If you were than one in every four adolescence gets enough exercise in this country. We have an epidemic across the nation. It cost about 90 million a year direct cost projected to be 190 billion by 2030. We know that physical activity levels have dropped 32 of less than two generations and that between the ages of nine and 15, our physical activity level has dropped 75 . A lot of kids fallout of sports during the middle school years. And we know that there are Many Health Benefits from playing sports, stronger bones, better heart health, lower levels of depression and we know that one study in 2004 out of Penn State University said that adolescents who played sports are eight times more likely to be active in sports at age 24 as adolescents who do not play sports. So in a nation we have a real interesting getting and keeping as many kids active in sports in their teenage years as possible. At the same time, we have another set of statistics we have to contend with particularly as it relates to the sport of football. You know i worked for espn and we recently conducted a survey of parents and 58 of those with suns younger than age 15 say they were cole very concerned about youth with all injuries. Nearly one in five discouraged their sons from playing the game. Foot wall has the highest concussion rate in sports along with hockey, and you have a lot of parents, a lot of people are wondering chico is this a game that is safe for my kid . Should i introduce them to at . What are the shortterm consequences . What are the longterm Health Consequences . So the central question we are going to be looking at today is how can football, the institution of football best serve the interests of children and communities and Public Health . How can football serve children, communities and Public Health . Everybody at the table here has their own narrow interest. We work for this organization or that organization and we are trying to grow our membership or whatever else it may be but this is a collective conversation about what are some great ideas that people have developed out there and could be scaled up, and is there a Common Ground that people can find to move this conversation forward and address the needs of the nation and the concerns of parents. People are worried. Should we hold off on football until high school somewhat arguing not play at all . Or can it be made safer through reforms at the lower levels . And what is the role of the nfl, the Players Association and profootball and the industry in general and creating an environment that is productive . Aspen begin to address these questions at the aspen ideas festival in june where we convened a panel called head games, can foot all save itself from itself and jim brown, the nfl legendary, the legendary nfl running back was on the panel and dan garza, professor at stanford who has worked on mouthguard technology that can measure the force of impacts on the head and kevin turner who was the subject of documentary which you will see a clip of it called american man produced by a colleague of mine who works at hbo. So, this panel will be featured in a show on the world channel on november 20 at 8 00 p. M. And on line as well. Pbs is working with, Public Television is working with the Aspen Institute to turn this into a onehour session. There will be a whole onehour session which will include conversations about football safety but we are going to play about a tenminute clip of that. [no audio] [inaudible conversations] lets come back to it. Sorry about that. So what i would like to do now is start off this conversation about the under 14 question, the prehigh school equation and i would like to do that with our special guest, dr. Robert cantu who many of you will of course are familiar with. He is the chief of neurosurgery and chairman of the department of surgery and drifter of services of Sports Medicine in concord massachusetts as well as the clinical professor of neurosurgery and the codirector of Boston University center for the study of traumatic and and encephalopathy. Is the he is a Senior Adviser to the nfl head neck and Spine Committee and is cofounder of the sports legacy institute, an organization dedicated to addressing the concussion crisis through research, treatment, education and prevention and he is the author of the new book, called concussions and their kids, americas leading expert on how to protect Young Athletes and keep sports safe, written with marc hyman who is with us here today as well. So dr. Cantu, what is the central thesis of your book here . First of all time i would like to thank you in the Aspen Institute for convening this Conference Today and for inviting me to participate in it. I think before i answer your question, i would like to start i just simply saying i am prosports. I want every sport to be continued and i wanted to be played in greater numbers, and i believe all of the opinions that i hold are trying to have that happen although right now maybe not everybody fully believes it. Footballs value is the exceptional exercise obtained in playing it. The last time i checked, it was the minutes if not hours of physical activity playing the sport that counts, not the milliseconds of bashing heads. As for the medical director of the National Center for catastrophic sports injury research, we track catastrophic sports injuries in this country. 97 of which comes from the sport of foot wall or 96. 9 to be precise. And that is even before you start to get into the concussion issue. Please believe that all sports that are currently being played should continue to be played that they should be made safer with regard to the head issue and in the sports of football especially involving our very young youth, we believe the tackle football should not be played, rather flag foot should be substituted and in the substitution of flag football its perfectly okay if pats are worn and if even helmets are worn. But the act of tackling, which is the activity were almost all of the serious injuries happen and the majority of the concussions as well is eliminated and instead flags are pulled. I personally view this as a tremendous opportunity for usa football because, if they were to offer flag football is an option and promote it, all they wrote the benefits that are needed would be there. The head injury risk and other injuries would the largely decreased and i think football would