Child Athlete Abuse Syndrome (CAAS) is a Short Title for a Clustering of Child (<18) or /Youth (15-18) (United Nations definition is UN 15-24) Athlete Serious Injures, Disease and/or Death (morbidity and mortality) that were inflicted, caused, created, or allowed to be inflicted, caused, created, directly or indirectly by a Problematic Coach, when the Coach crossed the line and + pushed and + punished Child/Youth Athletes beyond their physical and/or psychological limits or sexually abused them

When these are the circumstance and Child and Youth Athletes have sustained serious emotional and psychological injuries → they should seek diagnoses and treatments from mental health professionals.
• When these are the circumstances and Child and Youth Athletes have sustained serious physical injuries → they should seek diagnoses and treatments from medical/surgical professionals.
• When these are the circumstances and Child and Youth Athletes have sustained sexual abuse by a Coach Perpetrator → they should seek diagnoses and treatments from medical/surgical professionals.
• Doctors are mandated to report serious physical and emtptopa injuries, perpetrated by the Coach → to the County Attorney for investigation
• a Report is a call for investigation by legal authorities, when substantiated by a diagnosis and perpetrator circumstances

When Child (<18) and Youth (16-24 UN definition) Athletes sustain severe, adverse experiences, maltreatment and/or abuse they should seek professional consultation:
• Child Athletes will confide with their doctor, if he is a good communicator and many doctors are.
• “Trust is key to confidential communication.” [T.J.Minix,R.N. quality health care coordinator]
• “Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of patient-physician relationship.”1
• When their is good communication between children and their doctor children “are more likely to be satisfied with their care, and especially to share pertinent information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment.”1,6,7,9,14,16,18–23
• “Doctor-patient communication is a major component of the process of health care.”46
• “Doctors are in a unique position of respect and power. Hippocrates suggested that doctors may influence patients’ health.19 Effective doctor-patient communication can be a source of motivation, incentive, reassurance, and support.19,47

A good doctor-patient relationship can increase job satisfaction and reinforce patients’ self-confidence, motivation, and positive view of their health status, which may influence their health outcomes.”19,47

1. Hall J. A., Roter D. L., Rand C. S. Communication of affect between patient and physician. J Health Soc Behav. 1981;22((1)):18–30. [PubMed]
2. Duffy F. D., Gordon G. H., Whelan G., et al. Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Acad Med.2004;79((6)):495–507. [PubMed]
3. van Zanten M., Boulet J. R., McKinley D. W., DeChamplain A., Jobe A. C. Assessing the communication and interpersonal skills of graduates of international medical schools as part of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS) Exam. Acad Med. 2007;82((10 Suppl)):S65–S68. [PubMed]
4. Brédart A., Bouleuc C., Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17((14)):351–354.[PubMed]
5. Brinkman W. B., Geraghty S. R., Lanphear B. P., et al. Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial. Arch Pediatr Adolesc. 2007;161((1)):44–49.[PubMed]
6. Henrdon J., Pollick K. Continuing concerns, new challenges, and next steps in physician-patient communication. J Bone Joint Surg Am. 2002;84-A((2)):309–315. [PubMed]
7. Arora N. Interacting with cancer patients: the significance of physicians’ communication behavior. Soc Sci Med. 2003;57((5)):791–806. [PubMed]
8. Stewart M. A. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152((9)):1423–1433. [PMC free article][PubMed]
9. Tongue J. R., Epps H. R., Forese L. L. Communication skills for patient-centered care: research-based, easily learned techniques for medical interviews that benefit orthopaedic surgeons and their patients. J Bone Joint Surg Am. 2005;87:652–658.
10. Stewart M., Brown J. B., Donner A., et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49((9)):796–804. [PubMed]
11. Lee S. J., Back A. L., Block S. D., Stewart S. K. Enhancing physician-patient communication. Hematology Am Soc Hematol Educ Program.2002;1:464–483. [PubMed]
12. Baile W. F., Buckman R., Lenzi R., Glober G., Beale E. A., Kudelka A. P. SPIKES—a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5((4)):302–311. [PubMed]
13. Sawyer S. M., Aroni R. A. Sticky issue of adherence. J Paediatr Child Health. 2003;39((1)):2–5. [PubMed]
14. Kindler C. H., Szirt L., Sommer D., Häusler R., Langewitz W. A quantitative analysis of anaesthetist-patient communication during the pre-operative visit. Anaesthesia. 2005;60((1)):53–59. [PubMed]
15. Middleton S., Gattellari M., Harris J. P., Ward J. E. Assessing surgeons’ disclosure of risk information before carotid endarterectomy. ANZ J Surg.2006;76((7)):618–624. [PubMed]
16. Roter D. L. Physician/patient communication: transmission of information and patient effects. Md State Med J. 1983;32((4)):260–265.[PubMed]
17. Platt F. W., Keating K. N. Differences in physician and patient perceptions of uncomplicated UTI symptom severity: understanding the communication gap. Int J Clin Prac. 2007;61((2)):303–308. [PubMed]
18. Harmon G., Lefante J., Krousel-Wood M. Overcoming barriers: the role of providers in improving patient adherence to antihypertensive medications.Curr Opin Cardiol. 2006;21((4)):310–315. [PubMed]
19. Kaplan S. H., Greenfield S., Ware J. E., Jr Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care.1989;27((3 Suppl)):S110–S127. [PubMed]
20. Greenfield S., Kaplan S., Ware J. E., Jr Expanding patient involvement in care. Effects on patient outcomes. Ann Intern Med. 1985;102((4)):520–528.[PubMed]
21. Alazri M. H., Neal R. D. The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus.Diabetes Med. 2003;20((6)):486–490. [PubMed]
22. O’Keefe M. Should parents assess the interpersonal skills of doctors who treat their children? A literature review. J Paediatr Child Health.2001;37((6)):531–538. [PubMed]
23. Chen W. T., Starks H., Shiu C. S., et al. Chinese HIV-positive patients and their healthcare providers: contrasting Confucian versus Western notions of secrecy and support. ANS Adv Nurse Sci. 2007;30((4)):329–342.[PMC free article] [PubMed]
43. Hagihara A., Tarumi K. Doctor and patient perceptions of the level of doctor explanation and quality of patient-doctor communication. Scand J Caring Sci. 2006;20((2)):143–150. [PubMed]]

