Deciding when—or whether—your child engages in contact sports is a personal choice. But parents can employ a number of safety-enhancing strategies, such as the following:

Check in with coaches. “Make sure the coach and league are doing whatever they can to lessen the risk,” says Frederick Rivara, M.D., M.P.H., professor of pediatrics at the University of Washington and Seattle Children’s Hospital. “Is there real attention to player safety? Do coaches know the risks and have information and education about concussion? Protection of kids is highly variable, and it depends on a coach.”

More on Concussions

Programs such as Heads Up, developed by head-injury experts and the Centers for Disease Control and Prevention, can help coaches, sports officials, kids, and parents stay informed about concussion prevention, recognition, and response. 

Make sure protective rules are followed. The U.S. Soccer Federation, for example, recommends that children younger than 10 be prohibited from hitting the soccer ball with the head and that kids between 11 and 13 do this only during practice. Most soccer-related concussions, the organization notes, occur when two players collide while trying to “head” the ball. Check with coaches, officials, and organization websites to see what the rules are for your child’s sport.

Ask about both games and practices. Some research, such as a small study on football players with an average age of 11 that was published last week in the Journal of Neurosurgery: Pediatrics, suggests that young athletes may engage in practice drills that can lead to high numbers of head blows or high-impact blows.

“In terms of the amount of trauma to the head, it’s three times greater in an hour of game play than in an hour of practice,” says Robert Cantu, M.D., clinical professor of neurology and neurosurgery at Boston University Medical School and co-founder of the CTE Center. “But because you practice much longer than you play in a game, the risks of concussion (in practice) are much higher.”

Pay attention to light blows, too. Some studies have found that head blows that don’t reach the level of concussion can also pose a risk. “We now know those subconcussive impacts are extremely dangerous,” says neurologist Orly Avitzur, M.D., Consumer Reports’ medical director. “Too many impacts can damage the connections within the brain and make it harder for the brain to function properly.”

Have them wear helmets, but . . . “Any kind of helmet is meant to protect—to take the impact and protect the skull from fracture,” Avitzur says. “But it doesn’t mean they protect against concussive or subconcussive injuries.”

Don’t rely on anti-concussion devices. A variety of devices, from mouth guards to chinstraps to headbands, designed to sense concussive blows to the head are on the market. A review of 61 studies on four devices designed to measure head impact, published earlier this year in the Journal of Athletic Training, found that such devices may help sports staff get a sense of player exposure to head blows. But the research found that the products don’t appear to be sensitive enough to detect concussions.

“All have limitations in terms of their accuracy,” says Cantu, who was not involved in that study. And, he adds, some people can simply experience concussions at much lower forces than others, and no device can account for that.

Encourage kids to report symptoms. A survey of 288 male and female high school athletes in Michigan, published in July of this year in the Journal of Athletic Training, found that both knew a similar amount about sports-related concussions but that females were more likely to tell an authority figure.

Still, many in both genders kept their symptoms to themselves, in large part because they didn’t consider them sufficiently serious or didn’t want to let others down.

Make sure your youngsters know they should tell a coach or someone else in charge if they experience any of the following after a head blow: nausea or vomiting, headache or a pressured feeling in the head, balance problems, dizziness, double or blurry vision, sensitivity to light or sound, a sluggish or sleepy feeling, confusion, memory problems, or difficulty concentrating.  

Tune into possible gender differences. In some sports, such as soccer, ice hockey, and basketball, Cantu says, girls appear to experience two to three times the incidence of concussions that boys do. But girls may simply be more likely to report injuries, Rivara notes.

However, two-thirds of the 87 young athletes diagnosed with soccer-related concussions in a study presented last week at the American Academy of Pediatric 2017 National Conference were girls. These girls were significantly more likely to return to practice or game play on the day of their injury than boys were, which is inappropriate. (See “Concussion Treatment for Children.”)

Cantu attributes the difference to weaker neck muscles in girls, which means “the shock absorber system is not as strong.” According to the American Academy of Pediatrics, preliminary research suggests that a stronger neck may help reduce concussion risk in young players.