If you are involved in a private youth sports program which plays on publicly-owned fields, diamonds, rinks, or courts, or are in local government, you have probably been hearing a lot lately about what is being dubbed the "power of the permit": the authority municipalities and towns around the country are using to condition use of their athletic facilities by private programs on compliance with state concussion safety laws from which they would otherwise be exempt, or, in an increasing number of instances, to fill gaps in their state's law.

Contrary to what you may have been reading, however, the exercise by municipalities of the power of the permit to require private sports programs to comply with state-mandated concussion safety laws, or impose additional conditions beyond those required by state law, isn't an isolated or new phenomenon: it's been a growing trend for years.

I first recognized the power that a municipality has to control the use of its fields two decades ago when I started a new travel soccer program in my hometown and went looking for fields on which the teams could play. I soon learned that permits to the town's fields were given out by the director of the recreation department, whose practice had always been to simply hand over permits for all the town's fields en masse to the established travel soccer program, whose policy of exclusivity and lack of concern for player safety were the very reasons that led me to form my new program.

While my efforts to persuade the Board of Selectmen, the town manager, and the Rec Department director to allocate permits in a more equitable fashion, and to use their power to make sure that the programs using town-owned facilities met minimum standards for inclusiveness and safety, fell on deaf ears (we ended up being forced to use for our home games a dusty field the high school had essentially abandoned), I returned to a discussion of the "power of the venue permit" 10 years later in my 2006 book, Home Team Advantage: The Critical Role of Mothers in Youth Sports, where I suggested that one of the best ways for youth sports parents to improve the safety of privately-run sports programs in their communities was to lobby their elected officials to utilize that power to "reform youth sports by exercising public oversight over the use of taxpayer-funded fields, diamonds, tracks, pools, and courts, [and] deny permits to programs that fail to abide by a [youth sports] charter" covering such topics as background checks, and codes of conduct for coaches, players, and parents.

When I presented the next year in Atlantic City to recreational department directors gathered for the annual meeting of the New Jersey Parks and Recreation Directors' Association, I spoke to the critical role they could play in improving sports safety by proactively exercising the power of the permit to require youth sport coaches to receive more training in first aid, CPR, and the signs and symptoms of a concussion. It wasn't long after the speech that a rec director contacted me about using the Power of the Permit in his town.

All politics is local

Since then, a growing number of communities across the nation have utilized the power of the permit, not just to extend the reach of state concussion laws to private programs utilizing municipally-owned athletic facilities otherwise exempt from coverage (many of the concussion safety laws enacted by the states do not cover non-scholastic sports programs), but to impose additional requirements not mandated by state law. Here are just a few examples: 

• In May 2011, the Recreation Department in Franklin Lakes, New Jersey became the first municipal recreation department in the area to mandate baseline neurocognitive testing for all athletes 11 and older playing rec football, and announced its intention to eventually extend the requirement to all 3,000 children participating in the borough's sports programs.
• In March 2012, the Town of Ashland, Massachusettsenacted one of the most comprehensive concussion bylawsI have seen covering programs utilizing town-owned athletic facilities, imposing requirements going well beyond those required under Massachusetts law.
• In May 2012, the Brookline (MA) Park and Recreation Commission enacteda policysettng standards for the prevention and management of sports-related head injuries for all organized youth sports programs offered by Brookline Recreation and those groups permitted to use its facilities, which, the director of parks and recreation, Lisa Paradis, told me in an interview, did not need the approval of the Board of Selectmen because she closely modeled it on Ashland's policy. The Brookline policy goes further than the Commonwealth's concussion safety law by requiring baseline neurocognitive tests at least once a year, and by requiring that concussed athletes be advised to get rest while symptomatic. A permit holder's failure to comply with the policy could subject the user to permit revocation.
• In July 2012, two years before Virginia's concussion safety law wasamendedto cover non-interscholastic sports programs utilizing public school athletic facilities, the Town of Christianburg (VA) Parks and Recreation Department enacted its own Youth Sports Concussion Policy. Notably, unlike Virginia's law, the policy expressly empowers game officials to remove athletes from play if they are suspected of having suffered a concussion (a power that I have beenadvocating for many yearsgame officials be given, and a power conferred on game officials by laws at the state level in only 12 states, and by rule at the high school level by the National Federation of State High School Associations), and requires that coaches who disregard the safety and well being of a youth sports participant as it related to concussions be subject to indefinite suspension (only Pennsylvania and Connecticut have laws which penalize coaches for violating their statutes)
• Most recently, in May 2015, the City of Norwalk, Connecticut enacted an ordinance requiring private sports programs using municipal facilities to comply with a comprehensive concussion risk management program, including a requirement that all coaches take a concussion education course, a requirement absent from Connecticut's concussion safety law, more concussion education of parents and athletes, including an oral presentation (I have been advocating for such concussion education meetings to be held before each sport season for the past fifteen years), and requiring that a concussed athlete complete the six-step exercise protocol recommended by most concussion experts before receiving written clearance to play (only a handful of state laws, including California's, expressly make this a requirement).