• If Child and Youth Athletes have sustained emotional and psychological injuries they should seek diagnoses and treatments from mental health professionals.
• If they have sustained physical injuries, they should seek diagnoses and treatments from medical/surgical professionals.
• If they have sustained sexual maltreatment injuries, they should seek diagnoses and treatments from medical/surgical professionals.
• Afterwards, the Athlete or caretakers, when age appropriate, and the Doctor should report the serious injuries, if perpetrated by the Coach, to the County Attorney for investigation.
• A report is a call for an investigation by legal authorities, when substantiated by a diagnosis and a suspected Coach perpetrator.

One diagnostic psychological example, PTSD, is a devastating, potentially life-long morbidity, packaged in the minds’ of children and youth-adult Athletes.
• The PTSD incidents endure from the onslaught of trauma, through their humiliation and belittling, after they transfer or pull-out from sports altogether, into adulthood and can become, potentially, a very lengthy time period.
• No amateur Athlete should have to suffer morbidity, as my teammates and me suffered under Coach Charlie Bradshaw during University of Kentucky football 1962, (see The Thin Thirty by Shannon Ragland 2007) and others continue to suffer, and/or mortality from a substandard Coach perpetrator.
• Hence, importance of confiding in a doctor who utilizes electronic records.
• Every suspected Coach perpetrator, of course, has the right to the presumption of innocence until proven guilty.

The medical professional should make a telephone call and file a written report to the county attorney and submit a bill to the 3rd party payer, insurance company, with the following diagnostic codes:
• T74.31 Adult psychological abuse, confirmed or
• T74.32 Child psychological abuse, confirmed
• Add Coach modifier code: ICD-10 Coach Perpetrator Code = T07.53
• Appropriate record documentation and reporting require IDC-10 codes, that became effective 10/1/2015, contain critical information about epidemiology, health management, and treatment of all conditions.

Health care professionals use ICD-10 codes to record and identify health conditions.
• “By creating software ‘buckets’ data types are grouped together.
• These are aka ‘hashing algorithms’ where different items that have the same hash code (hash collision) and go into the same “bucket”.
• The object data are grouped by the hash.
• “A hashing function may map several different keys to the same index.
• Therefore, each slot of a hash table is associated with (implicitly or explicitly) a set of records, rather than a single record.
• For this reason, each slot of a hash table is often called a ‘bucket’ and hash values are also called bucket indices.”
[Hash Function, Wikipedia]
1. Konheim, Alan (2010). “7. HASHING FOR STORAGE: DATA MANAGEMENT”. Hashing in Computer Science: Fifty Years of Slicing and Dicing. Wiley-Interscience.
2. “Robust Audio Hashing for Content Identification by Jaap Haitsma, Ton Kalker and Job Oostveen”
3. Sedgewick, Robert (2002). “14. Hashing”. Algorithms in Java (3 ed.). Addison Wesley.
4. Menezes, Alfred J.; van Oorschot, Paul C.; Vanstone, Scott A (1996). Handbook of Applied Cryptography. CRC Press.
5. Fundamental Data Structures – Josiang p.132″. Retrieved May 19, 2014.

Public health workers, legal officials and researchers can use the records and reports from the ‘buckets’ of ICD-10 codes they request 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
• Promote deterrence of coaches’ unlawful behaviors and Prevent blindsiding Coaches with civil and criminal litigations.

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