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Authors: Aaron Michael Yengo-Kahn, MD; Steve Monk, MD; Glenn Harris, BA; Jeffanie Wu, BS; Patrick Kelly, MD; Stephen Gannon, CCRP; Chevis Shannon; Christopher Bonfield, MD (Nashville, TN)

Introduction:

A child’s decision to participate in sport is multifactorial, including both child and parental influences. Inherently, children and their parents apply different weights to various factors in these decisions. Recent media attention surrounding sport-related concussion and chronic traumatic encephalopathy (CTE) may significantly affect parents. Using a national survey of parents, we examined the factors influencing parents’ choices to forbid their child’s participation in collision sports.

Methods:

From November 2016 to May 2017 and July 2019, 609 parents were recruited, utilizing a national volunteer registry, to complete a 31-question survey regarding their attitude towards sport participation. Responses were recorded per child, resulting in 917 total responses. Individual sports were categorized into four groups (collision, contact, limited contact, and extreme), based on prior studies. Parent and child demographics, influences on decisions to allow or disallow participation and concussion history were obtained. Variables achieving significance (p<0.05 on univariate analysis) were combined in a multivariate logistic regression.

Results:

Most parents (98%) allow their child to participate in at least one play sport, however 50% forbid participation in collision sports. Forbidders more often identified safety concerns (47.9% vs 31%,p<0.0001) as the biggest influence compared to those who allowed collision sport participation. Parents who disallow collision sports are more often non-hispanic (OR=2.1, p=0.035, 95%CI 1.05-4.12) and influenced by personal experience (OR=1.45, p=0.047, 95%CI 1.06-2.08) and the media (OR=1.65, p=0.048, 95%CI 1.01-2.71). Older children were less likely forbade from collision sports (OR=0.96, p=0.01, 95%CI 0.94-0.99). A child or parent history of concussion appears to be a non-factor.

Conclusion:

The decision to allow a child to participate in collision sports is complex. The factors most commonly cited in disallowing collision sport participation are personal experience, and the media. It is important to recognize the increased influence of these factors and adapt our counseling of patients accordingly.

AAP/SONS Award, Kenneth Shulman Award