Filling gaps

As these local ordinances illustrate, even if private sports programs are covered by the state's concussion safety law, such laws often do not go far enough. For instance, many do not require that coaches receive training in recognizing the signs and symptoms of concussion, or require that parents be notified when their child is suspected of having suffered a concussion, and few penalize those who violate their provisions.

Especially at the youth level, where trained medical personnel such as certified athletic trainers are much less likely to be at games, and even less likely to be at practices, it is coaches and game officials who will most often have to make the initial remove-from-play decision in cases of suspected concussion. If no concussion education of coaches is required by state law, and if game officials are not empowered to remove athletes, I believe it is up to the municipality to use the power of the permit to mandate such training and confer such authority.

Even if a state's concussion safety law does cover community-based, private sports programs, very few states have enacted laws that cover all aspects of youth sports safety, such as requiring more broad-based safety training for coaches in first-aid, CPR, and the use of an AED, and the development and implementation of an Emergency Action Plan (EAP) to be triggered in case of medical emergencies, such as a cardiac event (e.g. sudden cardiac arrest), asthma attack, allergic reaction to a bee sting, or heat stroke, and environmental emergencies (lighting, tornado, or an excessively high heat index).

As a result, even if a private sports program that uses town fields, rinks, diamonds, or courts is required to comply with state mandates regarding concussion safety, I believe that there is a huge sports safety gap which, absent voluntary implementation by a private sports program of youth sports health and safety best practices, such as those we are pilot testing in Grand Prairie, Texas this fall as part of our SmartTeams^TM program, can and should be filled by a municipality by exercising its power of the permit.

"Safety Champions" Needed

As with legislation at every level of government, successful utilization of the power of the permit depends not so much on concerned citizens committed to making youth sports in their local community safer (although they are, of course, important) as on the willingness of governmental officials themselves to sponsor bylaw changes and push for enactment, in other words, to serve as "safety champions."

In the case of Norwalk, Connecticut, for instance, it was Diane Beltz-Jacobson, Assistant Corporation Counsel for the City, who, once a concerned mother brought the issue to the attention of governmental officials, spearheaded the effort which led to adoption of a concussion safety ordinance by the city. "Since my own son had just sustained a concussion and I was aware that there is a gap in the state laws that protect our youth athletes, I was motivated to draft the bylaw," Beltz-Jacobson told me in an interview, a bylaw which she modeled on the Brookline bylaw with her own enhancements. "Once I finished it and presented it to the common council, they took a number of passes to strengthen before they ultimately approved it."

For more on the Power of the Permit, including a video of a presentation by Professor Doug Abrams of the University of Missouri School of Law at a youth sports safety summit MomsTEAM Institute convened at Harvard Medical School in September 2014, click here.

Has your community used the Power of the Permit to make youth sports safer in your community? We want to know about it! Send your information to editors@momsteam.com. 

