Most parents in a nationally representative survey supported age restrictions for tackling in youth football, with mothers more likely to support such restrictions.
In a sample of about 1,000 parents, 61% supported age restrictions on tackle football, 24% might support these limitations, and 15% would be opposed to them, reported Sara Chrisman, MD, MPH, of Seattle Children's Research Institute in Seattle, and colleagues.
Mothers, or female respondents, were more likely to support such restrictions (OR 1.91, 95% CI 1.30-2.81, P <0.01), particularly if they were college-educated and had a greater perceived risk of tackle football, the authors wrote in .
"For us, the bottom line is we need to understand why some of the people said they would not be in support of age restrictions, what their concerns are, and what they see the value of this risk is in terms of the sport and their child's development," Chrisman told . "All activities [our kids participate in] have some kind of cost-benefit ratio and I do think football has borne the brunt of some of those fears."
In response to growing concerns about the risk of long-term risk of concussions sustained in youth, certain professional organizations have updated their guidelines regarding heading, body checking, or other forms of physical contact, the authors said. USA Hockey, for example, now in children ages ≤12 and U.S. Soccer for ages ≤11, according to the study. No age restrictions are currently in place for youth tackle football, however.
Sports-related concussions have recently been put under a media spotlight, but the risk of concussion and injury in football is similar to other contact sports like wrestling, hockey, and lacrosse, wrote Cynthia LaBella, MD, of Northwestern University's Feinberg School of Medicine in Chicago, in an .
LaBella noted that the evidence for long-term outcomes of tackling and head impacts on the developing brain is "unclear," citing one popular study with several limitations that found exposure to tackle football before age 12 was associated with future cognitive impairment and depression and another longitudinal study that found no differences in either outcome when comparing high school football players to a control group.
While the former "received widespread media coverage, which has led to significant public concern about the safety of youth tackle football," however, the latter "did not make any headlines," LaBella wrote. "So the public does not get a balanced report of the research."
For this study, Chrisman and colleagues examined data from a cross-sectional online survey conducted in October 2017 by the market research company . Participants included adults ages ≥18 who were parents of >1 child, age 5-18 years.
Overall, 56% of respondents were women, and participants ranged in age from 21-68. Most parents supporting age restrictions said they thought the minimum age for tackling should be middle school (45%) or high school (37%). About 7% said tackling in elementary school would be OK; 9% would not allow it until college.
Younger age (<35), female sex, presence of a child ages 6-12, less interest in professional football, and a greater perceived risk of tackle football were significantly linked to higher odds of supporting age limits, the authors noted.
But they found there was no significant association between race or ethnicity, geographic region, or whether parents in the survey had another child in the house, and parental support for age restrictions.
LaBella said that the most notable finding of this study was that more than three-quarters of parents perceived concussion incidence to be more than 10% among high school tackle football players, and one-quarter estimated it was more than 50%. LaBella noted that in reality, only about 4%-7% high school players will suffer a concussion per season, and the risk for youth players is even lower.
"This misperception about concussion risk in youth tackle football is likely due to the fact that most parents form their views on the basis of headlines and stories of former players in the media, rather than from published scientific data," LaBella said.
Chrisman and colleagues noted the primary limitation of this study was that they asked parents how they felt about age restrictions in theory, but could not evaluate how parents would respond if such regulations were enacted. It would be important to assess whether attitudes differed between parents who had children playing football and those who did not, they added. Lastly, they noted that education and socioeconomic status were not evaluated separately in their analysis.
Disclosures
Chrisman did not report any relevant disclosures.
A co-author is one of the team physicians for the Seattle Seahawks.
LaBella is a chairperson for the AAP Council on Sports Medicine and Fitness and is on the advisory committees of the Pop Warner Little Scholars, U.S. Soccer, and the Illinois High School Association.
The study was funded by the Seattle Children's Hospital Academic Enrichment Fund, the Seattle Pediatric Concussion Research Collaborative, and the Sports Institute at the University of Washington School of Medicine.
Primary Source
Pediatrics
Chrisman S, et al "Parents' perspectives regarding age restrictions for tackling in youth football" Pediatrics 2019; 143(5): e20182402.
Secondary Source
Pediatrics
LaBella C "Youth tackle football: perception and reality" Pediatrics 2019; 143(5):e20190519.