be gaining individuals coming from other sports at highrisk of head injury, especially like soccer. Soccer has been a drain on football for two decades and i think he would go the other way of foot ill were to offer the flag is an option to tackle. Youngsters are not miniature adults. Brain injuries and youngsters are a bigger problem than they are and adults. Youngsters brains are not fully my eliminated. That is the coding of the telephone wires as an analogy. It helps in and transitioned to get or structure and support to the brain fibers connecting nerve cells. Youngsters brains are more susceptible to the excited toxic shock of concussions and. Youngsters have big heads on weakness like the bobble head although head daul effect that puts them at greater risk than and it. I commend the nfl did try to alleviate this problem but tend to have the oldest equipment, the least experienced coaches, almost never have medical personnel on the sideline. Youngsters do not have informed consent i would offer. Rarely do they really understand the risk, especially at the youth level. So for these reasons as well as others which im happy to get into, i think that we should seriously approach football from a different standpoint for our youngest individuals and take tackle out of the football football at the youth level. And all of them came from one individual who was conflicting the trauma on others. There is not so good signs to tell you exactly what the scope of this problem is because statistics are just not been accumulated. What we do know from a wide variety of sources is that the brain of our youth are more susceptible to injury and the impact that the springs are being asked to absorb some times reached the same level commit bdg or higher that we see and adults and there is a lot of emerging evidence both on structural dti, on metabolic studies, functional mri as well as neuropsychological testing suggests that she dont even have to have concussions recognize for your brain structure and or function to deteriorate over a season of hope. Preseason testing versus postseasons declines under all three of those disciplines. So theres plenty of of evidence i believe we need to look at this differently. I was thinking of someone who was telling me hes a freshman in high school and its his first year playing and there were an awful lot of injuries this year, possibly because these kids havent played football before and theyre been introduced to tackle for the. Youve heard the thought. Kevin draskovic said North Carolina believes you need to teach kids how to tackle earlier to protect themselves at 14, 15 of 16. I mightve heard that once or twice. Kevin as Department Chair where we are adjunct professors, so ive heard that hes a respected colleague inquiry firm. I think in this one area we seriously disagree. Maybe theres one or two others, but i cite the following. If you look at some of the great individuals played in the National Football league, tom vries not a bad example. The guy that ran for 251 yards last week against oakland and other didnt play it down until they got to high school. Lets forget about them. Lets look at Tony Gonzalez, the alltime leading type and still adding to his numbers he played basketball at my alma mater end up in new england are right guard for years with Stephen Mayle who didnt play for in high school and college, came out of college with an outstanding of the wrestling career. Not much future in olympic style wrestling. Theres another activity that doesnt cope with the same name, but this guy to have that could fill you in where you can make a buck. So she went to football and theres many tracks as it did play football in college like some not to go into the nfl and call each. If you got the elite genes in the work got sick, you can make it in whatever sport you dont have to pick it up at a very early age. Youre going to be better at age five or 10 or 12 if you do. When your age 20 and will be what god gave you and which are willing to do for yourself that determines where you will find out. I dont play for second inning to teach the skill set at an early age to necessarily perform at a high level in your 20s for the reduce or even in high school. I dont think you necessarily need to stop them from learning skills if you go to flag football because flight football you will pull a flag to bring them down in tackling, but you can still teach all these skills. You can still teach tackling skills without having tackle be a part of the play. Instead of bashing heads you are hitting dummies, tackling dummies. The winningest football coach in this country, Tom Gagliardi known as 80s doesnt doesnt have any tackling once the season starts in his teams have won and his teams have embraced it. The only tackling that goes on as an gameplay. But they practice all week long. They just dont bring them to the ground. We talked about the importance of getting kids active. As a football one the sport but is actually accessible to kids over beasts are overweight . Theres no room on the soccer team or in any of these speeds, but in foot tall as a place. You eliminate the opportunity to give those kids physically to be opportunities. Lactam is checked, and site did have tackles and guards in different positions and i dont see flag eliminating those individuals from playing. Yes, they dont have as much as an advantage, but i think they can play flag football and get the aerobic benefits plan as a youngster i really did feel theres a lot of aerobic stuff that goes on. I dont want to see less of it. One governing body that is new to misdirection is is hockey. They have been body checking. Theyve also gotten rid of championships. There was a lot of angst when they were having this discussion about whether to push body checking off. What do you think of their reforms, how they work out. What if we learned . Two years ago when we started writing, it was 11 years of age full body checking started as you just indicated and over the course of the last two years, theyve upped it to 13. So the 13, 14yearolds are the minimum age that they start with full body checking. I came out and was facilitated by several reports out of canada that showed the incidence of concussion was dramatically higher when there is full body checking. So it was really good stuff that made it easier and i commend him greatly. I am not hung up whether its 14 or 15. Waitress