Note: This blog was originally published on Huffington Post on July 20, 2015. 

Earlier this week, I had the opportunity to talk to Lester Holt on NBC's Today Show about a subject I have been writing and talking about for the past decade - sports training for kids at earlier and earlier ages.  It was fitting to end the year and the last week of MomsTeam's first decade speaking to the nation about the tremendous pressure parents are under to place their infants and toddlers in programs that promote giving young children an "edge" in the mad rush to grab a seat on the runaway bus of youth sports.

When the Today Show producer called, she told me she had read the second chapter of my book Home Team Advantage: The Critical Role of Youth Sports Parents titled: "Too Much Too Soon: Making Sure Your Child's Involvement In Sports Is Developmentally Appropriate" and felt it provided ideal background information for the segment. While the book is now four years old, the fact that the tentacles of the youth sports business machine were now reaching into the cribs of babies to provide new customers was not really news.  What is surprising and new is the continued growth and proliferation of such programs even during a recession when money for so many families is so tight.

Since my segment aired I have heard from educators and child development experts and MomsTeam visitors (old and new) from around the nation, all applauding my stance and appreciating the research I have done (including the 31 publications listed in the bibliography for Chapter Two) to back up my assertion on the Today Show that "Children who are enrolled in sports programs while still toddlers and infants have no edge - no advantage over other children."

One of my favorite studies on youth sports development is one from 2006 published in the Journal of Physical Education, Recreation, and Dance. The study shows that only one out of four kids viewed as "superstars" at the age of 10, 11, and 12 year olds goes on to star in high school sports.

One only has to raise non-identical triplet boys, as I have done, to know that each child has their own developmental blueprint and develops at their own rate. To try to force a child to learn a sport long before they are ready is a fool's errand and a waste of money, in my view.  For years, I have suggested to parents that they save their money in a summer camp fund for when the children are older. Perhaps, thirteen or fourteen, when they are developmentally and psychologically ready to start concentrating on a single sport.

In the meantime, a local high school baby sitter with an interest in sports who will play one-on-one with your child, in their own environment at their own pace may be the best investment of your money.

For a transcript of the Today Show segment, Baby Goes Pro, click here. 

For the video of my interview by Lester, just named as the permanent host of the NBC Nightly News, click here.  

Although April - which was both National Youth Sports Safety Month and National Child Abuse Prevention Month - is now over, it doesn't mean that the work of parents in helping keep kids safer playing sports is over.

Indeed, as I have learned over the past 25 years, first as a mother, coach, administrator, and youth sports safety activist, then as the Founder and Publisher of MomsTEAM, and now as the Executive Director of the non-profit MomsTEAM Youth Sports Safety Institute, I have learned that, just as it takes a village to raise a child, it takes the continued involvement of every youth sports stakeholder to protect children at play from abuse -- not just physical abuse, but emotional, psychological and sexual -- and from sports injuries, many of which are preventable.

While the Federal Child Abuse Prevention and Treatment Act (CAPTA), provides guidance to states by identifying a minimum set of acts or behaviors that define child abuse and neglect, there are no federal, and very few state laws (outside the realm of concussion safety), which specifically protect children involved in sports; fewer still penalize those that violate its provisions.

But new child protection laws aren't the only way to help improve youth sports safety. There are numerous steps that parents can take, along with other like-minded parents, to make the sports experience safer for all children in their local communities. Here are just six:

1. Push your school and community-based programs to adopt comprehensive risk management programs. If concern is expressed that implementing such a program could end up increasing the exposure to lawsuits because any deficiency or oversight in meeting self-imposed safety requirements could provide the basis for a negligence lawsuit, help the club or school board understand that such fear shouldn't be an impediment to implementation. The alternative is worse: without such safety programs, more kids are likely to get hurt.

2. Lobby your community to use the power of the permit. In most places, youth sports organizations (YSOs) don't own their own facilities; they use taxpayer-funded fields, diamonds, tracks, pools, and courts instead. To use them they have to obtain permits.

