Committee on Safety in School Sports (CSSS) Report on School Sports Safety - 16 Dec 2010

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Committee on Safety in
 School Sports (CSSS)

   Report on School
     Sports Safety

                      16 Dec 2010
CONTENT PAGE

Main Paper

     Chapter                                                                   Page
1.   Introduction and background to School Sports                                2
2.   Findings from the Committee on Safety in School Sports                      5
3.   Recommendations to enhance Safety in School Sports                         10
4.   Implementation and conclusion                                              16

Annexes

Annex A      Members of the CSSS
Annex B      List of Sports CCAs and Competitions
Annex C      Current Safety Framework for PE and Co-Curricular Activities in
             Schools
Annex D      Best Practices on Youth Sports Safety from Other Countries
Annex E      Roles of Stakeholders in Promoting School Sports Safety
INTRODUCTION AND BACKGROUND ON SCHOOL SPORTS

INTRODUCTION

1.    In schools, sports and physical activities are an important component of
      holistic education, as they develop our students physically, and also provide
      opportunities for them to develop discipline, life skills and sporting skills.

2.    In May 2010, the Ministry of Education (MOE) set up the Committee on Safety
      in School Sports (CSSS) to review safety practices and issues in the conduct
      of school sports, and make recommendations for sustained improvement of
      safety in school sports. The composition of CSSS is at Annex A. In the
      course of its review, the Committee surveyed current guidelines and practices
      governing school sports, studied data on injury rates related to sporting and
      physical activities in schools, considered best practices in other countries, and
      tapped on views from the sporting community.

BACKGROUND ON SCHOOL SPORTS

3.    Sports and physical education (PE) are integral building blocks in a holistic
      education system. Through sports, we can build confidence, resilience,
      teamwork and other soft skills that are important for students to excel both in
      school and later in life. Students with sporting talents can also be identified
      and further groomed to realise their potential.

4.    It is useful to highlight MOE’s guiding principles of PE and sports development
      to set the context for the review of sports safety. Specifically, our guiding
      principles are:
      a.     Participation in PE & sports confers a range of benefits, such as
             psychomotor skills, health and fitness, and these benefits contribute to
             the holistic development of the students.
      b.     Provision for mass participation is our priority. At the same time, we
             also aim to provide a range of opportunities catering to students of
             different sporting abilities to achieve excellence.

VISION AND PURPOSE OF PE IN SCHOOLS

5.    The vision of PE in Singapore is "Every Child is Physically Educated", with the
      aim to develop students’ motor skills and games skills, and equip them with
      the skills, knowledge and attitudes to pursue and enjoy a physically active and
      healthy lifestyle. The specific objectives of PE in schools are:
      a.     To develop and maintain physical health and fitness through regular
             participation in physical activities.
      b.     To practise safety habits during physical activities.

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c.     To demonstrate positive self-esteem through body awareness and
             control.
      d.     To demonstrate the spirit of teamwork, sportsmanship and fair play.

6.    PE is compulsory at all levels. At the primary level, students are taught
      fundamental psychomotor skills and games concepts, and are given the
      opportunities for structured play, interaction and co-operation. At secondary
      level, students extend their psychomotor and games skills, develop more
      games concepts, acquire a holistic perspective of health and fitness, and
      foster teamwork, sportsmanship and discipline through sports. At Junior
      College (JC) level, students refine their sports and games skills and concepts,
      develop health-enhancing fitness management skills, and are given
      opportunities for leadership in sports.

VISION AND PURPOSE OF CCA IN SCHOOLS

7.    CCAs are an integral part of the curriculum as they provide students with
      authentic platforms to live and practice the values and soft skills taught in the
      classroom.

8.    CCAs foster social integration and help students develop a sense of
      belonging, camaraderie and loyalty. Active participation in CCAs allows
      students to develop healthy recreational interests, and improve their physical
      and mental well-being. Students with enriching CCA experiences will emerge
      from schools moulded in character and equipped with competencies, ready
      for the challenges in their adult life.

9.    The purposes of CCA are as follows:
      a.     Develop sound values, resilience and character.
      b.     Equip pupils with knowledge and skills to manage their mental and
             physical health.
      c.     Develop bonds of friendship and ability to work effectively in a team.
      d.     Develop pupils’ tacit knowledge to be comfortable operating in a variety
             of cultures and situations and awareness of a balanced lifestyle by
             exposing them to a variety of experiences, including those related to
             sports.

10.   Students are introduced to CCAs at Primary 3 and participation is voluntary.
      At the secondary level, they must participate in at least one core CCA. There
      is a wide range of CCAs in our schools. Students may choose from four main
      groups comprising Sports, Uniformed Groups, Performing Arts, and Clubs &
      Societies. There are currently a total of 63 Sports CCAs offered by our
      schools, ranging from Air Rifle, Cross Country, to Sailing and Tennis (see
      Annex B for the full list of Sports CCAs). Schools have the flexibility to
      determine which CCAs to offer based on their students’ interests and needs,
      and availability of facilities, teachers-in-charge of CCAs, and qualified
      coaches.

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11.    Over the years, with the growing emphasis on sports in Singapore and the
       provision of holistic education to our students, MOE has increased the
       diversity of sports CCAs and competitions. For example, in recent years, the
       range of CCAs and competitions has been expanded to include Wushu
       (2005), Floorball (2007) and Taekwondo (2010).

S CHOOL S PORTS C OMPETITIONS

12.    Sports competitions help generate students’ interest in sports and spur the
       pursuit of excellence in the respective sports. MOE set up the Singapore
       Primary Schools Sports Council (SPSSC) and Singapore Schools Sports
       Council (SSSC) in 1959 to oversee and organise inter-school competitions.
       Today, national inter-school competitions are organised by the SPSSC for 21
       sports in primary schools and the SSSC for 27 sports in secondary schools,
       JCs and the Centralised Institute (CI). (See Annex B for the list of sports
       CCAs with competitions)1.

13.    Schools compete in a number of co-curricular events at the zonal and national
       level each year. These include sports events such as the National Track and
       Field Championships. Outstanding athletes are then selected into the
       Singapore Schools Sports Teams2 to take part in regional and international
       competitions.

                                          .....

1
  Two sports – Floorball and Taekwondo – are organized by the respective National Sporting
Associations.
2
  Previously known as the Combined Schools Teams.

