A new study from Boston University’s Chronic Traumatic Encephalopathy Center has found that participation in youth football by athletes under the age of 12 can have deleterious health effects later in life, providing the most direct link to date that playing football at a young age can have a significant impact on an athlete’s life.

As reported by the Boston Globe and other outlets, the new survey found an increased risk among youth football players for the following impairments:

• a doubled risk of behavioral problems, including apathy
• a tripled risk of suffering depression and other psychological problems

Those risks are in addition to more direct damage that can occur with repeated impact from head-to-head collisions that occur during football games, whether or not those impacts lead to concussions.

“Parents have a really hard decision to make, and they can’t say the science is there yet to make an easy decision based on just one study,” Robert Stern, one of the study’s senior authors, told the Globe. “At the same time, there is growing research on the effect of football on the brain, and we can’t ignore it.

“I’m at a point where I feel comfortable saying that, based on logic and common sense and the growing totality of the research, I don’t think kids should be playing tackle football.”

According to the Sports & Fitness Industry Association, 1.23 million children between the ages of 6-12 played tackle football in 2015, the most recent year for which comprehensive data is available.

The new study falls in line with rising public opinion. As noted in the Globe’s story, a recent UMass Lowell Center for Public Opinion study found that 53 percent of adults say they believe playing football before high school can be hazardous to health.

Part of the impetus behind the shift in popular perception may have been a 2016 study from Wake Forest School of Medicine, where magnetic resonance imaging technology boys between the ages of 8 and 13 who played just one season of tackle football had diminished brain function in parts of their brains, as noted by the New York Times.

While the NFL and others long denied a direct link between youth football and future physiological and psychological issues, its recent actions paint a different picture. The league has advocated for a minimum of contact practices along with other safety measures including USA Football’s proposal to adapt a 7-on-7 form of football that incorporates a two-point starting stance and Practice Like the Pros, which has advocated for only flag football to be played until 7th grade.

At least one early CTE researcher expressed some skepticism about the causal links between the age at which football was played and future neurological conditions.

“With the changes that have occurred to reduce or eliminate head contact in practice and to eliminate open-field, direct-head hits, I think that football is safe as long as the players and their parents understand the risk and the pros and cons, the benefits and potential risks of participating,” Dr. Julian Bailes, the current medical director for Pop Warner football, told the Globe.