1. Our Ethical Obligation to Try to Prevent CTE in Children through Reasonable Reform to Youth Sports
Chris nowinski, Ph.d.

2. My relevant biography Founding CEO, Concussion Legacy Foundation
Co-Founder, Outreach, Recruiting, Education, and Public Policy Leader, Boston University CTE Center
Co-Founder, VA-BU-CLF Brain Bank
Ph.D. in Behavioral Neuroscience from BU School of Medicine
All-Ivy League DT for Harvard University

3. Setting the debate
We relied on our opponents’ op-ed “Does CTE call for an end to youth tackle football?” as it is their only publication on the topic to guide the discussion.
As Dr. Crary showed, the premise of their argument is based on misunderstandings of CTE evidence.

4. Listening to the experts
Experts (CDC, NIH, DOD) are on record saying they are convinced causation has been established.
We’ve known this for 90 years in boxing.

5. Role of nfl in creating confusion

6. FlagFootballu14.org

7. Our message
The message sent to assembled media and onlookers was that eliminating tackle football for youth is the key to safeguarding the brains and futures of America’s youth.”1
1 Chung J, Cummings P, Samadani U et al. CTE call for an end to youth tackle football?” 2018

8. Risk vs benefiT
There is strong evidence, as outlined by Dr. Crary, that exposure to repetitive head impacts is the only known environmental risk factor for CTE.
Risk increases with exposure.
Risk of CTE is >0

9. This creates cte risk

10. Risk vs benefit
There is strong evidence, as outlined by Dr. Crary, that exposure to repetitive head impacts is the only known environmental risk factor for CTE.
Risk increases with exposure.
Are there benefits unique to tackle football before 14?
Risk of CTE is >0

11. Benefits unique to tackle football?
There is no actual evidence that tackle football provides more non-football benefits (health, life lessons, etc.) than any other sport or activity.
Does youth tackle football make you a better football player?

12. experts don’t support youth tackle

14. Benefits unique to tackle football?
The consensus top 5 NFL players all-time did not play football until high school
Jerry Rice
Jim Brown
Tom Brady
Lawrence Taylor
Walter Payton

15. Benefits unique to tackle football?
There is no evidence that beginning tackle football before 14 even makes you a better football player.

16. Does football fight obesity?
“American youth are currently more sedentary than ever before.”1
“Until we grow up and separate children being hit on the head with the benefit of sports, we can’t make any progress.”
Me, March 31, 2018
1 Chung J, Cummings P, Samadani U et al. CTE call for an end to youth tackle football?” 2018

17. Which would you recommend?
25 doctors are recommending trading CTE risk in children for health benefits that are easily acquired other ways.
If your doctor suggested these activities have a similar risk-benefit ratio, find another doctor.

18. An ethical question
There is no evidence that beginning tackle football before 14 makes makes you a better football player.
Whatever we think we are teaching them… we can teach without hundreds of head impacts.
Benefits = 0
Risk of CTE is >0 and with exposure

19. We prevent similar exposures
Exposure to head impacts is an environmental risk factor for degenerative brain disease, just like exposure to lead and mercury.
We regulate these exposures. We protect kids.
“There is no safe level of lead exposure.” – Why?
The developing brain: In football, there is growing evidence that exposure before age 12 is associated with a greater risk of neurological symptoms like depression and cognitive impairment as an adult.

20. Why a law?
In 2015, we successfully lobbied the board of directors of US Soccer to create an age minimum for heading.
Unlike other sports, youth tackle football does not have a national governing body that controls the sport.
Youth football is more of a capitalist enterprise, it has no mechanism to change.
If an innovative league says flag only until 10, it invites a competitor filling the void, recruiting their 5 to 9-year-olds to tackle. Those kids remain in the competitor league, and the innovative league goes out of business.

22. Summary of youth tackle football
Risk of CTE > 0, and with exposure.
Benefits = 0
We are watching those with the greatest exposure die terrible deaths from CTE.
It is our obligation to protect those children.

23. Let’s use common sense
Do I really have to convince you that hitting a child in the head hundreds of times is a bad idea?
Audience survey
Does anyone hit their own kids in the head?
How about yourself?
Of course we don’t get hit in the head voluntarily! We know it is a terrible idea.
17% of adults smoke, but ~0% expose themselves to repetitive head impacts!
CTE is preventable. Let’s not squander this opportunity.

24. Thank you Learn more at: ConcussionFoundation.org FlagFootballu14.org
Chris Nowinski, PhD
@ChrisNowinski1