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PEDIATRICS Vol. 107 No. 6 June 2001, pp. 1459-1462
Participation in organized sports provides an
opportunity for young people to increase their physical activity and
develop physical and social skills. However, when the demands and
expectations of organized sports exceed the maturation and readiness of
the participant, the positive aspects of participation can be negated. The nature of parental or adult involvement can also influence the
degree to which participation in organized sports is a positive experience for preadolescents. This updates a previous policy statement
on athletics for preadolescents and incorporates guidelines for sports
participation for preschool children. Recommendations are offered on
how pediatricians can help determine a child's readiness to
participate, how risks can be minimized, and how child-oriented goals
can be maximized.
ABSTRACT
Top
Abstract
Introduction
References
Participation in organized sports can have physical and
social benefits for children. However, the younger the participant, the
greater the concern about safety and benefits. The involvement of
preadolescents in organized sports is a relatively recent phenomenon. In the early 20th century, physical activity was a more regular part of
life for the average child. Sports and games provided an
additional outlet for physical activity and were characterized by play
that was generally spontaneous, unstructured, and without adult
involvement. Participation in such sports and games allowed for
development of motor skills, social interaction, creativity, and
enjoyment for participants.
During the latter part of the 20th century, "free play" or
unstructured games primarily gave way to organized sports. The starting
age for organized sports programs has also evolved to the point that
infant and preschool training programs are now available for many
sports. Organization of sports has potential benefits of coaching,
supervision, safety rules, and proper equipment but can also create
demands and expectations that exceed the readiness and capabilities of
young participants. Organization can also shift the focus to goals that
are not necessarily child oriented. Clearly, the nature of the
organization can determine if it has a positive or negative influence.
This statement is an update to a previous policy statement on athletics
for preadolescents1 and incorporates guidelines for sports
participation for preschool children.2 Recommendations are
made on how pediatricians can help determine a child's readiness to
participate in organized sports, how risks can be minimized, and how
child-oriented goals can be maximized.
The effects of organized sports participation on growth and
maturation have come under question, as have the effects of growth and
maturation on the ability to participate in sports. Because children
are beginning to train and compete at earlier ages, there is increasing
concern about potential negative effects on growth and maturation.
Reports of gymnasts and divers with short stature or ballet dancers
with lean body types or late menarche have contributed to such
concerns. Despite such reports, it is unclear if these characteristics
were a result of intensive training or other factors, such as dietary
practices, psychological and emotional stress, or selection bias for
the sport.3
The effects of immaturity on sports participation are more obvious.
When the demands of a sport exceed a child's cognitive and physical
development, the child may develop feelings of failure and frustration.
Even with coaches available to teach rules and skills of a sport,
children may not be ready to learn or understand what is being taught.
Furthermore, many coaches are not equipped to deal with the needs or
abilities of children. Basic motor skills, such as throwing, catching,
kicking, and hitting a ball, do not develop sooner simply as a result
of introducing them to children at an earlier age.4
Teaching or expecting these skills to develop before children are
developmentally ready is more likely to cause frustration than
long-term success in the sport.5 Because most youth sports
coaches are volunteers with little or no formal training in child
development, they cannot be expected to correctly match demands of a
sport with a child's readiness to participate. Educational programs
are available for youth sports coaches, but most coaches do not
participate. Nonetheless, coaches may still try to teach what often
cannot be learned and blame resulting failures on shortcomings of
athletes or themselves.
Parental or adult supervision of children's activity is usually
considered to be desirable. However, in organized sports, inappropriate
or overzealous parental or adult influences can have negative effects.
Adults' involvement in children's sports activities may bring goals
or outcome measures that are not oriented toward young participants.
Tournaments, all-star teams, most valuable player awards, trophies, and
awards banquets are by-products of adult influences. Despite good
intentions, increased involvement of adults does not necessarily
enhance the child athlete's enjoyment. The familiar image of a parent
imploring their 5-year-old to "catch the ball," "kick the
ball," or "run faster" is a reminder of how adult encouragement
can have discouraging effects.
