Concussion Safety in Children's Sports: A Central Role for the "Power of the Permit"

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Since 2009, all fifty states and the District of Columbia have enacted statutes to improve prevention and treatment of concussions in children's sports. Most of the statutes follow a common pattern with three core mandates. First, leagues and teams must provide parents, coaches, administrators, and players with pre-season information and education about the dangers of concussions, how to recognize their symptoms, and how to help promote healthy recovery. Second, coaches must immediately remove from a practice session or game a player who is suspected to have suffered a concussion. Third, the player may not return to action until a physician or other licensed medical professional clears the player and affirms that return is medically appropriate.

Many of the new concussion laws leave the bulk of youth athletes unprotected, however, because the statutes regulate only interscholastic sports (middle schools and high schools, for example). They do not regulate private youth sports organizations that use fields, gymnasiums, and other public property that is managed by local governmental bodies, usually the city council, the parks and recreation department, or the public school district. Most private youth sports organizations are public users because they do not own their own facilities.

In states where concussion legislation does not reach private youth sports organizations that use public facilities, local government authorities should permit private use only by organizations that agree to adhere to the three statewide core mandates. This "power of the permit" derives from state and local police power to protect the public health and safety.