In my 2006 book, Home Team Advantage: The Critical Role of Mothers in Youth Sports, I argued that, "By utilizing the power of the venue permits, a municipality can reform youth sports by exercising public oversight over the use of taxpayer-funded fields, diamonds, tracks, pools, and courts, denying permits to programs that fail to abide by" municipal ordinances with respect to sports injury prevention and treatment.

It is a power, as University of Missouri Law professor Doug Abrams noted during a presentation at MomsTEAM's September 2014 youth sports safety summit, in a subsequent article on MomsTEAM, in a law review article, and in a recent Huffington Post blog, that has been a "bedrock principle of municipal law" for decades.

And it works.

When her efforts to get the Connecticut state legislature to expand the coverage of its youth sports concussion safety law to cover private sports organizations stalled, a concussion safety activist, armed with information about the power of the permit I had provided to her in an email, was able to successfully lobby the city council in Norwalk, Connecticut to use the power of the permit to force organized youth sports programs utilizing the city's recreational facilities to abide by the state concussion guidelines.

3. Take a public stand against hazing and push for adoption by your child's sports program of a strict anti-hazing policy. The policy emphasized in pre-season meetings and written materials distributed to every student/team member, and, above all, enforced.

4. Push for youth sports organizations to adopt a public health approach to injury prevention. Dr. Jim MacDonald, a clinical professor at Ohio State and pediatric sports medicine specialist at Nationwide Children's Hospital, urges a comprehensive approach to preventing youth sports injuries based on three proven public health strategies: (1) "thinking like Sweden" in setting a target of zero youth sports injuries; (2) encouraging greater use of personal protective equipment shown to reduce injury risk, including properly fitted and maintained helmets, and the wearing of mouth guards and goggles in a wide range of sports; and (3) recognizing that education is not enough to change the cultural and physical environment of youth sports, but requires active implementation of sports safety best practices, including more certified athletic trainers, not just in high school sports but at the middle school and youth level; and by doing a better job of getting high school and youth coaches to "buy" into injury prevention.

5. Ask for safety training of coaches and mandatory evaluations. The United States is the only country in the major sporting world that does not have a national coaching education program. With all the money being poured into youth sports, it is simply astounding that the least investment is in coaches, even though they usually have the most impact on kids and keeping them safe.

6. Call for community-, private- and school-based sports organizations to view youth sports safety from a child's rights perspective. Children playing sports are owed a duty of care. Encourage programs to identify best youth sports health and safety practices and implement child protection programs to combat physical, emotional and sexual abuse in youth sports, as has been done in the United Kingdom. Because such programs implement standards that apply to everyone, not just parents, but coaches, players, officials, and other adults who work with children in sports, they won't just reduce the number of out-of-control parents, but the number of out-of-control, abusive coaches, team-bullies, spectators, and volunteers as well.

Brooke de Lench is Executive Director of MomsTEAM Youth Sports Safety Institute, Founder and Publisher of MomsTEAM.com, Producer/Director of The Smartest Team: Making High School Football Safer, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins). You can follow Brooke on Twitter @brookedelench. 

If you follow the subject of sports-related concussions, you've probably seen a flurry of news on the subject of impact sensors in the last couple of weeks. As someone who has been writing about and beta testing impact sensors for the past five years, I have, of course, been monitoring developments, too.

On February 16, 2015, my local paper, The Boston Globe, came out with a powerful editorial in which it urged college, high school, and recreational leagues in contact and collision sports to consider mandating use of impact sensors, or, at the very least, experimenting with the technology, to alert the sideline personnel to hits that might cause concussion, and to track data on repetitive head impacts, which, a growing body of peer-reviewed evidence suggests, may result, over time, in just as much, if not more, damage to an athlete's brain, as a single concussive blow, and may even predispose an athlete to concussion.