relatively immature, move it up to 15 before you Start Coalition activities if you want. The reason that arbitrarily pick 14 is simply you want to learn at some point all of the skills and play sports similar as played in college. We will have that debate later and i look forward to it. How do you feel about some of the reforms that other organizations have adopted such as limits on practice time during the course of the week. Getting rid of certain bull in the ring type of drills . Well, i certainly commend all of those reforms. Acting role in the ring is insane at any age and doesnt help you play the sport any better. But lets think about it a little bit. Reducing the hitting by one third, and i support that. But that is up to 40 minutes a day, theoretically every day they practice, the ivy league a couple years ago went to hit two days a week in the National Football league and the Players Association now dont even have once a week. 14 times in 18 weeks. So these kids who have no medical personnel on the sideline, players sport than the late 1900 was designed for adults that came out of college and almost died in college if it werent for teddy roosevelt. The sport of his made for adults is being played at the youth level without medical personnel in attendance and are practicing every arguably 500 greater than the nfl uses. Affixed to open up the conversation a little bit. If you want to make a comment, ask a question. Go ahead and push your name tag up. The executive director of the u. S. A. Folk all. Talk to us a little bit about what you say football is doing in this area. Before that come address the general question. Is football serving the best interests of children in communities and how can it be improved . It is certainly striving for parents and kids. We all recognize this challenge is. We are at a point where we are learning. First i should think dr. Cantu for raising this important issues. I believe we are all in this together. Were all looking ways to create a better for players. I hope we are and that is to provide accurate and whenever possible evidencebased data for appearance. We have to be careful certainly not to scare parents. My interaction with parents across the country as they are looking for frankly someone to say we care about your kids. We were taking action. We recognize challenges and were doing something about it. So virtually theres two sides as best as i can tell. Theres a sports site in the football side and of course the science side. I will let the medical experts talk about the science side. Certainly zurich and others have been working closely for some time. U. S. A. Football have 3 million kids to play tackle football. Roughly twopoint play flag. It is a great outfit, a great option. In fact we suggest the experience should be flag no matter what age. In addition, we work with pop warner to make them better and safer. If that includes things that really nationally accredited program, using practice plans. Most coaches doug is practice plans come as you make sure you have an organized structure prior to his to make sure we have volunteers to come the commissioners, coaches out there putting their time. We need to educate them. Certainly every medical expert, every expert on this issue comes back to education being the most critical. U. S. A. Footballs focus is largely about education. We provide the best resources we can to make sure those folks are prepared. Literally down to drills that have 3d animations. You can literally be in the palm of your best techniques, nutrition information. Things like this are resources that ultimately folks to ultimately deliver a safer experience. With that said, we fully agree we need to how practices. Its actually started up a conversation a couple years ago akin to our our office and talk about the concept. It came up with something called levels of contact. The basic premise is there is a progression in track this. Start with error. The new transition 75 speed and may be the last 20 minutes your blood contact. So its things like that that is an agebased teaching concept. We set it about this cognitively, emotionally, physically. But in an eight under, 12 and under, how do we develop these folks . Parents of a 17yearold daughter and 16yearold son is football. To see development of an 8yearold or a 10yearold is dramatic. Emotionally, physically, cognitively, all of these things weigh in on how we ultimately produce resources that make the game safer. So those kinds of things seemed to me a logical step, maybe an interim step, a logical step in lieu of evidencebased right now that suggest we should effectively had 3 million kids stop playing football. Why not just adopt dr. Cantu suggestion of flag only before 14 . What is the argument about that . We support flag. If im not mistaken the arthur organizations work as well. The flag only is what you suggest . Yeah, from our standpoint, interacting with tears, talking to coaches are folks that love this game. Just help us understand how to play it more safely. So i guess in shortages to see that leap just yet, but that needs to be we need to take such a dramatic leap. Again, there is room to Work Together with the science experts and medical experts to create programs and resources and probably stronger standards that ultimately it didnt make this a better safer again. Dr. Cantu. Yeah, i would like to thank scott very much, too. It mostly its because of a very insightful meeting that he reference when chris and i spoke with him and other members of u. S. A. Football. Believe me, this is it me against u. S. A. Football. I what u. S. A. Folk all to prosper. I wanted to triple the number of people playing it. Yes i want to explain a little. When my eyes were open was when i talked to scott two years ago, he said basically im not opposed to flag football, but the parents will sign kids up for it. They want to see their kids emulating their sunday heroes and they want to see them do it as young as five years old. I may not be the quickest person in the world, but a lightbulb to go opposite wait a minute, ive been working this field for 35 years. Im not getting a lot of traction in terms of changes at the medical meetings. Yes i talk here and there, but it really dawned on me if anythings going to happen is going to be educating parents to demand changes in options and that was the genesis of the book. Ltd. The book, despite 31st