Hearing. We are here to continue the ongoing examination of concussions. His hearing follows an initial roundtable we had in march. We had a constructive dialogue with leading people on the field. While there is always some risk in injury, participating in sports at a young age is showed that many benefits. The benefits include better health, and proved academic achievements, physical skill building, to name a few. The Number One Health risk of risk is increasing child obesity. That leads to an adult risk for diabetes, cardiovascular disease, and other problems. They want children to pay careful attention to nutrition and remain active. Participatehildren in organized sports each year and despite this being the largest population of athletes, this group is one of the most underserved when it comes to Research Related to head injuries, which brings us to our task for today. We want to examine what is being done today to reduce the amount of head injuries to Young Athletes, how are the policies developed, do they go far enough , how does the large number of clubs,nt league teams, and Recreational Activity complicate efforts for injury prevention. Progress has been made in recent years. All 50 states and the district of colombia have enacted concussion laws. And others of them for months policies to reduce the amount of had contact in practice and games. Others provide education and guidance for training and awareness for coaches, parents, and athletes. Based on the experience thus far, are we doing enough and what does the science tell us . The last question is particularly interesting and important. There is a lot we do not know about concussions, but pediatric populations are severely underrepresented with existing research. And there is the challenge. Dramatict know how trump brain injury affects trump the youth and it makes it that much more challenging to protect them. Adding to the challenge we currently lack any form of surveillance. Given the large number of athletes, teams, and other recreational activities, this is a daunting task, but if we dont understand the magnitude of the challenge, how different factors such as age, gender, sports, socioeconomic status affects outcomes how can we make sure were making the best decision for our kids . This morning on our first panel, we are joined by two mothers. Ms. Karenjansen and siegel, both of whom tragically lost their son as a result of of injuries sustained while playing youth sports. One son was a promising athlete in colorado, mystical son patrick was a star running back of elizabeth Ward High School in my district and played football for the moment he could pick up a ball. We greatly appreciate your willingness to share your stories, as it reminds us why it is so vital to continue to examine this issue. Later in the second panel, we will have dartmouths head football coach and representatives from sports aganizations, he was football, usa hockey, and usa lacrosse to oversee and provide guidance to youth sports leagues. Really hear from practices like pros to find out options to keep athletics safe. We are prominent researchers in the field, theyll be able to speak on how we can approve research and surveillance, better monitor injuries, and better monitor injuries, and minimize the risk of injury aced upon science. I appreciate all of our panels for joining us this morning. It is an important issue. Your perspectives are perspectives are important to advance the public dialogue on these complex injuries. I want to thank Ranking Member for her support in this initiative and i look forward to continuing our efforts together in this endeavor. I now recognize the raking member for five minutes to deliver her own remarks. Thank you so much mr. Chairman for having this followup hearing on our roundtable we held on concussions and brain trauma earlier this year. I am pleased we are discussing it issports because proven that children and teens are more likely than adults to get a concussion and they take longer to recover. Athletes at the professional College Levels can make their own decisions about undertaking the risks associated with certain sports. But we need to ensure that children and their parents have enough data to make informed decisions about participation in youth contact sports. Part of that discussion needs to be the recognition of how valuable these sports are both for physical fitness and team building, as you so well stated, mr. Chairman. But i think we also need to have an open discussion about how to make them safer. I approach this issue both as a policy maker and a parent. As i said in the roundtable, i support evidencebased policymaking and i am very encouraged that we are having Ongoing Research to better understand brain trauma. But at our roundtable the expert saids they are going to have answers about what the protocols should be in seven to 10 years. What i said at that hearing was, as a mom, when i am deciding if my kid is going to play peewee sports, i cant afford to wait seven to 10 years. By then, they will be in high school. We need to take whatever evidence we have right now and we need to figure out for now, what we should tell parents and what we should tell leagues that they should be doing as the best track this far as we know right now. Age should, at what children Start Playing tackle football . How many times a week should children be engaging in full contact practices . And when they do because the play, how do we teach them to tackle