still have a long way to go as a society in reaching the goal of gender equality in sports.

Here's hoping that the increased prominence of women head coaches at this FIFA Women's World Cup leads to positive change, so that, by the time the next FIFA Women's World Cup is held in France four years from now, I'll be able to report that the number of head coaching slots at the tournament filled by women, and the number of women coaching at the professional, college, high school and youth level have all moved in the only direction they should go: up.

Adapted from the book, Home Team Advantage: The Critical Role of Mothers in Youth Sports by Brooke de Lench (HarperCollins 2006).

Brooke de Lench is the Executive Editor of MomsTEAM Youth Sports Safety Institute (MYSSI), Founder and Publisher of MomsTEAM.com, and Producer of The Smartest Team: Making High School Football Safer (PBS).  You can follow Brooke on Twitter @brookedelench.