book. Most of the others are medical to keep people awake at night reenlisted mark to help me with it and im really thrilled with the result. A Quick Response to that. I didnt realize they get to take credit for why he writes this book. But that is somewhat news to me. In fairness, had to in the reform that is probably a good one where weve done the research. We looked at the concept of an Education Program to past 15 quizzes. He passed 80 competency in a program like that. Theyve been trained for the last five years, but this is important. How do we know the transfer is in the new knowledge in the field . To try to be quick here, the concept does have a player safety coach that is part of the lake, some of the coaches respect, has been a coach and we were to train a person that began and they are on site to assess vendor to. So they work with coaches at the beginning of the season, throughout the season, tackling the proper way. They have the season with a work with the parents. We need to do a whole lot more with parents literally look and see thank you come youre making us feel more comfortable. So the long way to get to again i dont recall the conversation, but i hope they get royalties from the book. I think the parents are looking for ways to u. S. A. For all and other folks can Work Together to give them confidence that this can be a better, safer game. They are not looking to immediately jump to other sports that they want to play the sports in a better, safer way. Let me move it to rain now. But it should give us your title and affiliation in the work youve done at Virginia Tech. Podesta may not donate, i am breaking up, Current Research assistant. His apologies for not being able to attend the meeting. Really great work and i really agree with him that education is really what we need to teach these players, kids, players, coaches and parents and really at Virginia Tech we aim at giving the right information to players, parents and coaches family of about 120 players instrumented with acceleration devices that measure linear from six to 18 years old. What if he found in terms of the forces . Currently study shows some of these kids have forces that exceed collegelevel. So although the kids are young in age, they are asked various courses that may be injured injurious. We look more into that and currently a study we have ongoing this year spread out between Virginia Tech and university with dirty 2000 data points for head impacts that we are studying. We are making it available to some of the people here. Also, we are setting a neurocognitive and data to go along with impact exposure to to give the proper education to some of the physicians as far as the functioning of the brain and differences what we see. I would like to go to dr. Julia. Tell me about your work in terms of pediatric cases and concussions and figuring out when kids should return to play. Thank you, tom for wilderness foreign and obviously to bob who is that the science and discussion forward dramatically because one of the things we all know is we cant not do nothing or anything. See how many negatives are put in there to make a positive. We have to do something. As a clinician that these kids and families and our clinics in seeing the major education deficit on the fields today in all sports frankly, but also seeing the outcomes. Some of the things that raise talking about in terms of understanding forces is really important and we just completed some work in developing measures they are using so we can understand their cognitive symptom kinds of effects of these to kids. I think thats very, very important outcome to what we need to link up with the games. From the perspective actually was at the Aspen Institute this summer, where u. S. Nabobs question about, should we be eliminating football tackling a football before the age of 14. At that point i couldnt speak, although we did speak that night. One of the things i said as weve got to change things. In its current form of credit problem. Although the age limit is something that has to be further studied here it is going to finish my comments with research, but maybe starts with research in trying to understand what evidence do we have. One of the things that is hopeful that ive seen in sports like football, but also across, ice hockey, soccer other sports as we look at technique differently. This is a pretty young field and taking the issue of injury, concussion and linking it back with the sport is exactly what we need to be doing. Weve not really done that up until the last few years. But the other thing is we have so little data on kids right now in terms of concussions we have to start collecting more data. Again, what Virginia Tech is doing is important and what we do is important as well. We have to look at what type exar porton, the heads of tackling program. Weve got to look at rules and enforcement in procreation from my perspective and football that if you make no effort that the flag is thrown because otherwise youre just using your body is a target or as a torpedo. Looking at the whole issue of recognition and response, you can come educating coaches and parents we do a really good job with the 40 states that have passed laws. What we do is increase awareness, but weve got to know the train go to the Knowledge Transfer action and stage. I your coaches and a new something was wrong but didnt know what to do about it. Weve got to get to the point of making the next step in responding appropriately. Finally weve got to wrap that around research. At what age is it safe, is it not safe . When i was at the headcount meeting two weeks on boston, chris asked me did make some comments on what age he think we want to limit contact. I said i dont know. I wouldnt know how to make that estimate right now. But we know that less is better. We do know that. So the other pieces reducing unnecessary or inappropriate contact. Is there a safe contact . Ready to understand understand that. Ive been accelerometers side its outcome is important to know. So pop warner has been trying this, ideally, nfl. What can we do at our youth level . Those are five things we can start to do, but weve got to wrap it around evidence to now begin to many more precisely say coming to know what euros should we doing this. Nine euros should be doing this combat should do this. 12 euros should or shouldnt do this. From my perspective thats the direction they move in. The Virginia Tech study shows sun has a pretty big. The study showing theres sub concussive that are hard to measure and little kids suffer is not enough. We need more research, more data we really need to understand also with one of the things i would imagine if there will be a good case study of generic coaching technique and not taking other effects into that sort of thing. When we build some of these other measures and put a new technique and hopefully build out of recognition and response into that. I think it will be a Good Foundation on which to build. I went to go to julian bills. Do you disagree with dr. Cantu. And ive read about that . In what respect . 