Pediatric neurodevelopment and sports participation. When are children ready to play sports?

The Effectiveness of Coaching the Australian Recommended Fundamental Overarm Throwing Skill Criteria for Less-Skilled Adolescents

Purpose: The aim of this study was to investigate the effects of coaching the Australian recommended fundamental overarm throwing skill criteria for less-skilled adolescents on movement competency using three-dimensional (3D) motion analysis. Methods: Less-skilled non-sports-active and skilled sports-active pupils were assigned to FMS Group (n = 97) and Sports Group (n = 129), respectively. Demographic, anthropometric, whole-body kinematic (discrete and time-series angular displacement and angular velocity data), motor coordination (segmental sequencing) and motor performance (maximum ball release speed) were analyzed. Baseline data were compared using independent T-tests and Chi-Square tests; interaction effects were assessed using repeated-measure ANOVAs. Changes in time-series kinematic data were analyzed by comparing the areas enclosed by the 95% confidence intervals. Results:There was merely a modest improvement in motor competency for the less-skilled pupils. The FMS group significantly acquired 13/75 discrete kinematic variables (p < .01) and four movement patterns but not motor coordination (p = .469) and motor performance (p = .756). Prior to the intervention, the pupils acquired 4/7 recommended skill criteria. The descriptions of another three criteria were not appropriate with no improvement in motor coordination and performance. Two new skills were identified and improved after the FMS intervention. Conclusions: The recommended skill criteria for children were not developmentally and age-appropriate for early adolescents. The use of quantitative 3D motion data provided a more precise and developmentally applicable fundamental overarm throwing criteria than content validated skill criteria. The recommended skill criteria should be modified to facilitate teachers and coaches for effective education.

Physical Activity Over the Lifecourse and Cardiovascular Disease

Despite improvements in cardiovascular care in recent decades, cardiovascular disease (CVD) remains a leading cause of death worldwide. At its core, CVD is a largely preventable disease with diligent risk factor management and early detection. As highlighted in the American Heart Association's Life's Essential 8, physical activity plays a central role in CVD prevention at an individual and population level. Despite pervasive knowledge of the numerous cardiovascular and noncardiovascular health benefits of physical activity, physical activity has steadily decreased over time and unfavorable changes in physical activity occur throughout people's lives. Here, we use a lifecourse framework to examine the evidence reporting on the association of physical activity with CVD. From in utero to older adults, we review and discuss the evidence detailing how physical activity may prevent incident CVD and mitigate CVD-related morbidity and death across all life stages.

Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st century

Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.

Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.

Training the developing brain part II: cognitive considerations for youth instruction and feedback

Growing numbers of youth participating in competitive, organized physical activity have led to a concern for the risk of sports-related injuries during important periods of human development. Recent studies have demonstrated the ability of integrative neuromuscular training (INT) to enhance athletic performance and reduce the risk of sports-related injuries in youth. Successful implementation of INT necessitates instruction from knowledgeable and qualified instructors who understand the unique physical, cognitive, and psychosocial characteristics of the youth to provide appropriate training instruction and feedback. Principles of a classical theory of cognitive development provide a useful context for discussion of developmentally appropriate methods and strategies for INT instruction of youth. INT programs that consider these developmentally appropriate approaches will provide a controlled efficacious environment for youth to improve athletic performance and reduce risk of sports-related injury, thus promoting a healthy active lifestyle beyond an individual's formative years.

Patterns of Specialization in Professional Baseball Players

Two developmental pathways to sport excellence have been described: early specialization and early sampling (Côté, Lidor, & Hackfort, 2009). Despite a common assumption that early specialization (defined as playing one sport exclusively and intensely before age 12) is a necessary precursor to success at the collegiate or professional levels, research to support this assumption remains unclear. To add to this literature, the current study was a survey of 708 minor league professional baseball players on the ages at which they began to specialize in their sport. Results indicated that most players sampled a diversity of sports up through late adolescence. Only 25% of players specialized before the age of 12 and the mean age of specialization was 15 years. Furthermore, those who specialized later were more likely to receive college scholarships. Finally, we examined patterns of specialization as a function of athletes’ home climate and culture. At least in this sample of professional minor league baseball players, an early sampling pathway seems to have fortified success at both the collegiate and professional levels.

