The majority of U.S. parents support minimum ages for tackling in youth football, according to a new report by the American Academy of Pediatrics.
The national survey of more than 1,000 parents found 61 percent of those asked supported age restrictions for tackling. Another 24 percent said they may support age restrictions.
Parents were given options of "yes," "no" and "maybe" as responses to the question.
In 2018, six states considered legislation that would limit ages for tackling, according to brainlaw.com — a website operated by injury-law attorneys.
Lawmakers proposed the restrictions in California, Illinois, New York, Massachusetts, New Jersey and Maryland. None passed out of lawmakers' chambers, according to the site.
More than 1 million youth (ages 6-12) play tackle football each year, according to an Aspen Institute Sports & Society Program report titled "What if Flag becomes the standard way of playing football until high school." The institute — whose mission is to create dialogue that helps sports serve the public interest, with a focus on development of healthy children and communities, according to its website — recommended all youth football organizations shift to a standard of flag football for all football before age 14. It recommended the same organizations begin teaching fundamental blocking, tackling and hitting skills during practice at age 12 to prepare for high school football.
It also suggested minimization of non-game tackling and collisions — through adoption of the Dartmouth College-style practices, which prohibit them.
According to the academy report, elementary and middle school athletes are at higher risk of brain injury because of the rapid pace of myelination (or the process where brain cells receive a fatty, protective coating). This process generally occurs between the ages of 8-13, it said.
"Given the potential benefit of reducing exposure to high-risk contact during this vulnerable time period, some youth sports organizations have recommended restricting high-risk contact to older youth," the report states.
U.S. Soccer, for example, recommends limiting "heading" — the process of advancing or blocking a ball with your head — to children ages 11 and older.
U.S.A Hockey recommends youth not "body check" — a defensive technique in which a player uses their own body, whether hip, shoulder or arm, to physically disrupt an opponent — until they are 13 or older.
The report queried 1,025 parents, each of whom had at least one child from 5-18 years old. About 63 percent of female parents and 58 percent of male parents supported minimum age limitations for tackling.
Women, specifically those with college degrees, were more likely to support a minimum age for tackling in youth football. Data showed men with children ages 6-12 were about twice as likely to support age limits for tackling as men without children of those ages.
In 2015, the American Academy of Pediatrics Council on Sports Medicine and Fitness (COSMF) reviewed literature regarding youth injuries and considered age limits for tackling, because limits "would likely lead to a decrease in the incidence of overall injuries, severe injuries, catastrophic injuries and concussions."
However, the COSMF did not make specific recommendations about age limits, instead suggesting youth leagues consider switching to flag football.
And without nationally supported recommendations for low-contact substitutes, rural or impoverished areas may not be able to afford to switch, according to the report. Adding to concerns are questions about whether introduction of contact or tackling in later years would lead to greater severity of injuries.
Studies of hockey have found no evidence for greater injuries for children who did not have early introductions to high-risk contact, according to the report.
Despite a perception, the concussion rate for youth football (at 3-5 percent of players per season) is not much different than other youth sports, said Cynthia LaBella, a doctor in the Division of Orthopedic Surgery and Sports Medicine at Lurie Children's Hospital of Chicago.
"In contact sports, rates of overall injury and concussion increase uniformly with age and pubertal maturation status," she wrote in a column about youth football. "This is because as bodies get larger and faster, collisions occur with greater force. Thus, concussion risk in tackle football is lowest when players are less than 12 or 13."
Evidence of long-term brain injury is unclear, she said. The 2017 study "Association of playing high school football with cognition and mental health later in life" followed high school students into their 60s and 70s. It compared 834 who played football to 1,858 who played non-contact sports or no sports, matching football players to the other two groups based on age, IQ, family background and educational level.
"They found no differences in cognitive function or depression when comparing football athletes to non-contact sport athletes and to non-athletes," LaBella wrote.
More research into risks is necessary, according to the academy report.
Organizations that shape public discourse concerning health should consider parents' attitudes regarding age limits on tackling, it said.
"A majority of U.S. parents across sexes would support age restrictions for tackling in football," the report concludes. "This information should inform discussions when guidelines about tackling in youth football are revisited."