Baseline Concussion Testing for Children Playing Football?

What is Wrong with Children Playing Football?

By Gordon S. Johnson, Jr.

In an excellent article in Arizona Central by Nathan Brown, the movement towards baseline concussion testing for children in Pop Warner football is addressed. See

Note to Parents. If the experts believe that your child needs baseline testing for brain function to engage in a sport, perhaps they should be playing that sport.

The concept of baseline testing for those participating in sports was originally introduced as a part of research models on sport and concussion to aid in measuring the extent of brain injury in the activity. From a research standpoint, it is a great concept. But the reason it is a great concept is that football and other contact sports are a great laboratory to study concussion, because we can predict that there will concussions. Would you volunteer your children for any other activity where they are likely to be a research subject in a potentially life threatening activity?

Football is dangerous, even to highly trained professionals. But it is far more dangerous to children. Research is indicating that those who begin playing tackle football (with helmets) before 12 are at more risk for not only concussions, but also CTE than those who begin to play later. Bourlas, et. al, IBIA, 2014. Children are also at risk because the interplay of the following variables:

  • Imbalance Between Ability Levels. In youth leagues, even when selected by weight, the potential for difference in ability levels is drastic. We have all seen the movies portraying the kid who didn’t want to be playing being outclassed by the superstar kids. That is the reality of youth leagues, particularly because the differential rates upon which children mature physically. Dramatically different levels of coaching make this problem worse. The good teams often slaughter the bad. he good teams often slaughter the bad. That doesn’t just show up in the final score, but in the relative beating the children take. I played on a high school team that was severely outclassed by our competition, and we just were pummeled in every game.
  • Vulnerability of Growing Brains and Bodies. During developmental years, people are more vulnerable to injury than during adulthood. Brain injury is usually not just a function of a head impact, but the degree to which the head is set in motion and or stopped by the blow. Higher level athletes spend considerable training time strengthening their neck muscles. Children’s necks lack the strength to limit this acceleration/deceleration of the head, adding to the risk of injury.
  • Difficulty in Identifying Brain Injury Symptomatology. The sense of concussion is that it is a predominantly cognitive injury. Measuring the cognitive changes is the reason for baseline neuropsychological testing for children playing football. Yet, the cognitive domain is only one of four potential areas in which a concussion can impact anyone, but especially a child. The four areas are cognitive, behavioral, mood and motor (muscles and coordination.) With children as young as 10, it is very difficult to determine what is normal, and thus be able to identify dysfunction. Behavior and mood are particularly unpredictable in children between 10 and 18. How would you know if your child was having long term symptoms from concussion or CTE, when we dismiss most moods and behavior during such periods as related to adolescence?
  • Takes Years to Assess Degree of Frontal Lobe Injury in Pediatric Patients. We learn to become adults in our frontal lobes. As our frontal lobes change during the years leading to adulthood, behavior, manners, mood, depression, sexuality all grow. Likewise, an injury to areas of the brain that may not be primary to a person’s current age, may not show up for years. Damage to the frontal lobes may not manifest itself for years after an injury to a child. Your child may be cognitively cleared from a brain injury playing sports, but have significant injury to the frontal lobes and the axonal tracts which connect the frontal lobes, without it showing up until the appropriate point in the maturation process.

Football is a dangerous sport for brains, period. One might argue that there is a cost benefit analysis that a professional athlete will engage in. We hear lots of famous retired players talking about how good the game was to them. How ridiculous all the lawsuits are. Yet to those athletes, the benefit analysis, in hindsight, was great. They got a career, fame from the risks they took. “Statistically of the 100,000 high school seniors who play football every year, only 215 will ever make an NFL roster. ” See NFLPA .  If  you know your child is going to be one of those who not only plays, but plays long enough for it to be a meaningful career option, maybe you should take that risk. For the other 99,900 parents, maybe you should rethink this.

Remember: With concussion time may reverse; CTE only gets worse.

For more on frontal lobe injuries, click here.


Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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