14 and under. Keeping it to flag geared i agreed the brain circuits vulnerable and i agree we need to do everything we can to make us safe. If it is shown thats what the public wants through this education he talks about, maybe this will evolve to more flag play. But i dont know, as they think he 32, we dont have exact science about is there truly more injury in youth level . And also, this whole concept gives us it gives us a conflict in a way because we think that theres maybe 100 head impacts in a youth player per season and at the High School Level 3600 to 1000, some unlike that, studies have shown. Is it okay that we believe the longterm risk is cumulative and riskbased . Is it okay then to a thousand head a year, but its not okay to have 100 . The nature of football and other sports bring in some natural difficult questions. At pop warner, we instituted this year for the first time the first level at the time, we announced in june that we would have no had contact in the devcon pectorals of any type, over a third of the practice time. So to be critical and say that we have 500 more than the nfl is a little bit not addressing the positive steps we try to take in acknowledging them and comparing that to other levels of play. So i think we really looked forward to the results of this year where monitoring more than weve ever done and will have a very good survey of 18,000 coaches and concussion and we hope to have a better idea after this season not only a concussion incidents, but the acceptance of these rules changes and what effect they had, how parents and players and coaches are reacting to them. So we look forward to that and think that that may be work to come out of this. Dr. Cantu. Yeah, i hope people heard it the way i meant it to be that if i apply changes that julian and pop warner has put forward. Up the incidents of concussion. Dont now about the unrecognized. Thats why they upped the age from 11 to 13. So yes, we need more data, and yes, we should get it. As a person sits across the families who have hundreds that i can remember of the thousand of patients that we have seen have had their lives by cognitive and emotional problems of post concussion syndrome. Not all of which recovered from it. When we have chronic traumatic [inaudible] by the group we work it be you showing cte in a 17yearold and 21yearold College Player and others who played at the College Level and never beyond. I think its issue serious enough i think we need to talk about it now while we accumulate the data that jerry suggests. Im 100 in flavor of that. I would like we have fifteen minutes left on the particular topic under 14. I would like turn this part of the conversation to the participation question. You alluded to the fact theres concern if you live to flag, then therefore kids parents will not sign their kids up for the sport. Let me bring in tom cove on this. Why dont you tell us your name, your afghanistan, what you have learned about participation rates in football and some of the factors that might be drive the trends. Sure, thanks, tom. Im president and ceo of the sports and finance industry association, the trade group of people that make Sports Products around the world. And we go with a consortium of other trade associations and National Surveys of the Sports Participation. All kinds including all kinds outdoor and et. Cetera. 120 different activity. We have a strong basis to understand whats going on with Sports Participation at the casual level and we break it down gender and location and all these things. So what happened is football for years and years was steady as any team sport going. It is started to see some slight decrees and at the younger level probably a higher, faster rate of decrees. Its fairly small but real over the last five to seven to ten years. One of the concerns weapon look at football with all other sports. Is the concussion issue driving the reduction. First, at the High School Level, that decrees in the rate of participation is not happening. So its more the younger level. But frankly, its not clear why. Its a reasonable kind of question, certainly, to say with the the a awareness about con cushion and health and head injury. It might be a driving force. They make that at a all ages. We found that both from the Quantitative Research which is quite detailed but the qualitative focus groups, ease, there are other issues that are affecting football at the young age. The specialization of sports and youth in america. Clearly one of the most dangerous factors to Sports Participation because used to play three or four sports a year. Today people play one. Football suffers for that. Nobody plays football four seasons a year. Many people play will cross, soccer, swimming, et. Cetera. Thats a fundamental issue. Add the specialization, which probably happened and probably happened a the the higher 15, 16, 17 is moving down. The second thing is football clearly would be effected more than any other sports by the recession. Its a costly sport. The numbers reflect all sports that cost a lot for certain segment of the lower income population suffer. And the third issue is the idea that middle School Sports, because of school sport budget being cut middle School Sports are being cut. The gateway to football has been increase at high school when most its starts to degrade peoples interest specially in can getting the kids involved. Finish with its obvious that the con cushion issue is real and apparent on the front of mind for most parent flps are many other issues that affect it and team sports in general struggling to keep the prarption rates Going Forward. Football is one of them. Thats where we stand. John butler. I didnt see you there. Im sorry it [inaudible] yeah. I apologize. You have been holding the card up. What would you like to say . [inaudible] scott mentioned, we have knock against flag football. We have offered flag football i dont know when flak football started probably the early 1980s,ed at least if not earlier, but to scotts point no matter how we promote it. We never get over 950 team versus 7500 tackle football teams. Its not a matter of promoting one or the other. Thats what people sign up for. I can tell you the Fastest Growing divisions are the young two youngest divisions. We believe very strongly in education. We certainly, as we put put in arbitrary rules this year, we needed a starting point. We need to know Going Forward whether we need to adjust the rules further or create new rules as new Research Indicates appropriate. I have been asked a number of times over the last couple of years why dont they do away with tackle football and only offer flag football. My response, ive surveyed a number of people and if we did, 95 of our members would drop out and those kids would be playing for local independent youth Football Program. Whether it be kids or participants, they want to play tackle football. That goes to a whole question of education. Its, you know, its one of those things that were trying to do certainly the best question. We rely on our army of volunteers. We require training and background checks. We require at least minnal medical minimal medical training to be present at all practices and games. We will keep adjusting those rules. One quick correction for Tony Gonzalez did play growing up. Bob warner . Eddie maison is with us. Standing next to the pillar there. Want to pass the microphone over to him. Eddie is a former nfl player. Washington redskins, someone i interviewed for an outside lines peace of mind. Before kurt warner were stepping toward saying im not going let my kid football. Eddie was one of the voices that got the conversation started back then. Eddie, why adopt you tell us about your perspective an the decision you made with your son. Tom, thanks. Congratulations to the board. Thank you for your great work, scott, u. S. A. Football. I played the game 27 of years of my life has been devoted to the game. Eight years professionally. Theres consequences to the game. It comes along with it. At the end of the day, you know, working as a commission of sports league, being involved with two actually three fullcontact leagues in virginia, the thing i have seen since i have been retired and ive been training. Im on a Training Facility that works with Young Athletes from ages to six to pro. The issue is education, and the reality between the education and the reality is this. Is that the coaches, the that coach the game, whether its flag or tackle, for whatever reason, dont embrace change very well. Thats the issue. And the issue is that bob warner, u. S. A. Football can implement all the things they want to, you can implement rules and changes, until the Football Community embraces the reality of the sports, the reality of concussion, the reality of the damage that comes along with it, if you started early age, thats the problem. I have seen this. I work in it. I live it every day. And the problem is, you know, when i was coming up, we didnt use our heads. We werent taught to tackle with our heads. If you look at this at the elite level now, everybody leads. Where does it start in youth football. Is that because these guys arent implementing the right stuff . No, the coaches arent embracing change. Theres certifications that need to be implemented, there are rules that need to be changed, theres levels where we have to make decisions, real decisions, as to take it out of as we always tell people. Sometimes you have to take the decision outside of the hands of the parent and so you to make the change. We dont offer tackle at the age. We offer flag, and these are the reasons why. And then you develop an institute a set of rules and litigate that to a point where people emigres that. Not because we dont like tackle football. Tackle football changed my life. Of course, my familys live. Where what we are saying is safety number one. Number two is education, teaching. Number three, is the transition of learning how to play the game the right way. I think thats what it comes down at the end of the day. Tom and i both agree. My son is 8 years old. Hes not playing tackle. I didnt play tackle until i got to high school. And i fared okay. Do you feel like you need learn how to tackle before high school . Yes, it is important. I think flag teaches kids the points of contact. It teaches them how to drop their hips. How to keep their head up. Heads up u. S. A. Football, thank you. It teaches them how to enter in to the point of contact, without making contact. So when you talk about attacking the hip, which we teach in football, it is that exact point. Bent needs, heads up, eyes a the the point of contact on the hips. Obviously on the shoulder when do you play tackle. Thats what we teach. Thats why i think flag is important because it develops the mechanics of how to tackle. Theres other things that need to be implemented. Thing are courses that need to be taught. I think the coaches need understand at the youth level. How do you teach kids how to play tackle. How do you teach them eighth and ninth grade . How do i teach a kid how to tackle. That goes back to basic old school mentality. Some of the coaches that talk about us how to tackle properly. That will help improve some of the safety of the game and keep kids from using their heads. Got you. Sean, documentary film maker, youre making a documentary now on football; right . I dont know too much about it. It has to do with the central question should you let your kid play. What have have you decided and learns . Im working on a film serious. I shot about 30 hours of footage and i had the opportunity to work with ray about a year ago in Virginia Tech, and to eddies point about the coaching, there was a pregame before, you know, there was not a single ref of offense or defense. It was all just loining the kids up and having them tag each other. There was, you know, in my experience, watching and playing football when i was younger. Somebody is trying to elude somebody. It was literally bam, bam. And when the kid didnt rise up to the level of achievement the coach wanted. Its pitiful. Its not dancing. The back of the