Emory professor Bryan Williams is an epidemiologist whose research has focused in the areas of perinatal, pediatric, and environmental epidemiology and policy. His research also involves the examination of factors related to health and educational disparities among children.
In this essay, Dr. Williams talks about the need to make safety as important as performance in children’s sports.
By Bryan Williams
Sports can provide children with critical life skills. Despite the many benefits of youth sports, there are also perils, dangers posed not by the inherent risks of participation but the lack of oversight of youth sports organizations.
One cannot participate in youth sports without hearing, “it’s about the kids,” a sentiment so commonly voiced that one might expect to see it on T-shirts. Sadly, in many instances it is not about the kids. It is about the adults, parents convinced their 6-year-old is D1 material; coaches whose self-worth is solely a function of their win-loss record; and league officials who enjoy power and financial resources not available to them in their working lives.
The stakes of youth sports are inexplicably and unjustifiably high. Once a relatively innocent low-stakes activity for children, contemporary youth sports increasingly resemble their collegiate and professional counterparts. Like sports among older peers, youth sports are plagued with problems such as on and off the field violence, performance enhancing drugs, and pay-for-play.
We have created a culture in youth sports that has undermined its many intrinsic benefits and, most importantly, put children and adolescents at risk of physical and emotional injury.
According to Safe Kids, a nonprofit injury organization, at least 2.6 million children ages 19 and under visited the emergency room for injuries related to sports and recreation in 2012. Sadly, we really do not know how many children suffer catastrophic injuries (e.g., paralysis) or fatalities as the result of sports participation.
Children are consistently put at risk by league rules that neither mandate minimal protection measures nor require competently trained personnel. The obvious need to protect children has taken a back seat to our love affair with youth sports, an affection that is blind to the numerous tragedies waiting to happen.
Although child trauma is never pretty and always tragic, injury prevention has not received near the attention that performance has in youth sports. We have been far more concerned with commenting on a first grader’s highlight video than we have been making sure coaches are able to provide basic first aid. Parent and coach web forums are chocked-full of discussions of who is going to be the next “Johnny Football,” but seldom is there a meaningful discussion of how to make kids safe.
Two major factors are responsible for the lack of child protection in youth sports. First, the vast majority of youth sports have been taken out of the public sector and put in to the hands of nonprofit groups with varying agendas. Unlike the public sector, private entities such as recreational football leagues owe little or no accountability to public officials or regulatory groups. They are accountable only to their own boards, and these are often comprised of likeminded individuals who frequently don’t represent the diverse composition of their participants.
Secondly, youth sports administrators and coaches lack the requisite skills and training to protect young participants. While they may be great at their respective occupations, restaurant managers, insurance brokers, or transmission salesmen are not competent to make clinical decisions about children in emergency situations. But they are called on to do so several times throughout a season.
Few leagues require members of the coaching staff to have minimal credentials (i.e., American Red Cross first responder or CPR certification). If a coach is unable or unwilling to be certified, why should they be allowed to be in a position of authority over a group of children? Other civic groups including the Boy Scouts have made emergency care credentials a requirement for leadership.
The lack of coaching staff training is disconcerting since the vast majority of time a child spends participating in sport is during practice, a time when no emergency personnel are nearby to provide clinical assessment or, if needed, basic life support. That task is left to the coaches or a trainer with minimal (less than an hour) emergency training. If a child is lucky, there may be a parent with clinical credentials who could intervene. However, the lack of critical equipment and policies that preclude any parent (even a doctor or nurse) from coming on the field would certainly decrease the likelihood that a parent could intervene in a crisis situation.
One might be reassured that emergency medical services are only a 911 call away, and that response will be quick. Such reassurance erodes when one considers that remote practice fields and communication barriers (e.g., delays, inability to identify location, or diminishing the urgency of the situation) can easily undermine the efficacy of emergency response. Every youth sports organization should have a strategic emergency response plan to ensure the safety of its young participants.
As a coach and parent, I must admit my own complicity in the youth sport enterprise. As such, I have found myself succumbing to peer pressure. Like a recovering addict, my condemnation of those who misbehave in this context is equally hypocritical and uniquely insightful. In the midst of competition, it is far too easy to lose proper perspective.
Cognitive dissonance aside, as a child health advocate and researcher, it is my responsibility to respond to this problem accordingly. Parents, public health officials, policymakers, and clinicians must prevent rogue organizations from hijacking the agenda of youth sports. Our children deserve better.
The agenda of youth sports is to provide experiences that serve the needs of children, not adults. One way to support this agenda would be to have public schools take youth sports back into the fold. School-based primary and middle school athletic programs thrive in many communities and private schools. While not perfect, public schools provide a much better infrastructure for the administration of youth sports. Unlike most nonprofit organizations, schools are uniformly accountable to governing bodies (e.g., school boards) and policies.
In reality, nonprofit organizations are only accountable to a pro forma set of bylaws and advisory boards comprised of likeminded individuals. Teachers are accountable to state level professional standards commissions, local school boards, and their respective administrators. Former generations were coached by teachers, professional educators who entered their profession because of their genuine interest in helping children learn.
Albeit most elementary teachers do not understand the complexities of a spread offense or Cover 2 defense; but they presumably know how to teach a child basic concepts. Consequently, we need to put our children back in to the hands of those who are properly trained and accountable for protecting and educating children.