safely into protect their heads and the heads of other players . E thatw do we ensur coaches are educated and teaching these skills to Young Players . I am sure that we can ask other questions in all youth sports, not just football. I agree that most, if not all parents, would agree it is better to air on the side of caution. Onwould be better to err the side of caution. The risk Case Scenarios that we would discover later that some of these Safety Measures may have been unnecessary. But, as a mom i always want to have more safety rather than less safety. Especially when you are talking about our childrens brains. As we implement changes in sports now, this is not a reason to stop researching our gaps in knowledge. We need to understand the longterm effects of concussion and separate concussive injuries. We need to analyze whether the rule changes are being implemented or having the desired effect. We need to do study how to prevent brain injury in the first place. I am also interested in hearing from eyewitnesses on the second panel about the differences they are seeing in girls and boys sports and how the rates of concussions differ. I there have been studies suggesting that women and girls report concussions at higher rates than poison similars orts. About theknow disparity and also if there is any disparity about the actual effects on the brain. Both of our panels contain excellent witnesses and it is so important to have them here today. I am really proud to welcome two witnesses from colorado. Kelly janz, as you heard tragically lost her son jake to a second impact syndrome in 2004. Kelly, im so proud of you because what you did is, you were instrumental in ensuring concussions are taken seriously in youth sports and the information they need. As the chairman mentioned, in 20 jakee governor signed the youth concussion act. Our secondis in panel and she is from the Colorado School of Public Health and like me, a colorado native. She is one of the leading injury,in sports epidemiology. Her database gathers information on injury exposure and incidence among high school athletes. She looks at injury patterns , like examining the correlation between neck strength and concussion risk to inform prevention and litigation strategies. I want to thank you also for making you the sports safer. I want to thank everybody who is here today to help us figure this out. And i also really want to say, we want to see sports succeed. I cant let this hearing go by without congratulating the world champion, denver broncos, for example, which i have season tickets. And i also want to say, as i have said before, one of my Great Sadness is is that i was unable to persuade either of my daughters to play ice hockey and they took of dance instead. But the point is, every child in this country should be safe. We love sports. We want to see sports succeed, but that means we have to do our utmost to improve player safety and guarantee that participation does not mean you have longterm health consequences. I know, mr. Chairman, you intend to have more hearings. I think this is the Perfect Place to start. I want to thank you again and yield back. Thank you, go steelers [laughter] thats fine. The penguins are in the playoffs. Mr. Nt to recognize hudson for an opening statement. I thank you mr. Chairman and Ranking Member for your focus on this issue, even as painful as it is to hear talk about the broncos as representing charlotte, North Carolina, home of the panthers. Theres always next year. I would like to thank the panel is for your report and testimony today. Your experience and expertise of the committee better understand the gravity of concussions and you sports. What we need to do to prevent concussions and the longlasting effects in future generations. Unfortunately, pediatric traumatic injuries are part of the number of the number one killer of kids. Pediatric trauma has become a focus of mine. The Childrens Institute was started by my dear friend, s wifed childress and hiw sif judy, with the discovering of the best ways to prevent and treat injuries in children. The Childress Institute funds initiatives to prevent and treat injuries in youth sports. The Promising Research is being done to prevent and treat trauma broadly and also specific issues like concussions, take some particular importance to me as the father of a sevenmonthold baby boy. Im thankful for awareness be brought to this issue by discussions like today. As one trauma surgeon said to me, it is not a life saved, it is a lifetime saved. My fellowt to thank North Carolina red representative with the energy and Commerce Committee on tuesday. I will encourage anyone who is interested to please attend. With that, yield back. Thank you, mr. Chairman. I want to thank all of our participants. I would like to thank the chairman for his committee. Year, we had an initial roundtable on this issue. At the time, i requested the the chairman that we hold a hearing on sports related head trauma. I am gratified that we are here today to discuss this very topic and look forward to the additional hearings on this important issue. Parents across the country are concerned about the risk for concussions and with good reason. I have my own experience as a parent in dealing with my daughters concussion and deciphering the medical advice provided. Tois challenging as a parent balance the news stories and the latest research against the value of our childrens participation in sports. I can rlate to parents