jersey are reading animal and eliminator. My question is who is watching the people . My son is now 14, i interviewed dr. Can ton a couple of years ago, to decide whether or not i wanted to let my son play. And i went the junior high school, and they have no guidelinings. They just canceled the program this year. But there was no coaching guidelines. There was a kid out there coaching defense and hes literally every other minute telling the kids to light them up. Put them on the ass. That was all of it. There was no technique involved whatsoever. Who is watching these people . Thats what i want to know. There needs to be another layer. I agree with that. Uhuh. John walsh . Weve heard a couple of assessments here on the kids as early as age 5 says they want to imulate their heroes they see on saturday and sunday, we heard figures as high as 95 drop out if tackle football were eliminated from the youth. Where is this research . And how they are row is the research about the parents fulling kids out of programs . Tom would be best to answer that. Actually, theres i think john might have a better sense. With regard to parents taking kids out of programs, we dont have as much on that. Quite honestly. That is not well developed in the area of the motivation around leaving. What we do know about the motivation of leaving sports sports in general we know about that. Its not fun. And the pressure and all the other things we sort of in the youth Sport Community have talked about for years. It gets past what the original goal was. With regard to some of the questions that come up, if the child thinks its not fun, whether you want to say flag is better or not, thats going to be a challenge. If the sensibility of the child is they want to have fun playing the sport, we want to promote that. Obviously safety first even more than fun. We know that the number one motivation for leaving youth sports, it langs a fun lacks a fun component. Ashley . This is for scott and john. What possible benefit is there for a 6yearold to be playing tackle football . [inaudible] i dont know that benefits. I can tell you they have fun doing it. When we started our youngest division, which is right at that age, i thought it was kind of a random regional project. It has grown like crazy. You dont see a lot of track ling in the strictest sense. Not that theyre not being taught. The kids that the age tend to run in to each other and fall down or do a lot of shirt tackling. You know, grab the shirt. The primary goal to safe and the second goal it to keep it fun. I can tell you most of the kids i talk odd who played flag they say it was fun for a year or two years. When do i get the pads or helmet. Thats part of the education process. If we are going change this, if research kinds we need to make the change. We need a lot of education. Ashley talks about the nfl reporter for espn has written about i dont want to misquote you. You dont want your son to play football. Right. Hes 3 at this point. [laughter] theres a league out there for him. Theres plenty of things that kids want to do that are fun. But, i mean, isnt there a point where as parents as the adults so you to protect them from themselves . If you listen to dr. Can too what he says, i mean, think any parent would be nuts to allow their kids to play tackle football period but certainly before the age of 14. I think you touched on something important. Its the decision of the parents. And one of the things i stressed i didnt recall on is i think all of us is a responsibility to make sure we educate the parents. Theres a lot of information we adopt have yet. One of the things were trying to do. We dont run legs. First time we teach tackles at 7 years old. Not a big difference. For what its worth. Not based on some scientific evidencebased profile or something. I wish i had that. Its not nothing. We recommend the First Experience be flag, and we dont run leagues. We work with the groups make a better experience. The fact as john said is, parents make the decision and what we feel strongly about we need to do the best job question. I mean, we collectively. We need the medical expertise to help provide accurate and again, ideally speaking evidencebased information to parents so they can make the decision. They make the decisions all the time. They make it you make a decision all the time. When coi let my child ride a bike. When do you let them cross the road and walk to school. Theres all kinds of safety decisions parents make all the time. You acknowledge you made a subjective decision im not going allow my child to play tackle football ever. Or flag who knows. The other thing i think is important eddie touched on. The idea of proper tackling and teaching the ascending blow and holding the coaches accountable. They are not i hated to say it, this is our fundamental challenge, is getting with the leagues and working more closely together and creating standard to ensure that coach cannot walk on the field until they from properly certified. That doesnt geern tie they are going teach it properly. It goes back the right there monitoring making sure before he steps on the field knows how to fit equipment. Its frightening to realize that High School Coaches and Youth Coaches do not know how to properly fit equipment. Its a huge step in the right descricts if we can solve that. How do you teach tackles. Going back frankly to lack of the better word, the ascending below. Its not a launching below. Learning from you the idea we run one of the largest flag programs in the country. It we think about and we have coaching education in flag concussion manment education. We if we teach them as you probablily transition these are the kids of techniques you should be adopting that help grab a flag or make a tackle. Thats a great lesson learning from the great experience. Those are the kids of things we have to do together because the 40 states plus d. C. That has a concussion law. We had a conversation with the state senator in indiana talking about how do we push that down again to the middle school level and ultimately to the youth level . Obvious they tell you you have to an organization that can governor and control the youth sports. Most you cant because they are independent organizations. Were coming up with maybe the field. The fields are the place they can control. And if we Work Together and say coach has to be certified. You cannot walk on