                                            4
FINDINGS FROM THE COMMITTEE ON SAFETY IN SCHOOL SPORTS

KEY AREAS OF STUDY

1.    To understand the current sporting environment in schools and identify
      potential areas for improvement, the Committee conducted a series of studies
      in the following areas:
      a.     Best practices in youth sports safety in other countries. Best practices
             for youth sports safety in the United States, United Kingdom and
             Australia, which have established policies and initiatives on sports
             safety, and where sports play an important part in everyday life, were
             studied.
      b.     Benchmarking against international rules and best practices. The
             Committee benchmarked the local competition rules and practices
             issued by the SSSC and SPSSC for 6 key sports against international
             rules and best practices. These sports were: Basketball, Hockey,
             Judo, Rugby, Soccer and Taekwondo.
      c.     Focus Group Discussions (FGDs) with sporting community. FGDs
             were conducted with members of the sporting community to surface
             potential areas for improvement.
      d.     Assessment of the current safety framework. This covered issues
             ranging from leadership, safety education and training to safety
             practices in schools.
      e.     Governance of school sports competitions. The Committee studied the
             governance of the Singapore Primary Schools Sports Council (SPSSC)
             and Singapore Schools Sports Council (SSSC) to assess if and how
             safety in school sports competitions could be further improved upon.
      f.     Injury rates in school sports. The Committee studied the injury rates in
             schools to determine if they were reasonable and could practicably be
             further reduced and if there were any specific sports or injuries that
             required more attention.

K EY F INDINGS

2.    The Committee’s findings are elaborated in the following paragraphs.

Best Practices in Other Countries

3.    In scanning best practices for safety in youth sports, the Committee focused
      on the United States, United Kingdom and Australia, where sports play an
      important part in the life of their citizens, and regular research and studies on
      sports safety are conducted. These countries also have established initiatives
      and policies on sports safety. Websites consulted included those of
      international multi-sports organizations (e.g. International Olympic Committee
      or IOC), national or states sports councils (e.g. Australian Sports
      Commission), and non-profit athletic associations (e.g. National Collegiate

                                          5
Athletic Association or NCAA of USA). Peer-reviewed journal articles were
      also referred to. (See Annex C for details of the study.)

4.    The Committee notes the following good practices:
      a.     Educating and involving not only those who are directly participating in
             youth sports events (i.e., youth athletes, coaches and sports
             providers), but also relevant parties such as parents, sports officials
             and safety personnel.
      b.     Strong partnerships between key stakeholders to develop safety
             standards and good safety practices for sports providers, coaches and
             other relevant parties.
      c.     For sporting and physical activities with higher inherent risk of injuries,
             significant preventive measures include: modifying rules to be age-
             appropriate and minimize injury; matching competitors by strength and
             skill as well as by age, and ensuring proper use and maintenance of
             protective equipment.
      d.     Regulation and training of coaches to ensure that coaches are qualified
             and competent to train youths to play properly and in a safe way.
      e.     Tracking the type, incidence and severity of injuries in selected sports,
             especially those with high injury rates (e.g. Basketball, Martial Arts and
             Rugby). Based on this data and from existing findings on the aetiology
             of injuries in youth sports (i.e. where, when, and what injuries occur),
             safety measures and rules of the sport can be reviewed and further
             refined.

Benchmarking against International Rules and Best Practices

5.    The Committee undertook a benchmarking exercise of the local competition
      rules issued by the SSSC and SPSSC for six sports involving higher levels of
      contact or collision and cardiovascular and muscular intensity against
      international rules and best practices. These sports were: Basketball,
      Hockey, Judo, Rugby, Soccer and Taekwondo.

6.    The Committee found that in general, the local rules follow the
      recommendations by international organisations with respect to modifications
      for youth participants. These include modifications to the playing area, playing
      duration, and playing regulations. Some examples are:
      a.     For Judo, certain moves are banned and the duration of bouts is
             shortened. Students are also required to attain a certain level of
             proficiency (as sanctioned by the Singapore Judo Federation) before
             they are allowed to take part in competitions.
      b.     For Taekwondo, head kicks are disallowed.
      c.     For Soccer, the rules stipulate modified playfield dimensions.

7.    However, the benchmarking exercise highlighted instances when some
      specific technical aspects could be improved. For example, the SSSC and
      SPSSC rules and regulations largely focus on guidelines on personal

                                          6
protective equipment, and provide fewer guidelines on facilities and general
       equipment. In contrast, the rules of the international federations cover
       detailed specifications of facilities and general equipment in addition to
       personal protective gear.

Feedback from Sporting Community

8.     The Committee consulted members of the sporting community, comprising a
       mix of athletes, coaches and sports officials from across a range of sports3,
       through Focus Group Discussion (FGD) sessions, to gather feedback on
       current safety practices and to obtain suggestions for further improvements.

9.     Overall, the FGD participants were generally of the view that safety standards
       and measures relating to sporting and physical activities in schools were
       sufficient and appropriate, and were sometimes even stricter than those
       applicable to the general public. The FGD participants also identified some
       areas where safety measures could be improved, for example, better-fitting
       body floatation devices for water sports. The FGD participants further noted
       that some students might push themselves beyond their limits in training and
       competitions to meet expectations, which could result in higher risk of injuries.
       It was also felt that teachers-in-charge of CCAs could be given better training
       and support, so as to help them better oversee the conduct of their CCAs and
       work in partnership with coaches to ensure the safety of students. The FGD
       participants also suggested that awareness of sports safety among parents,
       students and teachers could be improved.

Current Safety Framework

10.    The Committee studied MOE’s current safety framework in detail, which
       covers the following key aspects:
       a.      Leadership. Within MOE HQ, the MOE School Safety Committee was
               set up in 2006 to provide leadership on school safety and develop
               safety policies and initiatives. Every school also has its own School
               Safety Committee, with the Vice Principal as the Chief Safety Officer.
               The Committees at the school level are responsible for addressing
               school safety concerns; the development of safety practices; planning
               and implementing safety training; and incident management.
       b.      Safety Practices. MOE provides schools with guidelines on school
               safety, including safety measures during PE lessons and CCAs and the
               use and maintenance of sports equipment.
       c.      Safety Education and Training. The MOE School Safety Unit (SSU)
               conducts seminars for schools’ Chief Safety Officers to share best
               practices. Training is also carried out through briefings to school
               personnel, e.g. Chief Safety Officers and Heads of Department (HODs)
               for PE and CCA, on areas such as the MOE Risk Assessment

3
 The FGD participants came from the following sports: Contact Sports (Basketball, Hockey, Rugby
and Soccer); Martial Arts (Judo, Taekwondo and Wushu); Water-based Sports (Canoeing, Diving,
Sailing, Swimming, and Water-polo); and High Intensity Sports (Cross Country and Triathlon).