Economic gradients in early child neurodevelopment: a multi-country study

Little is known about the importance of household wealth for child neurodevelopment very early in life including during infancy. Previous studies have focused on specific developmental domains instead of more holistic multi-domain measures of neurodevelopment and on economic effects for the "average" child instead of evaluating the heterogeneity in economic gradients by different levels of developmental ability. Furthermore, not much is known about whether economic gradients in early child neurodevelopment are country-specific or generalizable between populations. We evaluate wealth gradients in child neurodevelopment, an important predictor of future health and human capital, between ages 3 and 24 months in four South American countries. We also assess the heterogeneity in these gradients at different locations of the neurodevelopment distribution using quantile regression. Employing a unique dataset of 2032 children with neurodevelopment measures obtained by physicians in 2005-2006, we find a large positive wealth gradient in neurodevelopment in Brazil. The wealth gradient is larger for children at higher neurodevelopment rankings, suggesting that wealth is associated with child development inequalities in the form of a wider gap between low and high achievers on neurodevelopment in Brazil. This result highlights the need to target poverty in Brazil as a key factor in health and human capital disparities earlier in life rather than later as early developmental deficits will be carried forward and possibly multiplied later in life. More importantly, small or insignificant wealth gradients are generally found in the other countries. These results suggest that wealth gradients in child neurodevelopment are country-specific and vary with population demographic, health, and socioeconomic characteristics. Therefore, findings from previous studies based on specific populations may not be generalizable to other countries. Furthermore, wealth gradients in child neurodevelopment appear to be dynamic rather than fixed and sensitive to population characteristics that modify their intensity.

Differences in physical fitness and gross motor coordination in boys aged 6-12 years specializing in one versus sampling more than one sport

The Developmental Model of Sports Participation proposes two pathways towards expertise in sports between 6 and 12 years of age: early specialization and early diversification. This study investigated the effect of sampling various sports and of spending many or few hours in sports on fitness and gross motor coordination. Altogether, 735 boys in three age groups (6-8, 8-10, and 10-12 years) were profiled using a fitness test battery. A computerized physical activity questionnaire was used to obtain data on sports participation. In the eldest group, (M)ANCOVA showed a positive effect of sampling various sports on strength, speed, endurance, and gross motor coordination (P < 0.05). A positive effect of many hours per week spent in sports was apparent in every age group. These data suggest an acute positive effect of many hours in sports and a latent positive effect of early sampling on fitness and gross motor coordination. Multiple comparisons revealed that boys aged 10-12 years, who spent many hours in various sports, performed better on standing broad jump (P < 0.05) and gross motor coordination (P < 0.05) than boys specializing in a single sport. Therefore, our results highlight the importance of spending many hours in sports and sampling various sports in the development of fitness and gross motor coordination.

The Impact of Household Investments on Early Child Neurodevelopment and on Racial and Socioeconomic Developmental Gaps - Evidence from South America

This paper assesses the effects of household investments through child educating activities on child neurodevelopment between the ages of 3 and 24 months, and evaluates whether investments explain racial and socioeconomic developmental gaps in South America. Quantile regression is used to evaluate the heterogeneity in investment effects by unobserved developmental endowments. The study finds large positive investment effects on early child neurodevelopment, with generally larger effects among children with low developmental endowments (children at the left margin of the development distribution). Investments explain part of the observed racial gaps and the whole socioeconomic developmental gap. Investments may compensate for low endowments and policy interventions to increase investments may reduce early development gaps and result in high social and economic returns.

Sport participation by physically and cognitively challenged young athletes

Many physically and cognitively challenged athletes participate in organized and recreational sports. Health benefits of sport participation by athletes with disabilities have been well recognized. A careful preparticipation evaluation and proper classification of athletes ensures safe sports participation by athletes with disabilities. Some conditions in these athletes, such as problems with thermoregulation, autonomic control, neurogenic bladder and bowel, latex allergy, and many associated and secondary complications deserve special consideration. This article reviews common medical issues that relate to sport participation by athletes with physical and cognitive disabilities.

Towards a unified understanding of relative age effects

When athletes are placed into annual age groups to organize and coordinate sport participation, certain (dis)advantages occur as a result of the subtle age differences within these groups. These differences, termed "relative age effects", have been consistently related to youth and adult sport attainment. However, there has been a lack of consistency in the terminology used in this area of research. In this paper, we consider the operational terms used in relative age research, discuss appropriate applications of terminology, and suggest directions for future research. Importantly, we argue for a unified understanding of what "relative age" means, stressing the need for clarity in directing future advances in the field.

Do our children play safe?

Sports participation is a frequent cause of injury in general to children and adolescents. 719 athletically active school children belonging to the age group of 11-14 years were selected from the four urban localities in south India (i.e, Bangalore Chennai, Cochin & Hyderabad). Data was collected by a well structured questionnaire. The results revealed that the south Indian urban school children had inadequate levels of awareness regarding orofacial injuries and their emergency care. The knowledge regarding protective devices was found to be minimal. Majority of the children were aware of mouthguards but their usage was nil.