a puck Little School walk on a its a positive step in the right distribution. Trying to address the complex problem. I worked on the story involving a 13yearold kid out of l. A. Who was paralyzed because he stuck his head down. And, you know, one coach was trained but he wasnt teaching the way that bob warner taught him to teach. The assistant coach wasnt trained at all and believed he was teaching the right technique. He said in that spot i teach what i was caught. It goes back to eddies point. We have to break the cycle. Even if we were teaching the technique. That type of play, you know, there were coming at the angle to each other. Its trying to stop them at the goal line. It wouldnt have stopped. It wouldnt have prevented the injury was his his point was look, can you teach safe tackling. Is it a little bit by ever at the end of the day you can train coaches. Are you going get the point where it is safe for kids . So again, our view is we talk now to many, many coaches and experts across the country. I mean, nfl, college, high school, you name it. And the two critical pieces and interesting to get eddies perspective is the idea of heads up. Literally the keeping the head up. In the case theres debate whether he was taught to keep the head forward. And coach will tell you, ive teaching it heads up tackling. Then terminology. It is where the whole thing breaks down. Because the next statement is bite the ball. Lead with the screws. Put the screws on the number. Logic of that. Have the ball right here and youre biting the ball. You are leading with your head. So two things we have to change, maybe three, proper education, teaching proper heads up whatever possible. This game is the bang bang the sort of the happened so quick. Youre not going to be at the the avoid a potential helmet to helmet contact entirely. Theres no way. I do believe we can make dramatic improvement if we teach proper head up and have terminology that completely reinforce it is. No coach can say, as you said, lay hat on. That terminology has to be wiped out of football period. We need everybody. We need the priest of parents. I have great confidence if i can talk to every single football and explain in the kinds of things were doing with the head up Football Program that at least if nothing else would give them greater confidence make a better educate decision, and over time were going to see an improvement in proper tackle. I would like to move to the high school equation. We are ten minutes past the point where we should have. High School Football is entrenched in the society. You know, i can actually see us moving to a flag model at the very youngest ages. When youre talking about high School Football. This is community entertainment. Friday night lights. People gather around. Yet we have high injury rates in high school. We have a lot of schools that dont have athletic trainers on site. We can we have experts to talk about that. Kristin, why dont you tell us your credential and what your thought is on what we do with are there reforms that can be introduced at the High School Level to make it safer so we dont have as many kids being injured . Thank you, tom. Chris, executive directer of the legacy. And codirect earth of the center for traumatic at Boston University. High school is an interesting question. Its where i started playing football. And its hard to figure where on the spectrum it fits. We know youth is probably more dangerous than high school. We know that high school is a big part of our culture. I kind of want to go back, i have a lots of notes here to separate youth from kind of professional and then kind of where were in the middle. Because i think this discussion is really what is unique about football versus other sports and while were having the discussion. A lot comes down to the adult game is not really separated from the youth game. In a meaningful way. Like soccer theres no heading before a search age. No checking in ice hockey. Baseball no curve ball. We dont do that football. Its the real game where head contact is not rare, and accidental. And so i think we have to kind of identify that as a big issue. But i think we have to look to in terms what we should be doing we actually can look up to the nfl and the nfl pa about steps they have made in the last two years to make the game safer. You look at things like dramatically minimizing the hitting at practice. The one place they had a voice, they asked for it. Agot it. The medical infrastructure is incredible. The baseline testing. The athletic trainer in the sky box to watch the feed. We know we can miss the concussion on the field. You look at the session thats what grown men demand. If you look at the way it should be done whether or not thats the way you believe. If thats the model, its hard to justify exposing kids of any age under 18 on a philosophical level to the same sport without any of these infrastructure and resources. No limit on any level on practice exposure. Which is terrible. Theres no theres also no leadership from the High School Community to implement that in any way simple way. Medical infrastructure 42 of the high school have athletic trainers. A study coming out saying girl soccers are you are eight times more likely to identify concussion in girls socker. We are certain we are not going to spot concussion at the High School Level even with medical people. Without medical folks and the younger you go, its the wild west. If you catch one, in awhile, you think about how we train athletes, we train were begging the nfl players and college to offer their report them. Theres no real Education Program for children. Nobody believes we can train children to report the symptom. They dont understand concussion. You separate the two things and you realize that, you know, we are refusing to give children the things we think grown men deserve. And if you look at it from that perspective, the tackle football question especially when you get the youngest ages does seem out of place. That we allow that to happen. And this, this isnt a referendum on u. S. A. Football on warner. The leading on this in terms of reforms. And i think thats fabulous but the reality is the big lack of control over can you force youth Football Programs to do the things we know is a good idea. The answer we just said is no. We cant. With the unknown and issues, we have to take a serious look. Yeah i want to bring i