The following was published by CQ Researcher on May 8, 2020, and written by Dr. Gerard A. Gioia, Chief of Neuropsychology at Children’s National Hospital in Washington, D.C. USA Football was granted permission by the publication to post this essay in its entirety for the health and well-being of youth football players and their families. USA Football is a proud member of the U.S. Olympic & Paralympic Committee.

As Chief of Neuropsychology at Children’s National Hospital in Washington, D.C., I treat youth with brain injuries as young as 4-years-old, conduct concussion research, and have worked with the CDC’s National Center for Injury Prevention and Control for almost 20 years.

We all share a common goal across youth sports of reducing injury risk while optimizing benefits of sport participation and avoiding unintended consequences of our actions. Differences exist, however, in how to achieve this goal.

Do contact sports, including football, have challenges? Yes. And these sports are addressing those challenges proactively and responsibly.

USA Football, the sport’s national governing body, has long embraced the CDC’s Heads Up concussion education program. Recently, the Football Development Model (FDM) was introduced to modify how the game is taught and played. Based on the athlete’s age and skill level, coaches teach a curriculum emphasizing developmentally-sensitive skills to maximize fun and athleticism while reducing contact.

I volunteer with the FDM Council guiding this framework, serving with current and former coaches and experts across neurology/neuropsychology, sport science and coach education.

Banning tackle football is not the answer to these challenges. Broad, sweeping policy recommendations to ban youth tackle football take an extreme, scientifically unsupported position. 

Some of the statements in the press have been misleading and/or overstated regarding the research supporting elimination of youth tackle football.

Articles claiming mounting evidence of lasting cognitive damage caused by youth football and accumulated damage from ‘sub-concussive’ hits causing damage later in life are not supported by current research, mischaracterizing our current state of knowledge.

A recent evidence-based review of youth contact sports (Rivara et al., 2020) concluded: “High-quality data show no association between repetitive head impact exposure in youth and long-term neurocognitive outcomes. The association between repetitive head impact exposure and changes on neuroimaging in youth is inconsistent and the clinical implications of these changes are unknown. There is little evidence that age at first exposure to repetitive head impacts in sports is independently associated with neurodegenerative changes.”

Further, robust epidemiologic studies of high school football players do not find poor outcomes in later adult years, reporting no increased incidence of dementia, Parkinson’s Disease, ALS, lowered level of intelligence or rates of depression. 

Inspired to advance children’s health, we seek to learn more and play smarter.

I invite a scientifically supported stance on improving, not eliminating, the game of football for youth.