                                              7
Management System (RAMS). The External Safety Validation of
               schools’ safety practices, carried out by teams comprising HQ officers
               and key school personnel, further serves as a platform to learn about
               good practices. All qualified PE teachers are also trained in first aid.

11.    The Committee is of the view that the current safety framework is largely
       sound, and the guidelines also address a wide range of aspects for schools to
       take note of when conducting sporting and physical-related activities. To
       further improve on the current safety framework, the Committee also notes:
       a.      There is scope to further emphasise safety awareness amongst
               stakeholders (school leaders, teachers-in-charge of CCAs, PE
               teachers, coaches, sports officials, parents and students), as well as to
               enhance safety training and education, in particular, for teachers-in-
               charge of CCAs and coaches.
       b.      There is some variation in implementation of the guidelines by schools.
       c.      The levels of proficiency in technical and pedagogical skills amongst
               some of our school coaches can be further enhanced.

Governance of School Sports Competitions

12.    The Committee’s assessment is that the overall governance structure for
       school sports competitions is sound, with the appropriate checks and
       balances already in place to ensure that governance and safety issues are
       well looked after. The following summarises the Committee’s assessment of
       the key aspects of the governance structure:
       a.      Proper oversight from MOE. The Chairmen of the SSSC and SPSSC
               are appointed by MOE, and MOE CCA Branch (CCAB) officers are
               present at the various Council levels. All members of the SSSC and
               SPSSC are Principals in our school system, and are ultimately
               accountable to MOE.
       b.      Annual review of competition framework and regulations. Each year,
               the framework and regulations for school sports competitions are
               reviewed by each Convenor4 based on technical advice from CCAB,
               and the recommendations are tabled to the SSSC and SPSSC.
       c.      Professional expertise. All the Convenors and schools receive support
               from CCAB and National Sports Associations (NSAs). The NSAs’ main
               contributions come in the form of technical expertise (in particular,
               tailoring adult-level sport regulations to suit the needs of our students)
               and the provision of qualified referees and officials. Together, MOE
               and NSAs work hand-in-hand to provide technical and professional
               support for the organisation and conduct of school sports competitions.
       d.      Affiliation to larger sporting bodies. The SSSC and SPSSC are
               affiliated to the NSAs, which, as the national bodies, are in turn
               affiliated to credible international bodies in the sporting field. This
4
 In the SSSC and SPSSC framework, each sport is assigned a Principal who serves as the Convenor
and is responsible for overseeing the organisation and conduct of inter-school competitions for the
particular sport.

                                                8
allows the SSSC and SPSSC to tap into the larger network of sporting
                and safety best practices.

13.    Moving forward, the Committee recommends that MOE continue to ensure
that there are adequate resources (in terms of school facilities, teachers and MOE
personnel) as we continue to expand school sports and competitions in our
education system.

Injury Rates

14.     Aggregated data on sports injuries provide an important perspective in
        analysing and reviewing sports safety practices, by providing information on
        aspects such as the nature, incidence rates and severity of injuries. The
        Committee conducted a survey to determine injury rates in schools arising
        from sporting and physical activities.

15.     85 schools (representing approximately 25% of the total number of 355
        mainstream schools) participated in providing data on injuries relating to
        sporting and physical activities, for 2008 and 2009. The 85 schools were
        randomly selected to provide a good representation across different
        educational levels (primary, secondary, JC/CI), clusters, and zones.

16.     Overall, the survey data showed that:
        a.      The annual rate of serious injuries sustained during participation in
                sporting and physical activities was 1.6 per 1,000 students per annum.
                Serious injuries referred to injuries where significant medical treatment
                was required, such as fractures, dislocations, and lacerations which
                required stitching.
        b.      90% of the serious injuries sustained were fractures or dislocations. Of
                the serious injuries, 44% were sustained during participation in contact
                sports5, 30% during general exercise, and 15% in individual sports.

17.     A rough comparison with publicly available data from other countries suggests
        that our injury rates are relatively low. For example, US data indicates injury
        rates of between 2.4 to 10 injuries per 1,000 students (no age provided), while
        Australian data indicates 12.3 “significant injuries”6 per 1000 children aged
        between 0 to 14 years. However, the Committee noted that there are
        difficulties in directly benchmarking the Singapore data against those of other
        countries, due to differences in surveyed groups and lack of detailed data
        definitions (e.g. participating population, definition of injuries). A compilation
        of the injury rates in other countries is included in Annex D.

18.     In addition, as part of its study, the Committee also took into consideration the
        findings of the Committees of Inquiry (COIs) that were set up to look into two
        serious sports incidents in Rugby and Judo, which had taken place in Mar and

5
 Of injuries sustained during contact sports, 75% were contributed by soccer, basketball and rugby.
6
 In the study, a ‘serious’ injury was defined as a reported injury that required treatment, interfered
with performance of the activities of daily living, and/or had adverse effects on participation or
performance in subsequent activity.

                                                  9
Apr 2010 respectively. The findings from the COI for the Judo incident
      revealed that there were ample safety measures put in place for the Judo
      match and the rules and regulations for the Judo competition were also more
      stringent as compared to most international youth championships. There was
      no evidence of any illegal moves made by the players. In the case of the
      Rugby incident, the COI concluded that the organisation and safety provisions
      for the match were consistent with matches played at the National Inter-
      School Rugby Championships 2010 Police Cup Under-17. The COI also
      noted that the referee had carried out his duties in accordance with the
      applicable protocols, and was in control of the match.

S UMMARY   OF   F INDINGS

19.   The Committee has studied international best practices and sporting rules,
      consulted members from the sporting community, and reviewed MOE’s
      internal safety frameworks and injury rates over the course of its study. The
      Committee’s assessment is that MOE’s safety framework is largely sound,
      and is generally in line with international best practices. For example, as
      highlighted in the benchmarking exercise, the local rules had followed the
      recommendations by international organisations with respect to modifications
      for youth participants. There is also proper leadership and designation of
      roles and accountability in the safety framework for schools and governance
      for sports competitions. Overall, the sports injury rates in schools are
      relatively low, and indicate that our safety framework is generally working well.