The Globe editorial viewed as "shortsighted" the reluctance of players and coaches to adopt the use of impact sensor technology out of fear that sensors, if they triggered an alert, might result in a player's removal from the game (that, after all, is the whole point) or the player being labeled a wimp (what the Institute of Medicine has labeled the "culture of resistance"), and it called on professional leagues, like the NFL, to follow suit, suggesting that star players, by using the devices, could help break down barriers to their more widespread use.

Unfortunately, on February 19, 2015, just three days after than the Globe went on record as urging the NFL to set an example for colleges, high school, and youth leagues to follow by equipping its players with sensors (as the Arena Football League has already done), the league did exactly the opposite.

As first reported by Sports Business Journal and, later that same day, by The New York Times, the NFL decided to suspend a pilot program using sensors in players' helmets for the 2015 season because data collected during the 2013 season was not considered reliable enough (for what, they didn't say), and because the N.F.L. Players Association questioned whether the data would be kept private and not used against a player.

Researchers who have collected data for years, including Stefan Duma, who runs the biomedical engineering department at Virginia Tech and helped develop the STAR helmet rating system, were quick to say that the league was being too careful, and that, while not perfect, even with a 10 to 20 percent error rate, the sensors were valuable and give reasonable data that is useful, not only in football, but in analyzing head hits in sports like soccer and hockey. I agree.  (After all, if a 10-20% error rate hasn't prevented the widespread use of neurocognitive tests such as ImPACT, why should it be any different with sensors?)

Duma speculated that one reason the N.F.L. and the players' union might be ambivalent about the use of sensors was because they could show that players were receiving more blows to the head than was commonly thought. He feared that the decision could dampen research efforts by others and didn't acknowledge "all the good things" that sensors do.

I agree with Duma on that point as well. Indeed, preserving the status quo and making it harder to use impact sensors is a theme explored in a law review article published yesterday in the University of Maryland's Journal of Business and Technology Law, which I co-authored with MomsTEAM Senior Editor Lindsey Straus.  While our article is primarily about the role organizations such as the National Operating Committee on Standards for Athletic Equipment ("NOCSAE")  play in setting performance standards for add-on equipment, such as impact sensors (it is our position that such standards should be set either by governmental agencies, such as the Consumer Product Safety Commission, or by truly independent standard-setting groups, such as ASTM International, and not by groups such as NOCSAE and Sports Legacy Institute funded, primarily or in part, by the equipment manufacturers whose products are subject to the performance standards they set), we also address the same concerns raised by Dr. Duma: that groups like NOCSAE, NFL, and its players have a vested interest in protecting the status quo, which, in the case of impact sensors, means trying to put the brakes on widespread adoption of sensor technology, not because their use is unlikely to make sports like football safer (I think it will), but for fear that it may open Pandora's box by making it clear just how hard and how often players are getting hit, and scare off parents from letting kids play the sport.

What motivates my desire to see widespread adoption of  impact sensor technology? I can trace it back to my childhood. In the early 1960's, before seat belts were standard equipment in every automobile, I remember a time my mother, a now retired emergency room nurse, was driving my three sisters and I in our old station wagon on some errands when we were rear-ended. No one was hurt, thankfully, but the accident prompted her to begin working for enactment of a law requiring car companies to include seat belts as standard equipment in every new car. (By the way, my mom was also an early advocate for installing defibrillators in every ambulance and on banning smoking in public places.) My father, on the other hand, was a gifted athlete who excelled at a variety of sports (baseball, hockey, golf, skiing, tennis), who introduced my sisters and I to every sport imaginable, and never held us back.

No wonder, then, as the product of a mother who, as a result of her work in the ER, was understandably obsessed with safety, and a very athletic father who loved sports and encouraged us to play them with gusto, that when I became a mother raising athletic triplet sons I did everything I could to protect them while playing sports, but at the same time encouraged them to play whatever sport they loved, even ones like football, lacrosse, soccer, and skiing/snowboarding which came with the risk of head injury. In 1999, when my son Spencer sustained a concussion playing high school football (after suffering at least two earlier concussions, one snowboarding and one sledding), I began to focus more on the safety side of the sports equation, especially with respect to concussions.

