Is Letting A Child Play Contact or Collision Sports Child Abuse?

The last month has seen an all-out assault on the game of football, not coincidentally timed with the beginning of football preseason.  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 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 and in a sledding accident to retire from both football and lacrosse. Knowing all that 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.  Not even close.

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 (streaming free on this website), 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 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 knowing they 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 one 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 read or hear the stories of athletes whose lives have been affected or cut short by CTE, it is by no means clear – and indeed unlikely – that 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 advise 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 with 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.

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 the last 17 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 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.