20.   In the pursuit of excellence, the Committee nevertheless sought to identify
      additional measures to further level up safety across our schools. The
      Committee’s detailed recommendations on these areas are outlined in the
      following chapter.

                                        .....

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RECOMMENDATIONS TO ENHANCE SAFETY IN SCHOOL SPORTS

1.    Based on the key findings described in the preceding paragraphs, the
      Committee has made its recommendations for continuous improvement,
      which are broadly categorised into three key areas:
      a.     Safety Education and Training.
      b.     Preventive Measures.
      c.     Monitoring, Intervention and Follow-up Measures.

I) S AFETY E DUCATION   AND   T RAINING

Continuously Improving Safety Culture, Education and Training in Schools

2.    All stakeholders – schools, teachers, coaches, sports officials, parents and
      students – have a role to play in safety. Given its importance, safety must be
      maintained as a priority and as a part of all stakeholders’ mindsets. The
      Committee recommends that MOE promote greater awareness amongst the
      various stakeholder groups of their responsibilities in ensuring safe practices,
      and augment the safety training and education of school leaders and
      teachers. Some ways this can be done include:
      a.     Providing teachers-in-charge of CCAs with more training and support
             to enable them to play a stronger role in ensuring school sports safety
             and enabling students to better realise the rich learning outcomes from
             involvement in CCAs. The Committee recommends strengthening
             CCA teacher deployment and handover guidelines (between CCA
             teachers) for schools. For example, schools should as far as possible
             take into account teachers’ backgrounds, interests and qualifications
             when deploying them to CCAs.
             For in-service teachers who are already deployed by their schools to
             oversee certain CCAs, the Committee recommends that their training
             be enhanced through regular briefings on safety rules and the use of
             safety checklists specific to these CCAs.
             As teachers-in-charge are often the first responder to incidents
             involving students, the Committee also recommends that teachers-in-
             charge of sports CCAs maintain current first-aid certifications.
      b.     Enhancing the recruitment and training of new PE teachers, as well as
             the deployment of qualified PE teachers. As qualified PE teachers
             would have the necessary background and interests to conduct PE and
             sports CCAs for students and would also have undergone training in
             first aid, the Committee recommends that MOE ensure that there are
             sufficient numbers of qualified PE teachers deployed in schools even
             as MOE increases PE curriculum time in Primary and Secondary
             levels. The Committee notes that the recent establishment of the
             Physical Education and Sports Teacher Academy (PESTA) will further
             support the in-service training and professional development of
             qualified PE teachers to strengthen the delivery of PE and sports CCAs
             in schools.

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c.    Better engagement with parents. Parents play important collaborative
            and supportive roles in helping to promote and encourage school
            sports safety. In this regard, the Committee recommends that schools
            can better engage parents through ways such as school briefings, and
            providing accessible information on safety practices. Parents may also
            be able to provide help and support to schools, teachers or coaches in
            increasing sports safety awareness and in the implementation of safety
            practices.
      d.    Heighten schools’ and students’ awareness of safety issues. The
            Committee recommends that MOE heighten schools’ awareness of
            safety issues, by continuing to reinforce safety messages at a senior
            level and to key personnel in schools.
            Currently, prior to the start of any physical activities, students are
            asked to alert their teachers and coaches if they feel unwell or have
            recently recovered from illness. Some students may, however, not
            understand the potential implications of taking part in physical activities
            when unwell, and choose not to highlight their conditions for various
            reasons. Given these observations, the Committee recommends
            reinforcing the awareness of safety among students, through parents,
            PE teachers and teachers-in-charge of CCAs.
      e.    Instilling a healthy sporting culture that encourages fair play and
            playing within the rules amongst all stakeholders (schools, teachers,
            coaches, parents, students, sporting associations), in cognisance that
            an overly competitive mindset can be detrimental to sports safety.

3.    Annex E summarises the roles that the Committee recommends various
      stakeholders can play to enhance sports safety in schools.

II) P REVENTIVE M EASURES

Boosting Safety Standards

4.    The Committee’s findings revealed that MOE’s safety framework is largely
      sound, and schools generally adopt MOE’s safety guidelines in the conduct of
      sporting activities. There are also benefits to be gained from minimising
      variations in implementation across the school system, while increasing the
      pervasiveness of safety guidelines. As such, the Committee recommends
      that MOE should expand on its existing guidelines to cover areas, where
      applicable, such as equipment and protective gear, facilities and environment,
      first aid, medical support and pre-participation screening and consent, and
      ensure that there is more even and pervasive implementation of these
      guidelines across all schools.

5.    Implementation-wise, MOE would need to continue to carry out the necessary
      checks for adherence to the safety framework, through a centralised unit in
      MOE HQ, with cognisance that the unit will need to be staffed adequately to
      perform this role. This unit could also take on the role of promoting a safety
      culture, training, and the sharing of best practices across schools.

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Enhanced Safety Standards for Specific Sports

6.       Beyond the general safety guidelines applicable to all sports, additional safety
         measures would probably be beneficial for specific sports. In general, the
         risks of injury would depend mainly on three key factors:
         a.       Risk of contact or collision;
         b.       Cardiovascular and muscular intensity of the activity; and
         c.       Specific environment, facility or equipment factors.

7.     The Committee recommends taking a risk management approach to adopt
additional safety measures for different sports. Table 1 reflects the nature of some
sporting activities involving moderate and above levels of contact/ collision and/or
intensity, as well as those involving specific environment/ facility/ equipment factors.

     Table 1: Examples of Sporting Activities Involving Moderate and Above Levels of
              Contact/Collision; Intensity; Environment / Facility / Equipment

      Contact or Collision               Intensity           Environment / Facility /
                                                                   Equipment
              Basketball              Cross Country                 Archery
                Hockey                  Triathlon                    Sailing
                 Judo                                               Shooting
                Rugby
                Soccer
              Taekwondo

7.       In formulating additional safety measures and classification guidelines for
         existing and new sports CCAs, MOE should consult practices established by
         international sporting federations, best practices in other countries, the
         Singapore National Sports Associations (NSAs), as well as local experience
         and injury data.