Management of sport-related concussion in young athletes

Sport-related head injuries are a common clinical problem. Most head injuries in young athletes are mild traumatic brain injuries or concussions. The highest number of sport-related concussions has been reported in American football. In addition to the well described physical and psychosocial growth, there is ongoing neurocognitive development of the brain during childhood and through adolescence. This developmental process has direct implications in the assessment and management of head injuries in young athletes. Research on the management and long-term outcome following brain injuries in young athletes is limited. Traditionally, the assessment of concussion has been based on clinical history and physical and neurological examination. Increasingly, neuropsychological testing, especially computerised testing, is providing objective measures for the initial assessment and follow-up of young athletes following brain injuries. Numerous guidelines have been published for grading and return to play criteria following concussion; however, none of these have been prospectively validated by research and none are specifically applicable to children and adolescents.

Do episodes of peer victimization trigger physical injury? A case-crossover study of Swedish school children

AIMS

The aim of this study was to investigate how long the effect of peer victimization on the occurrence of physical injury lasts and whether the effect varies according to how frequently an injured child is victimized.

METHODS

A case-crossover design was employed. Children aged 10-15 years residing in Stockholm County during two consecutive school years were eligible as cases. Further inclusion criteria were that the children had been hospitalized or called back for a medical check-up due to a physical injury. Information on children's exposure to peer victimization at school was gathered in interviews, and on their social characteristics through a questionnaire filled in by parents. A total of 575 children were included.

RESULTS

Our analyses show that there is an increase in risk of unintentional injury after an episode of peer victimization shortly after the end of exposure to victimization (RR = 5.5) but not thereafter. The risk is substantially higher among children seldom victimized (RR = 49.9) than among those victimized on a more regular basis (RR = 2.5). The extent to which family social circumstances modify the risk is difficult to establish from the material at hand.

CONCLUSION

Peer victimization may trigger the occurrence of unintentional injuries in childhood and the effect is short lasting. The results need to be replicated and special attention should be given to separating lesson time from break time to avoid confounding by time of day.

Is perceived failure in school performance a trigger of physical injury? A case-crossover study of children in Stockholm County

OBJECTIVES

To investigate whether perceived failure in school performance increases the potential for children to be physically injured.

SUBJECTS

Children aged 10-15 years residing in the Stockholm County and hospitalised or called back for a medical check up because of a physical injury during the school years 2000-2001 and 2001-2002 (n = 592).

METHODS

A case-crossover design was used and information on potential injury triggers was gathered by interview. Information about family socioeconomic circumstances was gathered by a questionnaire filled in by parents during the child interview (response rate 87%).

RESULTS

Perceived failure in school performance has the potential to trigger injury within up to 10 hours subsequent to exposure (relative risk = 2.70; 95% confidence intervals = 1.2 to 5.8). The risk is significantly higher among pre-adolescents and among children from families at a higher education level.

CONCLUSIONS

Experiencing feelings of failure may affect children's physical safety, in particular among pre-adolescents. Possible mechanisms are perceptual deficits and response changes occasioned by the stress experienced after exposure.

Behavioral aspects of children's sports

This article considers some of the numerous behavioral aspects that are related to children's sports. The pediatrician, during various encounters with the athlete and his or her parents in the office, or on the field, can positively influence the sport participation experience of the athlete, by screening and identifying potential problem areas as well as providing anticipatory guidance on various issues.

Peer victimization during early adolescence: an injury trigger, an injury mechanism and a frequent exposure in school

There is a documented effect of peer victimization in school as an injury trigger, but the question of differences between children according to age and sex remains unexplored. Nor do we know the role played by school peer victimization as a direct injury mechanism.

OBJECTIVE

The study considered age and sex differences with regard to peer victimization's triggering effect on physical injury, its direct relation to injury (i.e. physical violence), and its age- and gender-specific frequency and manner of occurrence.

METHOD

Data were gathered through structured interviews with children aged 10-15 years, residing in Stockholm County in Sweden during two consecutive school years, and who had been hospitalized due to injury (n = 592).

RESULTS

Peer victimization operated on injury risk-both indirectly as a trigger of injurious events (most of which are unintentional), and directly as a causal mechanism in relation to intentional physical harm. Further, intentionally injured children frequently knew their offender(s)--often from school--and, in those instances, had been previously victimized by them. There is a quantitative and a qualitative difference in the manner in which occasional and frequent victims are victimized by their peers.

CONCLUSION

Peer victimization impacts on children's safety and is a common element in the school background of many children. Differences between occasional and frequent victims in forms and consequences of victimization are more remarkable than those based on sex and age of the child, with the exception of victimization as a direct cause of injury.