Attitudes and Counseling Practices of Pediatricians Regarding Youth Sports Participation and Concussion Risks

Published:February 24, 2017DOI:https://doi.org/10.1016/j.jpeds.2017.01.048

      Objective

      To examine attitudes and practices of pediatricians toward sports-related head trauma and youth participation in tackle football and ice hockey.

      Study design

      A respondent-anonymous electronic survey was distributed 3 times to members of the American Academy of Pediatrics Section of Bioethics, Council on Injury, Violence, and Poison Prevention, and Council on Sports Medicine and Fitness.

      Results

      Of 791 eligible pediatricians, 227 (29%) responded. Most respondents (189/223; 85%) treat sports-related concussions, among whom 83% (137/165) reported access to an established return-to-play protocol within their practice. Virtually all (160/166; 96%) reported increased parental awareness/concern regarding concussions and 85% (139/163) reported increased visits for head trauma. Overall, 77% (140/183) would not allow their son to play tackle football and 35% (64/181) and 34% (63/184) would not allow their son or daughter, respectively, to participate in ice hockey. Most respondents endorsed limiting or eliminating tackling (143/176; 81%) and checking (144/179; 80%) from practice. Respondents were evenly divided in their support for counseling against youth participation in full-contact sports, with 48% in favor (87/180).

      Conclusions

      Most respondents would not allow their own child to play tackle football and endorsed limiting or eliminating tackling in practice. The American Academy of Pediatrics should consider recommending restrictions on tackling in football to support the current concussion concerns of its members.

      Keywords

      Abbreviations:

      AAP ( American Academy of Pediatrics), COIVPP ( Council on Injury, Violence, and Poison Prevention), COSMF ( Council on Sports Medicine and Fitness), SOB ( Section on Bioethics)
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      Linked Article

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          To evaluate the potential impact of a concussion management education program on community-practicing pediatricians.
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      • Pediatricians, racial disparities, and tackle football
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          Fishman et al1 report that most pediatricians across the 3 sections of the American Academy of Pediatrics that they surveyed would not allow their own child to participate in tackle football. In contrast, respondents were less likely to consider it appropriate for physicians to counsel against youth participation in full-contact sports. Fishman et al highlight this striking disconnect “between physicians' beliefs and practices regarding their own children vs what they recommend for their patients.” They ask whether physicians should disclose their personal attitudes to patients, particularly given evidence that those beliefs strongly influence clinical practice.
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