trying to make the right decision. s youthuma during one can have serious consequences. Purdue university researchers, led by one of our witnesses today, found significant structural changes to the brains of High School Football players, even among those who were not diagnosed with a single concussion. And what is particularly troubling is these changes persisted even 12 month later, suggesting lasting damage. Many other studies have documented an association with sub concussive hits and changes in brain chemistry, decreased brain functioning, and behavioral changes. A recent study by a group of researchers at Boston University found exposure to hits, regardless of whether a concussion occurred, is associated with a higher likelihood of disorders like depression. The linkage between head impacts and cte, a devastating degenerating brain disease. It affects Young Athletes as young as 25 years of and adults who never played football beyond the high school level. They remain a number of Unanswered Questions about what risk factors make individuals more susceptible to these debilitating conditions. We also need to understand what happens with the brain when its hit and how many hits trigger these neurological hits. While Research Still needs to be done, that should not be an excuse for inaction. What is not dispute is the association between head trauma from contact sports, such as football and lasting brain damage and degenerative diseases , such as cte. Even the nfl acknowledges this link. Some researchers suggest that we should wait on the science before making changes to the rules of youth sports. I respectfully disagree. We cannot ask children and parents to wait 10, 15, 20 years for the signs to catch up before we take measures to make sports safer. We need to be asking questions right now. And implementing appropriate changes. Science has raised up enough red flags about the dangers of competitive head trauma to take every effort to make the games as safe as possible. Earlier this month, the subcommittee Ranking Members joined me in sending letters to collegiate and youth football leaders. We asked them to explain what rules or policy changes they are considering to address the risk associated with both concussive and sub concussive hits. I expect that well have a response by may 25. I commend pop warner for announcing yesterday that it will be in games for take off this fall. I would like to hear whether additional measures need to be considered. Last, mr. Chairman, i want to express my deep thanks to kelly siegel for being here today. Thank you for your willingness to shre your experiences with this committee. We can learn from you as we pave our path forward to better protect our kids. All of ourou to witnesses for helping us with our comp has a review of concussions and head trauma. I hope we can all continue to work forward to address the best ways to protect our children. I yield back. I ask unanimous consent that Opening Statements be introduced into the record. Now, i would like to introduce the witnesses for the first panel in the hearing. We will try to get through their testimony before the vote. Jake. Nz is the mother of he passed away after suffering from second impact syndrome, following her sons death. Ms. Janz has become a dedicated activists, committed from raising awareness for youth sports. We thank you for your testimony and we look for to your insight on this matters. I also would like to welcome ms. Karen siegel. She is president of the patrick cte Awareness Foundation. The foundation was foundation was created in memory of her son patrick, who i enjoyed reading about and his football career. He passed away after suffering from cte. Thank you for your testimony today, we look for to your comments. Do either of you object to testifying under oath . Thathair then advises you you are entitled to be advised by counsel. Do either of you desire to be advised by counsel . Would you mind, please rising and raising your right hand . I will swear you in . Do you swear the testimony you are about to give is the truth, the whole truth, and nothing but the truth . Thank you. Of answered in the affirmative and are now under both. Minute you has a five summary of your written statement. Itll be a lie in front of you when your time is up. We will begin with you, ms. Janz. Chairman murphy and raking member and members of the subcommittee, thank you for this opportunity to provide testimony on the important issue regarding use and is related sports youth and youth related sports concussions. I commend you and your colleagues to shed light on this critical issue. My name is kelly janz, i am the snakenburg. My son was your typical allamerican boy, devoted to sports, his friends, and her family. Jake was often referred to as our social butterfly in our family. He had a big heart and genuinely cared for those in his life. He had a joy about him that others could not resist. His big brother summed it up best when he said, jake drank up life like it was pouring from a fire hose. In everything, especially sports. On september 18, 2004 jake got up at 6 15 a. M. This was in anticipation of his freshman football game. He loved football and all its offered. The physical challenge, this spirit of competition, and most of all the friendship that were involved. He was excited about playing this game because he had been held out of a few practices because the week prior, he had suffered an injury where his arms and hands went numb and