In contrast to unstructured or free play, participation in
organized sports provides a greater opportunity to develop rules specifically designed for health and safety. Organization can allow for
the establishment of developmentally sound criteria for determining
readiness to play. Organization can also allow for a fair process in
choosing teams,6 matching competitors,7 and
enforcing rules. Rules specifically targeted at younger athletes can
reduce injuries. Recommendations have been made to limit dangerous practices, such as headfirst sliding in baseball8 and body
checking in hockey.9 Safety accommodations associated with
organized youth sports can also include smaller playing fields, shorter
contest times, pitch counts for Little League pitchers, softer
baseballs, matching opponents by weight in youth football, and
adjusting play for extreme climatic conditions.10 The
availability of qualified coaches in organized sports can be a key
factor in providing safety and a positive experience.
In this regard, the effects of organization provide positive
environments for young participants. Unfortunately, not all youth sports participants have access to all known safety measures. Furthermore, a great deal remains to be learned about safety in youth
sports. Additional resources are needed to study injury prevention and
ensure that all participants will benefit from existing safety
measures. The prospects for additional development and implementation
of safety measures are far greater for organized sports than for
unstructured free play.
Despite many potential benefits of organization, there is no consensus
as to the overall value of organized sports for preadolescents. A
return to the days of free play has been suggested as one means to
eliminate negative aspects of organized sports. Unfortunately, the days
when children had the time, opportunity, or inclination to play in
neighborhoods or local parks have passed. Today, there are more demands
on a young person's time, more options for free time, diminished
requirements for regular physical activity, and fewer opportunities for
free play. School-based physical education programs have also been
reduced throughout the years and can no longer be relied on to provide
adequate levels of healthy activity.11
Regular physical activity can help reduce the risk of many adult health
problems, including diabetes, obesity, and heart
disease.12 However, with less time dedicated to free play
and school physical education programs, the result may be lower
activity levels and lower levels of fitness for children. There is a
greater need to protect opportunities for structured and unstructured
physical activity for children. Organized sports may not provide all
physical activity needs but can be a viable means to increase
activity levels in children and, hopefully, lead to the adoption of
active lifestyles as adults.
Organized Sports Programs: Optimizing the If organized sports are going to be safe, healthy, and beneficial
for children and preadolescents, there must be reasonable goals for
participation and appropriate strategies to attain these goals.
Reasonable goals for children and preadolescents participating in
organized sports include acquisition of basic motor skills, increasing
physical activity levels, learning social skills necessary to work as a
team, learning good sportsmanship, and having fun.13
Organized sports sessions should be tailored to match the developmental
level of participants. Most preschool children have short attention
spans and are easily distracted; therefore, exercise sessions should be
short and emphasize playfulness, experimentation, and exploration of a
wide variety of movement experiences. A reasonable format would consist
of no longer than 15 to 20 minutes of structured activity combined with
30 minutes of free play. Concentration will be maximized if
instructional sessions take place in a setting with minimal
distraction. Instructing younger children using a show-and-tell format
with physical demonstration may be more effective than with verbal
instruction.
For children and preadolescents, factors such as fun, success, variety,
freedom, family participation, peer support, and enthusiastic leadership encourage and maintain participation, whereas others such as
failure, embarrassment, competition, boredom, regimentation, and
injuries discourage subsequent participation.14
Pediatricians, as experts in child development, can help parents and
coaches determine readiness of a child to participate in organized
sports. Readiness is often defined relative to the demands of the
sport. Because different sports and even the same sport may vary widely
with respect to demands and expectations, pediatricians must understand
these demands to help determine if they are appropriate for the
physical and cognitive maturation of participants. Preparticipation
examinations are typically not mandated until junior high and high
school. However, annual examinations for younger children afford an
opportunity to promote physical activity and address issues of
readiness as they apply to organized sports.
Pediatricians can further advocate safe sports participation by
promoting better education and training of youth sports coaches. Standards for coaching competency are available, and certification for
youth sports coaches should address these competencies.15 In addition, pediatricians can work with sports administrators and
coaches within their community to share relevant information on child
development, injury assessment, first aid, and injury prevention.
Pediatricians can also take an active role in developing safety
programs while ensuring that existing safety measures are observed. A
pediatrician may be one of the few adults who can objectively
determine when pressures and expectations of organized sports
become excessive for any individual or group. Finally, pediatricians
can serve as role models for appropriate sideline behavior and can help
parents and other adults remember the reasons children want to
participate.