8.       Based on the Committee’s findings in benchmarking the local competition
         rules issued by SSSC and SPSSC for the six sports highlighted in Chapter 2
         (namely, Basketball, Hockey, Judo, Rugby, Soccer and Taekwondo), the
         Committee recommends that:
         a.       The level of detail in documentation be increased for the SSSC and
                  SPSSC rules and regulations. The current rules and regulations do not
                  spell out every game-specific rule, although they specify that the rules
                  from the governing bodies of each sport are to be used in conjunction
                  with them. The Committee recommends that, as far as possible, the
                  documentation of the SSSC and SPSSC rules and regulations be self-
                  contained one-stop reference documents for coaches and teachers-in-
                  charge of CCAs, eliminating or minimizing cross-references to other
                  documents.
         b.       The consequence of violations be more particularly spelt out in the
                  SSSC and SPSSC rules and regulations. The consequences of
                  violating sporting rules and regulations are generally taken from the

                                                  13
penalty norms of the respective International Federations. These
             penalty norms could be further refined, especially for the purposes of
             adapting them for school sports competitions.
      c.     MOE carry out further benchmarking exercises for other sports CCAs.
      d.     MOE institute a more robust approval process for new CCAs and
             student activities. Currently, schools do their best to accommodate a
             wide range of student interests. A more robust and systemic approval
             process for offering new CCAs and student activities would be a useful
             upstream measure to instil greater awareness among schools of the
             need to take into account issues such as the requirement for adequate
             expertise / training of their teachers, resources, and ability to sustain
             the CCAs.

Uplifting the Capacity of School Coaches

9.    Sports coaches hired by schools play an integral part in the school sporting
      landscape. As they spend a substantial amount of time with students during
      actual training and gameplay, they can help minimise the chances of injury by
      instilling a strong sense of safety consciousness in students, enforcing safety
      regulations, and taking timely corrective measures when they spot early
      warning signs of injury. By providing proper training and guidance to our
      students, coaches help our students build important soft skills, values and
      enhance their mental and physical well-being, through participation in sports.

10.   Given the important role that coaches play in school sports, the Committee
      recommends that MOE work closely with coaches to enhance coaches’ level
      of safety awareness and ownership of safety issues during the conduct of
      sports training and competitions. The Committee recommends the following:
      a.     Emphasise the importance of safety during sports trainings and
             competitions. MOE should make explicit in contracts with school
             coaches that they are responsible for the safety and welfare of the
             pupils under their charge during training and competitions, and that
             safety is paramount. Together with the teachers-in-charge of CCAs,
             coaches should make the necessary risk assessments and put in place
             appropriate safety measures prior to the conduct of sports activities.
      b.     Encourage coaches to upgrade through technical skills qualifications,
             for instance, the National Coaching Accreditation Programme (NCAP)
             qualifications administered by the Singapore Sports Council and NSAs,
             which would allow them to conduct sports activities with greater
             confidence and proficiency. MOE will conduct courses for coaches on
             safety. MOE will also conduct courses to familiarise coaches on the
             desired outcomes of sporting activities in schools, such as the
             inculcation of sporting values.
      c.     Enhance sharing of information on school coaches across schools,
             such as by creating a central register of CCA coaches and instructors
             in MOE. This will allow schools to more effectively identify suitable
             coaches for their needs.

                                           14
11.     With these recommendations, MOE’s aim is for school personnel, such as our
teachers-in-charge of CCAs, and our coaches to work together more confidently and
effectively to ensure that our students will be able to safely benefit from participation
in school sports.

III) M ONITORING , I NTERVENTION    AND   F OLLOW - UP M EASURES

Enhanced Framework of Tiered Insurance Coverage

12.    The Committee recognises that despite best efforts in enhancing safety
       measures, it is not possible to prevent accidents or injuries. Currently,
       schools purchase insurance for their students, with coverage including
       medical expenses and hospital allowance benefits. The specific amount
       varies from school to school, depending on the plan chosen. We have noted
       that some insurance plans purchased are personal accident plans, for which
       claimable medical expenses could be a few thousand dollars. There may also
       be a weekly hospital (ward) allowance included in the plan, up to a cap. These
       are comprehensive insurance plans under which all student incidents during
       participation in activities in schools, including PE and sports CCAs, are
       covered.

13.    While the basic level of insurance coverage is generally adequate for the daily
       activities of the majority of students, this may not be the case in the event of
       very serious accidents involving intensive medical treatment and/or prolonged
       hospitalisation. In such instances, the costs of medical treatment would pose
       a significant burden to the families involved.

14.    As the probability of very serious accidents leading to prolonged
       hospitalisation and medical treatment is very low, insurance is an effective
       means of pooling risks to cushion the financial impact of medical treatment.
       The Committee thus recommends a tiered framework of school insurance,
       comprising a basic comprehensive insurance coverage for all students, with
       enhanced payouts to cover the risks of accidents or injuries. MOE could
       examine if centralised purchase of insurance plans for students will allow for
       significant economies of scale to be reaped.

Improved Injury Data Collection System

15.    To facilitate regular review and improvements in safety, it is important to have
       a robust and comprehensive system to collect data on injuries and when and
       how they occurred.

16.    The Committee recommends that MOE require schools to carry out incident
       reporting, and establish a repository of specific types of injury data. The
       repository could include data on the nature/type/severity of injury and type of
       activity that led to the injury. In developing this repository, a balance would
       have to be struck between comprehensiveness and level of detail of data,
       versus convenient data reporting / entry and timeliness of reporting by
       schools.

                                           15
17.   The Committee further recommends that MOE put in place a structured
      process to periodically analyse the data, with a view to determining the
      effectiveness of existing sports safety measures, proposing refinements
      suggested by the data analysis, and track the follow-up actions taken.

C ONSULTATION   WITH   S CHOOLS   ON   R ECOMMENDATIONS

18.   The Committee consulted school principals, Heads of Department, and
      teachers-in-charge of CCAs for their views on the recommendations through
      FGD sessions. The participants were supportive of the key recommendations
      of the Committee, especially the recommendations to uplift the capacity of
      school sports coaches, and for better training and support to be given to
      teachers-in-charge of CCAs. In particular, teachers expressed strong support
      for the recommendations to strengthen CCA teacher deployment and
      handover guidelines for schools; provide teachers-in-charge of CCAs with
      more training on safety through means such as safety briefings and safety
      frameworks; and require teachers-in-charge of sports CCAs to maintain
      current first-aid certifications.

                                        .....