About five years ago, I started to write about companies who were developing impact sensors, not just for research, but for use at the youth, high school, and college level; sensors that, while not as sophisticated as the ones used for research - which cost upwards of $1,000 per player - could be used to alert sideline personnel to athletes who had sustained hits hard enough to cause concussion, and identify athletes whose poor technique caused them to sustain an unusually large number of high force impacts. 

In 2012, when I was asked by the high school football program in Newcastle, Oklahoma for help in implementing an evidence-based concussion risk management program (one which we now call The Six Pillars^TM, it seemed like, pardon the pun, a "no-brainer" to see if a impact sensor manufacturer wanted to beta test its sensors by donating them to the school for installation in some of the Newcastle players' helmets. (We left it up to the players and their parents whether the sensors would be installed in their helmets).

My experience with impact sensors during the filming of "The Smartest Team: Making High School Football Safer" convinced me that they had value as a technological "end run" around the persistent problem of chronic under-reporting by athletes of concussion symptoms, and would, as the cost came down and the reliability went up, eventually become standard equipment in contact and collision sports.

From talking candidly at length with the players in Oklahoma after a duck-hunting trip (next to playing football, their favorite activity), I learned that they actually  wanted to wear the sensors. Why? Because they knew that, if they took a heavy hit, it would register on the iPad the athletic trainer or his assistant was holding on the sideline. In other words, knowing that they would be checked out if the sensor alerted sideline personnel to a blow with the potential to cause a concussion, they felt more comfortable, if they were experiencing concussion symptoms, reporting them to the AT without fear of being labeled a wimp by their teammates or the coach.

Is the technology perfect? No, it's not. But, like Dr. Duma, and others, I believe that, in hitting the pause button on the use of sensors, the NFL is essentially throwing the baby out with the bathwater, and sending out exactly the wrong message about sensors. Our experience at MomsTEAM Institute in field testing seven different impact sensor models over the past three football seasons, at both the high school and youth level, is that they are, at this stage, a bit of a mixed bag. Admittedly, the technology is still in its infancy.

In my view, however, equipping players with sensors does not, as one critic has suggested, turn them into crash-test dummies. With appropriate safeguards in place to ensure that the privacy of the players is protected, and that access to the data the sensors generate is restricted to those who can use that data intelligently (such as an AT or coach), I continue to believe that the best way to refine and improve impact sensor technology, and educate players, coaches, parents, and ATs about their advantages, is, well, to use it. Sadly, the NFL's decision to stop using impact sensors is likely to set back the kind of widespread use MomsTEAM have been advocating for years (not because we have a dog in this fight, but solely because we believe in the technology). How much of a setback remains to be seen. More on this later.

Here are some of our articles on impact sensors:

Impact Sensors: Frequently Asked Questions

Underreporting of Concussions: Is Monitoring Head Impact Exposure A Way Around The Problem? 

Impact Sensors: Many Benefits Of Real-Time Monitoring

AFL Becomes First Professional Sports League to Require Helmet Impact Sensors

Conflict of Interest Statement on Impact Sensors 

The decision by San Francisco 49er Chris Borland to retire from the NFL after just one season out of concern for the long-term effect of head trauma has predictably generated a media firestorm. But lost amid the hoopla is what it means for sports parents.

Here are two lessons I think parents with kids playing -- or considering playing -- football or other contact and collision sports can take away from the Borland retirement, and one lesson they shouldn't take away:

1. Retirement from contact/collision sports should always be an option

Borland is to be applauded for making his decision to walk away from a pro career only after carefully weighing the risks and rewards with family, friends, doctors, and concussion experts, and after doing his own research. Parents need to let themselves and their children know that there is no shame in doing the same.

To read the full blog on Huffington Post, click here.