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. 2023 Apr 1;58(4):285-292.
doi: 10.4085/1062-6050-0560.21.

Youth Tackle Football Head-Impact Estimation by Players and Parents: Is the Perception the Reality?

Julianne D Schmidt  1 , Rachel S Johnson  1 , Landon B Lempke  1 , Melissa Anderson  1 , Rachel Khinh Le  1 , Robert C Lynall  1
Affiliations

Youth Tackle Football Head-Impact Estimation by Players and Parents: Is the Perception the Reality?

Julianne D Schmidt et al. J Athl Train. .

Abstract

Context: With growing concerns surrounding exposure to head impacts in youth tackle football, players and parents must understand the exposure level when assenting and consenting to participate.

Objective: To determine whether youth football players and parents could estimate on-field head-impact frequency, severity, and location.

Design: Prospective cohort study.

Setting: Football field.

Patients or other participants: We administered a 10-question head-impact estimation tool to parents (n = 23; mean age = 36.5 years [95% CI = 31.7, 37.3 years]) and players (n = 16 boys; mean age = 11.1 years [95% CI = 10.3, 11.8 years]).

Main outcome measure(s): Player on-field head-impact exposure was captured using the Triax SIM-G system. We determined the accuracy between player and parent estimates relative to on-field head-impact exposures using κ and weighted κ values.

Results: Youth tackle football players and parents did not accurately estimate on-field head-impact frequency (κ range = -0.09 to 0.40), severity (κ range = -0.05 to 0.34), or location (κ range = -0.30 to 0.13). Players and parents overestimated head-impact frequency in practices but underestimated the frequency in games. Both groups overestimated head-impact severity, particularly in games. Most players and parents underestimated the number of head impacts to the top of the head, particularly during practices.

Conclusions: Underestimations of head-impact frequency in games and to the top of the head suggest that informed consent processes aimed at educating players and parents should be improved. Overestimations of head-impact frequency in practices and severity may explain declining rates of youth tackle football participation.

Keywords: concussion education; mild traumatic brain injury; sport policy.

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Figures

Figure 1
Figure 1
A–C. Head-impact frequency. The percentage of players and parents estimating each response option (bars) is shown relative to the percentage of players in each category based on their on-field head-impact exposure (dashed line). Bars below the dashed line indicate an underestimation relative to the on-field head-impact outcomes. Bars above the dashed line indicate an overestimation relative to the on-field head-impact outcomes. Weighted κ values represent agreement between the player's or parent's estimation relative to how the matched player or parent was categorized based on the on-field outcomes.
Figure 2
Figure 2
A–C. Head-impact severity. The percentage of players and parents estimating each response option (bars) is shown relative to the percentage of players in each category based on their on-field head-impact exposure (dashed line). Bars below the dashed line indicate an underestimation relative to the on-field head-impact outcomes. Bars above the dashed line indicate an overestimation relative to the on-field head-impact outcomes. Weighted κ values represent agreement between the player's or parent's estimation relative to how the matched player or parent was categorized based on the on-field outcomes.
Figure 3
Figure 3
A–D. Head-impact location. The percentage of players and parents estimating each response option (bars) is shown relative to the percentage of players in each category based on their on-field head-impact exposure (dashed line). Bars below the dashed line indicate an underestimation relative to the on-field head-impact outcomes. Bars above the dashed line indicate an overestimation relative to the on-field head-impact outcomes. Weighted κ values represent agreement between the player's or parent's estimation relative to how the matched player or parent was categorized based on the on-field outcomes.
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