                                         16
CONCLUSION

1.   The Committee recommends that MOE set up an implementation committee,
     comprising professionals with the expertise in the various areas, to work out
     and coordinate the details and implementation of the various
     recommendations.

2.   The Committee also recommends that the implementation committee aim to
     put in place the majority of the recommendations by end 2011. These include
     the expanded safety guidelines, providing teachers-in-charge of specific
     sports CCAs with better safety training and support, for example through the
     development of safety frameworks for each of these sports CCAs. Some
     recommendations such as the additional safety-related training courses for
     school coaches may however require more time to be developed and rolled
     out.

3.   In conclusion, the Committee notes that PE and sports play an important role
     in our schools, by contributing towards developing students’ psychomotor
     skills, health and fitness, as well as a lifelong orientation towards managing
     one’s health and well-being. They also enhance the development of 21st
     century competencies in our students, by providing opportunities for them to
     develop life skills such as teamwork, resilience, and discipline.

4.   While MOE’s current safety framework and practices are already sound and
     are generally in line with international best practice, the objective of this report
     is nevertheless to seek out areas for improvement. The implementation of
     these recommendations would require additional effort, resources and
     commitment on the part of MOE, schools and other stakeholders, including
     the National Sports Associations, parents and students. The Committee’s
     view is that these additional measures will help to further ensure that students
     can enjoy and excel in PE and sports activities, training and competitions in a
     safe environment.

                                        .....

                                          17
Annex A

  MEMBERS OF THE COMMITTEE ON SAFETY IN SCHOOL SPORTS (CSSS)

Chairman
Dr Mimi Choong May Ling
Deputy Secretary (Services), MOE

Members
BG Ishak Bin Ismail
Commander, 6th Division

Mrs Shirley Lo nee Shirley Hoo Sok Kuan
Chairman of South View Primary Parents’ Association

Oon Jin Teik
Chief Executive Officer, Singapore Sports Council

Dr Quek Jin Jong
Principal Officer, Office of Director, National Institute of Education

Richard Seow
Chairman, Singapore Sports Council

Dr Ben Tan
Head & Senior Consultant, Changi Sports Medicine Centre

Wong Siew Hoong
Director, Schools, MOE

Ms Sum Chee Wah
Director, Education Programmes, MOE

Chua Kwan Ping
Director, Finance and Development, MOE (up to 11 Oct 2010)

Ms Evelyn Khoo
Director, Finance and Development, MOE (from 12 Oct 2010)

Ms Melanie Martens
Principal, St. Anthony’s Canossian Secondary School and Member of Secondary
Schools Sports Council

                                          A-1
Annex B

             LIST OF SPORTS CCAS AND COMPETITIONS

Sports CCAs offered by schools

 1.  Adventure Club   21. House              40. Shorinji Kempo    58. Volleyball
 2.  Aikido           22. Ice Skating            (Japanese Shao    59. Water Polo
 3.  Archery          23. In-line Skating        Lin)              60. Weightlifting
 4.  Artistic         24. Judo               41. Silat             61. Windsurfing
     Gymnastics       25. Karate             42. Snooker           62. Wrestling
 5. Athletics         26. Lawn Bowls         43. Soccer            63. Wushu
 6. Badminton         27. Modular Sports     44. Softball
 7. Basketball        28. Mountain           45. Squash
 8. Boccia                Trekking           46. Swimming
 9. Boules            29. Netball            47. Synchronized
 10. Canoeing         30. Petanque               Swimming
 11. Cricket          31. Rhythmic           48. Table Tennis
 12. Cross Country        Gymnastics         49. Taekwondo
 13. Diving           32. Rowing             50. Tchoukball
 14. Dragon Boat      33. Rock Climbing      51. Ten-pin Bowling
 15. Equestrian       34. Rope Skipping      52. Tennis
 16. Fencing          35. Rugby              53. Touch Football
 17. Floorball        36. Sailing            54. Touch Rugby
 18. Frisbee          37. Sea Sports         55. Track & Field
 19. Golf             38. Sepak Takraw       56. Trampoline
 20. Hockey           39. Shooting           57. Triathlon

                                       B-2
Sports CCAs with inter-school competitions

      Competitions for Secondary         Competitions for Primary
      Schools and above                  Schools (Organised by SPSSC)
      (Organised by SSSC)
      1 Badminton                        1    Badminton
      2 Basketball                       2    Basketball
      3 Canoeing                         3    Floorball
      4 Cricket                          4    Golf
      5 Cross Country                    5    Gymnastics
      6 Golf                             6    Hockey
      7 Gynmastics                       7    Netball
      8 Hockey                           8    Rope Skipping
      9 Judo                             9    Rugby
      10 Netball                         10   Sailing
      11 Rugby                           11   Sepak Takraw
      12 Sailing                         12   Soccer
      13 Sepak Takraw                    13   Softball
      14 Shooting                        14   Swimming
      15 Soccer                          15   Table Tennis
      16 Softball                        16   Taekwondo
      17 Squash                          17   Tennis
      18 Swimming                        18   Tenpin Bowling
      19 Table Tennis                    19   Track and Field
      20 Tennis                          20   Volleyball
      21 Tenpin Bowling                  21   Wushu
      22 Track & Field
      23 Volleyball
      24 Waterpolo
      25 Wushu
      26 Floorball
      27 Taekwondo

                                      B-3
Annex C

       BEST PRACTICES FOR SAFETY IN YOUTH SPORTS IN OTHER
                           COUNTRIES

BACKGROUND AND METHODOLOGY

1.     In carrying out the scan of best practices for safety in youth sports, the
Committee focused on the U.S, United Kingdom and Australia, where sports play an
important part in the life of their citizens, and regular research and studies on sports
safety are conducted. These countries also have established initiatives and policies
on sports safety. Websites consulted included those of international multi-sports
organizations (e.g., International Olympic Committee or IOC), national or states
sports councils (e.g., Australian Sports Commission), and non-profit athletic
associations (e.g., National Collegiate Athletic Association or NCAA of USA). Peer-
reviewed journal articles were also identified7.

W HAT      ARE THE     F ACTORS     THAT CAN       A FFECT S AFETY      IN   Y OUTH S PORTS ?

