Public Release: 

Study finds gap in awareness of return-to-play practices following youth sport head hits

Coaches and parents need more education on how to detect and respond to symptoms of concussions in child athletes to avoid the risk of further injury

American Academy of Pediatrics

WASHINGTON, DC - Coaches and parents need more training on concussions to avoid making bad calls about when to let a young athlete back in the game, according to a study to be presented at the American Academy of Pediatrics (AAP) National Conference & Exhibition in Washington, DC, on Saturday, Oct. 24.

In a survey, more than 40 percent of coaches and 50 percent of parents said they would feel comfortable sending a young athlete back into the game before a doctor's OK, contrary to medical guidelines on caring for athletes after a head hit. For the study, "Post-Head Hit Return to Play Awareness in Parents and Coaches," researchers collected responses from a total of 506 parents, coaches who are also parents of children aged 18 or younger, and coaches who do not have children 18 or younger. Participants completed the survey during a visit to the Nemours website,

These statistics mean that 20 percent of the time, child athletes would lack proper attention after head hits, said lead researcher Edward J. Hass, PhD., director of research and outcomes at the Nemours Center for Children's Health Media. Further, he said, symptoms requiring emergency room treatment would not receive such urgent attention 25 percent to 50 percent of the time.

According to the study, it's not that parents don't recognize their child has a symptom such as headache, dizziness or vision problems; it's that they don't realize these symptoms mean a possible concussion. Parents in the study were identified as taking one of two approaches to seeking medical attention after a head hit, based on certain symptoms.

"One group's typical response was to `take no chances' and seek immediate medical attention, while the second group was more likely to engage in `watchful waiting' and delay seeking medical attention," Dr. Hass said. "Our research leads us to believe the latter group was not adequately informed about the implications of key symptoms pointing to a possible concussion."

Dr. Hass said the magnitude of these findings is underscored by the fact that tens of millions of children age 18 and younger play some organized sport each year.

"The study shows there are gaps that must be filled to ensure that all youth athletes have an advocate for the safety of their developing brains on the field of play," he said. "These results speak to me as a researcher, parent of a youth athlete, and youth coach."

The study also found that news coverage of athlete concussions has made parents of active student athletes more vigilant on their player's behalf. However, one in four parents whose children do not currently play sports said that such concerns would make them keep their child out of sports.

"While that is certainly acting on the side of caution, it also keeps a child from experiencing the benefits of sports," Dr. Hass said. "We feel that with continued awareness-building on safe return-to-play protocols, sports participation can be enjoyed by all children in as safe a manner as possible."


The abstract will be presented at 3:10 p.m. on Saturday, Oct. 24 in room 143B at the Walter E. Washington Convention Center in Washington, DC. To view the abstract, visit Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available, or may be preparing a full-length article for submission to a journal. Contact the researcher for more information.

The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit

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