tingly. What he described to us sounded like maybe he had tweaked or strained his neck. He did not lose consciousness and he did not see stars. You would not have associated it with a major type of injury. He did not report to his dad or me any headaches during the week. The bits friends had said that after the injury he had complained of some headaches for top regardless of that, he was able to return to practices and meet the required number of practices to play on game day. May 18, hes on the picked up a really hard hit. He noticed me looking on and waved me off to let me know that he was okay. When the game began and he lined up for a play, right before the snap, jake stumbled forward. And theyle was blown call the penalty and the flight was thrown. Jake got up and started to come to the sidelines. He stumbled and went down again and he never got back up again. He was unconscious and 911 was called immediately and life fl ight was dispatched to the football field. He was airlifted to a swedish medical center, where a steps weren told us being taken to decrease the swelling in his brain. He told us jake may never play football again and would likely have a long recovery. But he followed that statement with, if jake survives this injury. Tragically, jake did not survive. Determined that jake had suffered second impact syndrome. It is a phenomenon unique to young brains. It was likely that jake had suffered a concussion the previous week. Subsequent hits during practice though notps, associated with a concussion had a compounding effect and continue to further injure his already compromised brain. Since jakes death, i have made my mission to continue to raise awareness for concussions in sports. Torlowing his death, doc mcavoy developed the project that has been made available to the Colorado Department of education. This program deals with all youth concussions, regardless of the cause. Meaning not just sports related concussions, as in a concussion can directly impact a Students Learning ability. I have read the opportunity to support reaps Concussion Management program, which has been adopted by other states, by helping distribute the reap manuals. Looking at the wealth of research on the consequences of youth concussions and the rapidly evolving management, we would be remiss and it would be irresponsible not to take every possible opportunity to develop measures to protect our youth from the devastating disabilities and potential death resulting from these types of injuries. Excuse me. I think actually, in closing, these children are our future and it is our responsibility as parents, coaches, teachers, medical professionals, policymakers, and the community as a whole, to make sure we do all they can to support the necessary culture change to make youth sports as safe as possible and protect our children, as well as to provide appropriate treatment and assistance should a concussion occur. I would like to thank you again for addressing this critical issue and allowing me to participate in the hearing today. Thank you. Fors. Siegel, you can go five minutes. Thank you. Chairman murphy, Ranking Member, and members of the committee, thank you so much for inviting me to speak today. My son patrick was a Hometown Hero in High School Football. Lamb going to cry. He grew up in an area that measure the worth of a man by his prowess and heart on the football field. He started just south of pittsburgh and with the elizabeth forward youth league when he was 10 years old. He was not gifted with size or speed, but nonetheless worked hard to become a great player and through that, achieved his dream to go to an it is that work ethic and perseverence in a collision sport that ultimately killed him. Patrick took his own life at the age of 32 but actually we have come to know cte took his life. Patrick never played in the n. F. L. Patrick was like millions of children before and after him that just played for fun and success in life. But throughout high school, prep school, and dartmouth college, our sweet, tough, young runningback received enough subconcussive blows to his head to essentially seal his fate. When he died, a newscaster friend of the family suggested he might have cte. Id never heard of cte before. I heard about n. F. L. Players having brain injury and concussions, but i never dreamed it could affect a player at the College Level. Autopsy revealed he had cte i was in shock and horror. How many other players like patrick are there . How many families are dealing with a loved one gradually becoming unwired with no clue what happened. Not every grieving family has a newscaster friend saying the word cte. For the sake of American Families this has to change and we are grateful this committee is conducting this hearing to learn more about the disease and the impact on families and on our society. Personally, i worried about patrick becoming paralyzed, but i thought the chances were extremely small. And i thought he had so much to gain from playing. If i had known the repeated tackles my son endured was slowly killing him, i would have stopped it. No family wants their child to suffer a disease that causes him to lose his mind slowly and with such anxiety and loneliness. Yet every day parents are signing their kids up for youth collision sports. These parents dont understand the horror they may face with their child. Parents need to be told the truth. The brain is much more fragile. It doesnt heal the way skin and bones do. Traumas could