2.    Several factors that affect safety in youth sports, for which safety procedures
should be put in place, were identified (Australian Sports Commission, 2005; Reeser,
Verhagen, Briner, et al., 2006; Sport and Recreation Victoria, 2008; Sports Medicine
Australia, 2008; NCAA, 2009a). Please see Table 1:

                      Table 1: Factors Affecting Safety in Youth Sports
   Athlete Factors              Coach Factors               Sports Factors         Environment Factors
 Pre-existing medical        Qualifications            Nature of the sport      State of the facilities
  conditions                  Competency                Nature of the risks       / equipment
 Current health              Planning /                 involved in the sport    Weather conditions
  status                       management of             Adherence to the
 Infectious Diseases          activity sessions          rules

3.      Athlete Factors. These factors include the current health status of the
participants (e.g., level of physical fitness), their known medical conditions (e.g.,
asthma, epilepsy, etc) and the presence of infectious diseases. Coaches and
officials should be aware of these when making decisions about athletes during
training and competitions.

4.      Coach Factors. These factors include the qualifications of the coach in the
specific sport, as well as his/her competency in effectively training athletes (e.g.,
teaching proper techniques in the game, conveying the right attitudes and values,
etc). The coach’s planning and management of activity sessions (e.g., ensuring
proper warm-up and cool-down, managing the amount and intensity of the activities,
sufficient preparation before competition, etc) also affect safety in youth sports.

5.     Sports Factors. These factors include the nature of the sport and the nature
of the risks involved in the sport. Participation in different sports presents different

7
    Information about Asian-oriented sports (e.g., martial arts) was limited.

                                                    C-1
levels of risk8 and different types of risks (e.g., different types of injuries to different
parts of the body). In addition, steps taken to ensure adherence to the rules before,
during and after the sport also affect safety in youth sports, particularly for those
involving contact sport and competition.

6.     Environment Factors. These factors include the state of the facilities and
equipment used in the sport (i.e., these should meet standard requirements for
safety in the sport), as well as weather conditions that can impact participants’
physical well-being (e.g., extreme heat or cold, lightning, rain, etc).

W HAT P RACTICES             CAN BE       I MPLEMENTED           TO   E NHANCE S AFETY              IN   Y OUTH
S PORTS ?

7.     Based on the factors described above, best practices implemented in other
countries to help promote and enhance safety in youth sports were identified,
categorized into (i) Education and Public Awareness; (ii) Prevention and (iii)
Intervention.

(I)      Education and Public Awareness

8.     This includes programmes, campaigns and materials to educate the public
and youths so as to raise their awareness of good safety practices in youth sports. In
particular, those who are more directly involved in youth sports (e.g., athletes,
coaches / teachers, sports providers, parents, etc) should be aware of their roles and
responsibilities in promoting safety.

9.    For example, under the National Safe Kids Campaign, the National Athletic
Trainers’ Association (NATA) provides guidelines and checklists for parents and
coaches on what to consider before a child participates in organized sports (physical
examination; ascertaining coaches’ qualifications; reducing the risk of heat illnesses,
dehydration or injury; emergency plans in the event of an injury, etc) (NATA, 2003;
2010). Likewise, the NCAA RESPECT Campaign was embarked on by the NCAA
Committee on Sportsmanship and Ethical Conduct in U.S.A. to raise awareness and
commitment to sportsmanship among members of the association. In line with this,
the RESPECT campaign brochure was produced to provide information for campus
leaders and advisory groups on communication and educational plans in order to
promote sportsmanship in student athletes, student athletes’ family members,
coaches, opponent teams and venue staff (NCAA, 2009b).

(II)     Prevention

10.    Some of the sources reviewed estimated that 50% or more of sport injuries
are preventable (USA’s Centers for Disease Control or CDC, n.d.; Sports Medicine
Australia, 2008). Some preventive measures to promote sports safety before, during
and after games are listed below and summarized in Table 2 (Accident
Compensation Corporation, 2002; Sports Medicine Australia, 2008):

8
  For instance, football was found to cause 1,024,022 injuries, soccer led to 368,726 injuries, gymnastics resulted
in 67,542 injuries among U.S. youths under the age of 18 (University of Michigan Health System, 2009).

                                                      C-2
Table 2: Preventive Measures to Promote Sport Safety
         Before game                            During game                            After game
 Screening for pre-existing            Abiding by rules (Note: this          Proper injury management
  medical conditions and for             may include the need to                procedures
  record-keeping                         review and modify rules to
 Proper warm-up, cool-down              make the sport safer and
  procedures, learning right             more appropriate for younger
  techniques in sport and                athletes)
  avoiding overexertion                 Match competitors by size,
 Conducive environmental                gender, strength, skill or
  conditions and well-                   experience instead of age
  functioning equipment                 Use of protective equipment
                                         that meet safety standards

Before the game
        Screening. Screening aims to identify athletes who have pre-existing medical
         conditions that pose as risk factors in sport participation; identify factors that
         may predispose athletes to an increased risk of injury; obtain baseline
         physical data; assess efficacy of a rehabilitation programme on previous
         injuries; and assess lifestyle factors that may affect injury risk or performance.
         Screening can be done through questionnaires or medical testing.
        Physical training and practice. Proper warming up and stretching procedures
         should be done to reduce the risk of injury during training and/or competition.
         In addition, physical conditioning is required to prepare the body for the
         demands of the game, and includes training in the areas of strength, flexibility,
         endurance, balance, speed, and power. Athletes should also be taught the
         right techniques as incorrect techniques increase risk of injuries. Coaches
         should also guard the athletes against overexertion.
        Environment. This involves assessing environmental conditions to determine
         suitability for the sport (e.g. not playing during a storm when there is a
         possibility of being struck by lightning). Playing fields and facilities should also
         be regularly checked to ensure they are safe to use (e.g., not littered with
         dangerous materials such as broken glass). A comprehensive checklist
         should be developed to note what needs to be done.

During the game
        Rules and Fair Play. Following the rules of the sport helps protect oneself
         and others from injury. Rules may also be changed or enforced to avoid a
         situation where injury often occurs (e.g., by making certain actions illegal9 or
         making the use of protective equipment compulsory). In sports involving
         children, rules may be modified depending on the needs and abilities of the
         young athletes (e.g., using smaller/lighter equipment, reducing size of playing
         area, reducing match time to adapt to different levels of physical ability).

