The effects of concussion legislation one year later--what have we learned: a descriptive pilot survey of youth soccer player associates.

Objective: To assess the knowledge of youth soccer athletes' parents, coaches, and soccer officials regarding concussion and return-to-play guidelines contained in the Lystedt Law in Washington State.

Design: Survey study.

Setting: Surveys were distributed via the youth soccer association monthly electronic newsletter in September and October 2010. Links to the survey also were provided via the Washington Youth Soccer Facebook page and Twitter feed.

Participants: Respondents were 18 years or older and were associated with Washington Youth Soccer.

Main Outcome Measures: The percentage of correct responses to questions regarding the identification and management of concussion symptoms and return to play guidelines as outlined in the Lystedt Law.

Results: A total of 391 adults responded; 63% were exclusively parents, 20% were coaches, and 17% were noncoaches (eg, club officers, referees, or volunteers). A total of 96% knew that concussions were a type of traumatic brain injury, 93% identified concussions as serious, and 93% knew that loss of consciousness is not universal. From the responses, 98% identified neurological manifestations of concussions, 90% chose to delay return to play in the presence of neurological symptoms, 85% were aware of the Lystedt Law, and only 73% knew that players must receive written clearance to return to play. A total of 88% were aware that a parent or legal guardian was not allowed to clear an athlete to return to play if a trained professional was not available. Survey respondents were less sure of soccer association guidelines for reporting medical clearance to club officials.

Conclusions: These data suggest that, although general knowledge of parents, coaches, and referees in youth soccer in Washington State is high, gaps in knowledge and practice regarding the prevention of concussion in youth soccer athletes still exist.