Sports, recreation, exercise (SRE) adverse childhood experiences (ACEs) are extremely high.

“Traumatic childhood experiences, such as abuse, neglect, witnessing experiences such as crime, parental conflict, mental illness, and substance abuse can create dangerous levels of stress and derail healthy brain development—resulting in long-term effects on learning, behavior and health. A growing network of leaders in research, policy and practice are developing approaches to prevent adverse childhood experiences (ACEs) and mitigate their impact through building resilience.” [Robert Wood Johnson foundation]

The 5 main objectives for the definition of Child Athlete Abuse Syndrome (CAAS) are:
1. Prevent abuse and cruelty to Child and Youth Athletes, who Participate in Sports, Recreation and Exercise (SRE)
2. Promote Athlete Safety 1st
3. Prevent criminal and civil Risks for “Problematic Coaches” who don’t know about the legal relationship they have with Children who participate in SRE
4. Define the circumstances creating or causing CAAS, so that everyone concerned completely understands the legal coach-athlete relationship and repercussions and risks, when the relationship is violated, for everyone’s protection and safety
5. Utilize education, teaching, scholarship, research and advocacy for prevention

Child Athlete Abuse Syndrome (CAAS) is a Short Title for a Clustering of Child (<18) or Youth (15-18) (United Nations definition is 15-24) Athlete Serious Injury, Disease and/or Death (morbidity and mortality) secondary to:
► Physical endangerment, maltreatment and/or abuse
► Psychological (Emotional) endangerment, maltreatment and/or abuse
► Sexual Abuse
► Failed child custodial protection
► Negligent care giving supervision
► Human rights violations
► That were inflicted, caused, created, or allowed to be inflicted, caused, created, directly or indirectly by the Problematic Coach, including the Strength Training, Conditioning and other specialty Coach, Problematic Parent or other Problematic Caretaker Person who has Child and Youth Athlete custodial protection, supervision, care and control during Sports, Recreation and Exercise (SRE) Participation
► Additionally, other offenders, when discovered in the abuse narration, include colleagues and oversight administrators of Coaches who were involved in a Code of Silence and conspiracy to cover-up bad Coaching Behaviors and Child Athlete Endangerment and/or Sexual Abuse.
► Failure of mandated reporters report the morbidity and mortality to Authorities is Illegal. [Child Welfare Information Gateway’s Mandatory Reporters of Child Abuse and Neglect at cfm ]
► In most United States, Children are minors when less than 18 years of age
► Child Athlete Youth Abuse (15-18). The United Nations define Youth as persons between the ages of 15-24

The morbidity, mortality and legality of Child Athlete Abuse Syndrome and Cruelty to Children in SRE are matters of particular importance to Doctors and Health Care Personnel and should be priority and urgency matters of federal and state governments, because 69% girls and 75 % boys in the U.S. participate in organized team Sports [How Many Youth Participate in Sports in the U.S.? By Kay Uzoma, Living Strong Dec 08, 2015]

CAAS summons all doctors and health care personnel into action for the awareness and prevention of these Child Athlete preventable, not-accidental morbidities and mortalities, which are epidemic. Similarly all parents, Coaches, the entire athletic community, athletic program administrators and government officials should be summoned.

Most don’t heed the summons. Coaches, parents, doctors, athletic trainers and other health care personnel have been called-out as the primary culprits for these abnormal behaviors by conscientious, concerned doctors and advocates for prevention.

Everyone, who has knowledge should report all forms of child abuse in every venue, including SRE, to authorities i.e department of community based services (DCBS), child protective services (CPS) and/or the community county attorney and in emergent circumstances law enforcement.

“Approximately 48 States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands designate professions whose members are mandated by law to report child maltreatment. Individuals designated as mandatory reporters typically have frequent contact with children. Such individuals may include: Social workers ƒ Teachers, principals, and other school personnel ƒ Physicians, nurses, and other health-care workers ƒ Counselors, therapists, and other mental health professionals ƒ Child care providers ƒ Medical examiners or coroners ƒ Law enforcement officers. [Children’s Bureau/ACYF/ACF/HHS 800.394.3366,,]

ICD stands for the International Classification of Diseases. ICD-10 replaces ICD-9 and became effective Oct.1, 2015. For the first time, the coach has been included in the ICD-10 diagnostic codes as an offender of Child Abuse, which designates the coach-athlete legal relationship, unequivocally.

• The transition from ICD-9 to ICD-10 is enormous, as it reflects a five-fold increase in diagnosis codes, to roughly 69,000 codes for all conditions.
•IDC-10 codes will contain critical information about epidemiology, health management, and treatment of all conditions.
• Health care professionals use ICD codes to record and identify health conditions.
• Public health workers, legal officials and researchers can use the records and reports of ICD-10 codes to find statistical trends in health, track the causes and outcomes of morbidity (disease) and causes of mortality (death) and statistical and data mining.
• Insurers use ICD codes to classify conditions and determine reimbursement.
• Transitioning to ICD-10 is required by anyone covered by the Health Insurance Portability Accountability Act (HIPAA)—this includes doctors, hospitals and health insurance companies, all of whom rely on these codes for diagnosing patients and billing for services.
• Direct written reports by all Doctors and Health Care Personnel about Child and Adult Athlete Abuse Syndrome, in follow-up to telephone reports to CPS, DCBS, County Attorneys, should include ICD-10 codes for the diagnoses, treatments and perpetrators.
• All Doctors and Health Care Personnel are mandated reporters for all forms of Child abuse and cruelty by federal and state laws.
• The new Coach Perpetrator ICD-10 Code T07.53 makes the legal relationship of the Coach to the Athlete “crystal clear” for all the entities in crisis, who have ignored SRE, abandoned Coaches and everyone involuntarily ignorant, who formerly believed “SRE were nations unto their own, without outside interference by the justice system”[Condoleezza Rice], heretofore addressed, but camouflaged in the category other, by the U.S. Surgeon General 2005. [Surgeon General’s Workshop on Making Prevention of Child Maltreatment a National Priority: Implementing Innovations of a Public Health Approach, Lister Hill Auditorium, National Institutes of Health, Bethesda, Maryland, March 30-31, 2005]
• Legally, the Coach is a “temporary substitute caregiver” to Child Athletes as defined by the ICD-10 codes and has responsibility for the health and welfare of Adult Athletes, who are included in the newly revised abuse codes.

Examples of recorded code utilization by health care personnel:
Diagnosis: Child Sexual Abuse: ICD-10 Diagnostic Code = T74.22XA
Add the Coach modifier: ICD-10 Coach Perpetrator Code = T07.53
Diagnosis: Child physical abuse, confirmed, initial encounter = T74.12XA
Add the Coach modifier: ICD-10 Coach Perpetrator Code = T07.53
Diagnosis: Heat exhaustion, anhydrotic, water deprivation initial encounter = Code T67.3XXA
Add the Coach modifier: ICD-10 Coach Perpetrator Code = T07.53
[2016 ICD-10-CM Diagnosis Code T07]


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