9
 For example, a research study found that modifying rules in a taekwondo competition such that contact to the
head, face, neck, or groin was prohibited, with the exception of the headgear, led to a reduced injury rate (Burke,
Barfoot, Bryant, et al., 2003)

                                                      C-3
   Matched Competitors. Competitions should be balanced (i.e., competitors
         should be ideally matched by size, gender, strength, skill, or experience
         instead of just by age group).
        Protective Equipment. This refers to the proper use and maintenance of
         equipment. Examples of protective equipment include: mouthguard, helmet,
         protective padding (e.g., shin guards), eyewear, and footwear. In addition,
         regulatory bodies should oversee and enforce standards for protective
         equipment. For instance, in U.S.A., sports equipment that meet a certain
         safety standard will be endorsed by the National Operating Committee on
         Standards for Athletic Equipment (NOCSAE) (NCAA, 2009a).

After the game
        Injury Management. An injured athlete should be assessed and managed by
         qualified personnel (e.g., a sports first-aider or sports trainer). Good injury
         management minimizes the consequences of the injury and pain / discomfort
         to the individual. An example of a first aid management approach is the
         RICED (apply Rest, Ice, Compression, Elevation, & Diagnosis).

(III)    Intervention

11.     In the event that injuries occur, it is important that the relevant parties are
aware of the procedures to follow in order to minimize the damage done. The NCAA
Sports Medicine Handbook (2009a) provides guidelines on emergency plans for
practice sessions and competitive events. These include the presence of a qualified
and dedicated person who is able to provide emergency care, access or planned
access to a physician, access to working emergency equipment, planned access to
a medical facility, access to a telecommunication device for communication and
transportation, availability of emergency information about the student athlete, as
well as certification of athletics personnel in cardiopulmonary resuscitation
techniques (CPR), first aid, and prevention of disease transmission. Likewise, the
Australian Sports Commission Junior Sport Guidelines (2005) also emphasizes on
the need for emergency planning.           Sport providers should be familiar with
emergency procedures and possess current first aid qualifications. Medical advice
should be sought when the health and recovery from illness/injury of a student
athlete is uncertain; and when the student athlete is injured while training or during a
competition. The Guidelines recommend the prohibition of the young persons to
participate if medical advice is unavailable.

12.    In addition, a sports injury surveillance system is required to collect
information on the incidence, nature, and severity of injury in a sport, monitor
longitudinal trends in injury, determine the risk and causal factors behind the injury,
and assist in evaluating policy regarding injury prevention by planning preventive
measures to reduce the incidence of injury. For example, the NCAA has a system
which contains data on injury trends in U.S. intercollegiate athletics. Data on injury
and exposure are collected on a yearly basis from a representative sample of NCAA
member institutions. This data is then reviewed by NCAA Sport Rules Committee
and the NCAA Committee on Competitive Safeguards and Medical Aspects of
Sports, to guide them in making appropriate recommendations for safety measures.
One example is the NCAA’s Competitive Safeguards Committee’s recommendation

                                          C-4
of having a championship sports-wide playing rule prohibiting student athletes who
display signs of concussion from returning to play until they are cleared by a
physician or designated health-care professional. Similarly, based on data on areas
where injuries are most likely to occur, the rules of certain sports (e.g., volleyball,
American football, taekwondo) have been modified to prevent / reduce injuries.

L EARNING P OINTS    FOR   S INGAPORE S CHOOLS

13.    The above scan of best practices for safety in youth sports in other countries
has highlighted the following learning points for Singapore schools, based on the
three tier framework of Education and Public Awareness; Prevention; and
Intervention:

      Education and Public Awareness
      (a) It is important to educate and involve not only those who are directly
          affected (i.e., youth athletes, coaches, sports providers), but also relevant
          parties such as parents, sports officials and safety personnel.

      Prevention
      (b) There should be strong partnerships among the key stakeholders (e.g.,
          MOE, Singapore Sports Council (SSC) and the National Sports
          Associations (NSAs)), to develop safety standards and good practices for
          sports providers, coaches and other related parties.

      (c) For high-risk sports, important preventive measures that should always
          be in place include: ensuring that rules are appropriately modified to
          minimize injury and appropriate for youth sports; ensuring matched
          competitors (based on criteria such as strength and skill instead of purely
          by chronological age group); and ensuring proper use and maintenance
          of protective equipment.

      (d) A system to ensure the regulation and training of coaches should be
          established, to ensure that coaches are qualified and competent to
          ensure the youths are trained to play properly and in a safe way.

      Intervention

      (e) It is important to have an injury surveillance system, to track the
          incidence and severity of injuries in selected sports, especially those with
          high injury rates (e.g., rugby, football, martial arts, basketball). Based on
          such data and from existing findings on etiology of injuries in youth sports
          (i.e., how, where, when, what injuries occur), safety measures and rules
          of the sport could be reviewed and further refined.

                                        C-5
REFERENCES

Accident Compensation Corporation (ACC). (2002). ACC Sportsmart: Educational
   Resource. Retrieved, 30 April, 2010, from http://www.acc.co.nz/preventing-
   injuries/playing-sport/sportsmart-10-point-plan/index.htm.

Australian Sports Commission. (2005). Making sport safe. Junior sports guidelines.
   Retrieved, 30 April, 2010, from
   http://www.ausport.gov.au/participating/schools_and_juniors/juniors/resources/ju
   nior_sport_framework.

Burke, D., K., Barfoot, Bryant, S., Schneider, J., Kim, H., H., & Levin, G. (2010).
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Centers for Disease Control (CDC). (n.d.) Protect the ones you love: Sports injuries.
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Dick, R., Agel, J. & Marshall, S. W. (2007). National Collegiate Athletic Association
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International Olympic Committee (IOC). (2009). Olympic Movement Medical Code.
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    g.pdf.

Junge, A., Engebretsen, L., Alonso, J. M., Renstrom, P., Mountjoy, M. L., Aubry, M.
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McInulty, K. (2006). Creating a safe environment for children in sport. UK:
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Micheli, L., Glassman, R., & Klein, M. (2000). The prevention of sports injuries in
   children. Clinics in Sports Medicine, 19(4), 821-834.

National Athletic Trainers’ Association (NATA). (2003). Parents’ and coaches’ guide
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National Athletic Trainers’ Association (NATA). (2010). Sports safety checklist to
    help prevent common athletic injuries. Retrieved May 3, 2010 from
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National Collegiate Athletic Association (NCAA). (2009a). 2009-10 NCCA Sports
    Medicine Handbook. Retrieved May 3, 2010 from

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