If your kids play contact sports such as tackle football, ice hockey, lacrosse, or soccer, you may be worried about them experiencing a concussion.

New research might increase your concern about concussions in children: A new study published in the journal Translational Psychiatry finds that playing tackle football before 12 years of age is associated with a heightened risk of mood and behavioral issues in middle age.

More on Concussions

Researchers from Boston University's Chronic Traumatic Encephalopathy Center used online questionnaires and telephone interviews to compare adults who'd started playing football before age 12 with those who'd begun after that age. The average age of the respondents was 51. (Chronic traumatic encephalopathy, or CTE, is a progressive brain disease.) 

"We found that those who started playing before 12 had increased odds of having problems with behavioral regulation—controlling emotion and impulse—and with executive function by twofold and increased odds of clinical depression by threefold," says lead author Michael Alosco, Ph.D., a post-doctoral fellow at the CTE Center.

The study did not look specifically at the number of concussions—injuries that occur when blows to the head cause the brain to move quickly back and forth—or subconcussive blows the players reported. But other research suggests that even young tackle football players may experience numerous head impacts; one 2015 study of 11- to 13-year-olds put the per-game average at 12 and the seasonal average at 252.  

"While there has not been conclusive scientific evidence that suffering concussions as a youth predisposes a child to developing CTE, we know there are professional athletes with repeated concussions who have been adversely affected by CTE and neurodegenerative diseases," says neurologist Orly Avitzur, M.D., Consumer Reports medical director.

Concussions in children do appear to be on the rise, especially among those ages 10 to 19, according to research published last year in the Orthopaedic Journal of Sports Medicine

The researchers found that the incidence of diagnosed concussion in 10- to 19-year-olds more than doubled between 2007 and 2014. But, they say, it's unclear whether this is due to a rise in sports-related activities or simply an increased awareness of concussions in children. 

Before you pull your child off the sports team, it's important to put these findings, and those of other studies, in perspective. And to know that the effects of single concussions in children are usually short-term—though in some cases they can be serious and lasting. Here, a deeper look at the research and the expert insights that will help you safeguard your youngsters. 

Why Is This Study Important?

While some previous research, including several other studies from Boston University's CTE Center, also linked early tackle football play to health issues years later, the new study offers a few significant differences.

For instance, this study had 214 participants, while prior studies were much smaller. This also appears to be the first to include former high school and college players, along with those who were professionals. That means any issues unearthed can't be blamed solely on the intensity of professional-level play. And, in fact, the research found that those who only played in high school were just as likely to experience behavioral and mood issues at midlife as those who continued playing in college or professionally. 

This research does have limitations, however. For example, participants were self-selected. "People who have symptoms already are probably more likely to participate," says Alosco. "Another big limitation is that we can only really generalize our findings to male football players." Too, the study's self-reporting of symptoms and gathering of information by telephone is considered less reliable than in-person neuropsychological testing.  

In addition, some research, notably a study on 45 former professional football players, published in 2016 in the Journal of American Sports Medicine, found no relationship between early football play and mood and behavioral issues down the road.  

We reached out to Pop Warner Little Scholars (which calls itself the largest youth football, cheer, and dance organization in the world) for comments on the new study. Pop Warner responded with the following statement:

"The participants in this study played youth football 40 years ago. Youth football has evolved significantly since that period and the major changes Pop Warner has implemented have revolutionized the sport, making it safer and better than ever before." Among these changes is a medical advisory committee of physicians and other health professionals. Pop Warner also noted that this committee will review the new study and compare it to others with with dissimilar findings.

“There’s not a lot of research on this topic and there are inconsistent reports across studies,” says Alosco. That's why, he adds, additional research needs to be conducted on issues such as the potential risks of other contact sports, the impact of head blows on female athletes, and the interplay of genetics and head injuries.

And we need long-term studies, instead of those that look back in time, says Alosco: “Ideally, you’d be able to follow a lot of people who played youth football from the time they played into adulthood."