The Committee on Sports Medicine and Fitness of the American Academy of Pediatrics (AAP) has issued a position statement on medical conditions that affect sports participation in children and adolescents. This statement, which replaces a previous AAP statement published in 1994, provides additions and changes to increase the accuracy and completeness of the information. The statement appears in the May 2001 issue of Pediatrics.

According to the AAP committee, children and adolescents with medical conditions present special issues in athletic participation. The physician should help to determine whether a child with a health condition should participate in certain sports by assessing the child's health status, suggesting appropriate equipment or modifications of sports to decrease the risk of injury, and educating the athlete and his or her parents on the risks of injury as they relate to the child's condition.

Recommendations for sports participation by children with specific medical conditions are outlined in the accompanying table. The medical conditions have been assessed to determine if participation would create an increased risk of injury or adversely affect the medical condition. Because decisions about sports participation are often complex, the AAP committee states that the usefulness of the table is limited by the frequency with which it recommends individual assessment when a “qualified yes” or “qualified no” appears.

The AAP committee stresses that a physician's clinical judgment is essential for applying these recommendations to individual patients. When making decisions about athletic participation, physicians should consider factors such as published information on the risks of participation, the current health of the athlete, the availability and efficacy of treatment, whether the sport can be modified for safety, and the ability of the athlete and parents to understand and accept the risks involved with participation.

When an athlete's family disregards medical advice against participation, the AAP committee recommends that the physician ask parents, guardians and the athlete to sign a written consent form indicating that they understand the potential dangers of participation.