Updates in Pediatrics
Editor: Jack Wolfsdorf, MD, FAAP
header with photos of various children
January 12, 2022 | Volume 13 | Issue 2
Exposure to head impacts and cognitive and behavioral outcomes in youth tackle football players across 4 seasons
“Repetitive sub-concussive head impacts during childhood have been implicated in the development of chronic cognitive and behavioral problems”. Retro- and prospective studies however have yielded conflicting results.

The American Academy of Pediatrics (AAP) doesn’t specify what age is appropriate for children to participate in tackle football but states “Delaying the age at which tackle is introduced to the game would likely decrease the risk of these injuries”. The Concussion Legacy Foundation “strongly recommends you delay enrolling your child to tackle football until age 14 years”. Some previous retrospective studies have suggested that exposure to repetitive head impacts in tackle football before the age of 12 years is associated with neurobehavioral and cognitive problems later in life. Other studies have not confirmed this.

A prospective cohort study of 70 boys aged 9-12 years undertaking youth tackle football over 4 seasons examined (before and after each football season) the association between 10 cognitive and behavioral outcomes and head impact (using helmet-based sensors to yield cumulative head impact gravitational force equivalents per season).

After correcting for multiple comparisons no association is found between impacts and cognitive/behavioral outcomes. (There is however an association between head impacts, premorbid conditions including ADHD, anxiety and depression and worse cognitive/behavioral outcomes.
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