New safety rules were in place in central Massachusetts: Any 10-to-12-year-old playing Pop Warner football suspected of having a concussion was not allowed to return to play until cleared by a doctor. Plus, a certified EMT was present during the game, and the league had established concussion education programs for coaches, officials, players and their parents. Yet as the concussions on one outmatched team mounted and the injured players were taken to the sidelines, no one stopped the contest, which ended in a 52-0 blowout and five concussed players.

According to the "Boston Globe," league officials suspended the coaches of both teams for the rest of the season and barred the referees from the league for not recognizing the increasing danger to players still on the field and stopping the game. But that judgment came after the fact. Where were the adults during the game?

"That story again raises the myriad issues related to concussion in sport," said Chris Hummel, an Ithaca College faculty member who has researched the effects of concussions and served as an athletic trainer for 15 years. "What's particularly concerning about the Pop Warner game is that very young athletes were the center of the story and the adults around them failed to protect them."

At least 41 states have passed concussion safety laws to educate coaches, parents and athletes on how to recognize concussions; provide guidelines for return to play; and create concussion management teams. But in the case of that Pop Warner game, Hummel said, rules and education didn't lead to action.

"Someone should have stepped up and stopped play, not just because of Pop Warner rules but common sense. Medical professionals, like certified athletic trainers, can and should be on the sidelines to enforce the rules that the coaches, officials and parents were not willing or able to do in this instance."

Indeed, the "Globe" quoted the parent of a concussed player as saying, "We were playing a football game. Every kid who was out there wanted to play and not give up." "Adults need to do more to protect youth in sport," Hummel said. "Not only do we need more education, we need to enforce the rules of concussion management in all youth sports, not just football."