be very well permanent. We were so proud when patrick carried him team to victory. When in fact they may have cte. When i see a guy on tv hitting his wife, shooting his friend, or going on a highspeed car chase, i wonder if maybe he played one too many football games. People need to know that this invisible disease is more common than we know. That it can develop in youth, high school, and College Levels of collision sports. Families need to know what the causes and symptoms are and how to address the disease. This has been hidden in plain sight for much too long. It was this realization that prompted us to form the Awareness Foundation and the website stop cte. Org. We also created a brochure flag until 14, help parents derstand the key issues of cte. Heading the ball has recently been eliminated from youth soccer, checking in hockey has been eliminated in youth league. Yet over 2 million children are still putting their pressure brains sat risk in tackle football. The urgency of this problem is beyond measure. I wish we would have known the truth 25 years ago. There are those out there who would prefer parents didnt know about cte. They will obvizz kate the issue. We heard a few like you can get is a concussion from riding a bike. Or do you want them to sit and play video games for the rest of their lives . When youve lost your son to cte and you understand how it is caused and how prevlept it is, these arguments are hurtful and in my opinion keep children at risk. We see cte as a human tragedy of immense proportions and we need the help of everyone in this room and beyond. We all now have the duty to save children and families. Cte is 100 preventable. We need to remove repetitive head trauma from youth sports. To do anything else is to be complicit to the problem knowing more families will suffer the pain we personally endure every day. Thank you very much. I thank both of you for that moving testimony. Im going to ask one question, that is, you mentioned that patrick began playing football at age 10 and continued on. , anybody w if coaches working with the teams had any specialized training to recognize or be aware of concussions and injuries and if this was discussed with his teammates . Do you know if there was any training . At that time i knew most of the coaches personally and i would have to guess no. Were going back a ways before people started talking about it. Even on the College Level, too . At the College Level i as a parent i was never informed of anything like that. Ok. That would have been nice to know then but no. Ms. Chance can you answer that too . Any training that you thought the coaches had to recognize be aware of anything to do with head injuries . Back in 2004, even jakes step father and myself were both medical professionals and while we understand obviously hitting your head is a bad thing, we certainly didnt have the background that we have now where you would have the opportunity to truly step back and look at it. Perhaps he would have been pulled and not played the next week. So i think that in those times we did not have that, and now we have an opportunity to make sure that coaches and the people who are involved with our kids have all of that information. Thank you. Just following up on the chairmans questioning. Ive been given this brochure. I think probably your foundation was involved in helping put this together. Right. Reap. Its called riu move reduce education accommodate pace by the center for concussion at the Rocky Mountain hospital for children. And it really goes through a lot of information for educators and parents. Its a wonderful piece. Im wondering, is this distributed . What do folks do with this . Well, weve used that it is distributed and available. Weve made it available to school districts, to various groups, actually i like to say anybody who i can get to listen i will be happy to give that to. Nd its a comprehensive a way of managing concussion and its community based. It has a section for parents, and it has a section for medical professionals, and it has a section for students and teachers. So everybody has a different piece in this. Were not with our kids 24 hours a day. And and you have also formed a foundation, an advocacy foundation. And im assusming that youve also been working to get information out like this to parents, educators, coaches. Right. Our current goal is were examiners medical and coroners on one end trying to get them to recognize the disease if they are presented with a Drug Overdose or a suicide or Something Like that. Then on the other hand were trying to get push for parents to have informed decisions that flag football is fun and it could be a lot of very famous Football Players never played until high school. And youve got your brochure right next to it. My daughter made that up. Your daughter made that . Thats wonderful. Mr. Chairman thank you so much. I ask unanimous consent to put both of these in. Without objection. Thank you for coming. We want to thank our first panel. They just called votes. So what were going to do is take a break, i think we have three votes. Well do that as quickly as congressly possible. Well come back. This will give the second Panel Opportunity to be ready. I will ask members to get back immediately. Our goal is to finish the hearing before the second set of votes. Thank you. We will recess until the votes are continued. Thank you. The votes. [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible] [inaudible]