Organized sports for children and preadolescents provide an
opportunity for increased physical activity and an opportunity to learn
sports and team skills in an environment where risks of participation
can potentially be controlled. Unfortunately, when demands and
expectations of the sport exceed the maturation or readiness of the
participant, benefits of participation are offset. The shift from
child-oriented goals to adult-oriented goals can further negate
positive aspects of organized sports.
To optimize the safety and benefits of organized sports for children
and preadolescents and to preserve this valuable opportunity for young
people to increase their physical activity levels, the American Academy
of Pediatrics recommends the following:
1. Organized sports programs for preadolescents should
complement, not replace, the regular physical activity that is a part of free play, child-organized games, recreational sports, and physical
education programs in the schools. Regular physical activity should be
encouraged for all children whether they participate in organized
sports or not.
2. Pediatricians are encouraged to help assess developmental
readiness and medical suitability for children and preadolescents to
participate in organized sports and assist in matching a child's physical, social, and cognitive maturity with appropriate sports activities.
3. Pediatricians can take an active role in youth sports
organizations by educating coaches about developmental and safety issues, monitoring the health and safety of children involved in
organized sports, and advising committees on rules and safety.
4. Pediatricians are encouraged to take an active role in
identifying and preserving goals of sports that best serve young athletes.
5. Additional research and resources are needed to:
a a. determine the optimal time for children to begin
participating in organized sports;
b b. identify safe and
effective training strategies for growing and developing
athletes;
c c. educate youth sports coaches
about unique needs and characteristics of young athletes; and
d d. develop effective injury prevention
strategies.
Committee on Sports Medicine and Fitness, 2000-2001
Reginald L. Washington, MD, Chairperson
David T. Bernhardt, MD
Jorge Gomez, MD
Miriam D. Johnson, MD
Thomas J. Martin, MD
Thomas W. Rowland, MD
Eric Small, MD
Liaisons
Claire LeBlanc, MD
Canadian Pediatric Society
Carl Krein, AT, PT
National Athletic Trainers Association
Robert Malina, PhD
Institute for the Study of Youth Sports
Judith C. Young, PhD
National Association for Sport and Physical Education
Section Liaison
Frederick E. Reed, MD
Section on Orthopaedics
CONSULTANTS
Steven Anderson, MD
Stephen Bolduc, MD
Oded Bar-Or, MD
Staff
Heather Newland
Committee on School Health, 2000-2001
Howard L. Taras, MD, Chairperson
David A. Cimino, MD
Jane W. McGrath, MD
Robert D. Murray, MD
Wayne A. Yankus, MD
Thomas L. Young, MD
Liaisons
Missy Fleming, PhD
American Medical Association
Maureen Glendon, RNCS, MSN, CRNP
National Association of Pediatric Nurse Practitioners
Lois Harrison-Jones, EdD
American Association of School Administrators
Jerald L. Newberry, MEd, Executive Director
National Education Association, Health Information Network
Evan Pattishall III, MD
American School Health Association
Mary Vernon, MD, MPH
Centers for Disease Control and Prevention
Linda Wolfe, RN, BSN, MEd, CSN
National Association of School Nurses
Staff
Su Li, MPA
INTRODUCTION
Top
Abstract
Introduction
References
ORGANIZED SPORTS PROGRAMS: LIMITATIONS AND RISKS
ORGANIZED SPORTS PROGRAMS: BENEFITS
Benefit-to-Risk Ratio
SUMMARY AND RECOMMENDATIONS
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FOOTNOTES |
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The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
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REFERENCES |
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Top
Abstract
Introduction
References
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Statement of reaffirmation:
The following policy statement has been revised:
This article has been cited by other articles:
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  S. G. Rice and and the Council on Sports Medicine and Fitness Medical Conditions Affecting Sports Participation Pediatrics, April 1, 2008; 121(4): 841 - 848. [Abstract] [Full Text] [PDF]
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Committee on Sports Medicine and Fitness Promotion of Healthy Weight-Control Practices in Young Athletes Pediatrics, December 1, 2005; 116(6): 1557 - 1564. [Abstract] [Full Text] [PDF]
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 U.S. Preventive Services Task Force* Behavioral Counseling in Primary Care To Promote Physical Activity: Recommendation and Rationale Ann Intern Med, August 6, 2002; 137(3): 205 - 207. [Abstract] [Full Text] [PDF]
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 T. Nugent Teach young children safety, noncompetition through organized sports AAP News, June 1, 2001; 18(6): 260 - 260. [Full Text] [PDF]
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