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The Costs and Benefits of Early Sport Specialization: A Critical Review of Literature

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Title: The Costs and Benefits of Early Sport Specialization: A Critical Review of Literature
Language: English
Authors: Waldron, Shelby, DeFreese, J. D., Register-Mihalik, Johna, Pietrosimone, Brian, Barczak, Nikki
Source: Quest. 2020 72(1):1-18.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 18
Publication Date: 2020
Document Type: Journal Articles
Information Analyses
Education Level: Higher Education
Postsecondary Education
Descriptors: Athletics, Specialization, Higher Education, Performance, Risk, Mental Health, Physical Health, Ethics, Research Methodology, Burnout, Well Being, Youth, Self Determination, Motivation, Psychological Patterns, Injuries, Physical Activity Level, Persistence
DOI: 10.1080/00336297.2019.1580205
ISSN: 0033-6297
Abstract: There is a growing trend toward specialization in American youth sport, evident in the number of elite youth competitions and position statements from major medical organizations. Despite growing interest on this topic for kinesiology professionals within higher education, there is a dearth in research regarding the relationship between specialization and athlete health outcomes, especially psychosocial outcomes. This critical review describes specialization theory and the limited extant research on the costs and benefits of single-sport specialization. Topics include: (a) the proposed benefits of specialization from the performance perspective; (b) early specialization and alternative sport participation pathways; (c) the posited psychosocial and physical health risks of sport specialization; (d) ethical concerns; and (e) methodological issues and recommendations for future research. Deeper understanding of the costs and benefits of sport specialization has significant practical implications for youth athletes' performance and well-being and for other relevant stakeholders in the youth sport system.
Abstractor: As Provided
Entry Date: 2020
Accession Number: EJ1243867
Database: ERIC
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  Value: <anid>AN0141751483;qus01jan.20;2020Feb18.02:29;v2.2.500</anid> <title id="AN0141751483-1">The Costs and Benefits of Early Sport Specialization: A Critical Review of Literature </title> <p>There is a growing trend toward specialization in American youth sport, evident in the number of elite youth competitions and position statements from major medical organizations. Despite growing interest on this topic for kinesiology professionals within higher education, there is a dearth in research regarding the relationship between specialization and athlete health outcomes, especially psychosocial outcomes. This critical review describes specialization theory and the limited extant research on the costs and benefits of single-sport specialization. Topics include: (a) the proposed benefits of specialization from the performance perspective; (b) early specialization and alternative sport participation pathways; (c) the posited psychosocial and physical health risks of sport specialization; (d) ethical concerns; and (e) methodological issues and recommendations for future research. Deeper understanding of the costs and benefits of sport specialization has significant practical implications for youth athletes' performance and well-being and for other relevant stakeholders in the youth sport system.</p> <p>Keywords: Athletic injury; burnout; specialization; youth sport</p> <p>Recently, American-organized youth sport has been characterized by early specialization, with sport programming often requiring high levels of investment from early ages, discouraging participation in other activities, nationally ranking talented youth as early as sixth grade, and offering a growing number of elite youth competitions, such as the Junior Olympics and Amateur Athletic Union (Andrews, [<reflink idref="bib2" id="ref1">2</reflink>]; Hecimovich, [<reflink idref="bib33" id="ref2">33</reflink>]; Hill & Hansen, [<reflink idref="bib34" id="ref3">34</reflink>]; Malina, [<reflink idref="bib47" id="ref4">47</reflink>]). While lacking a universal definition, the most prominent conceptualization of sport <emph>specialization</emph> is high intensity, year-round training in a single sport, with the exclusion of other sports (Wiersma, [<reflink idref="bib77" id="ref5">77</reflink>]). Specifically, the trend in American youth sport (see below) has been toward early specialization (Gould, [<reflink idref="bib28" id="ref6">28</reflink>]; Jayanthi, LaBella, Fischer, Pasulka, & Dugas, [<reflink idref="bib39" id="ref7">39</reflink>]; Wiersma, [<reflink idref="bib77" id="ref8">77</reflink>]). <emph>Early specialization</emph> refers to focusing on a single sport with high levels of deliberate practice (effortful activities designed to increase sport-specific skills which are not inherently enjoyable) and low levels of deliberate play (inherently enjoyable activities often involving adapted rules and loose monitoring), before age 13 (Côté, Baker, & Abernethy, [<reflink idref="bib17" id="ref9">17</reflink>]; Côté, Lidor, & Hackfort, [<reflink idref="bib19" id="ref10">19</reflink>]; Ericsson, Krampe, & Tesch-Romer, [<reflink idref="bib25" id="ref11">25</reflink>]). Specialization is in direct contrast to sport <emph>sampling</emph> or participation in multiple sports, with high amounts of deliberate play and low amounts of deliberate practice. Because of its importance to kinesiology professionals, a critical literature review is necessary to both further understanding of specialization as well as to situate implications of this topic within higher education.</p> <p>While empirical data on prior rates of sport specialization are lacking, prevalence seems to be steadily increasing (Jayanthi & Dugas, [<reflink idref="bib38" id="ref12">38</reflink>]). In 2008, it was estimated that 12% of all US youth athletes began competing in organized sport before age six, up from 6% in 1997 (Brenner, [<reflink idref="bib10" id="ref13">10</reflink>]). Specialization rates have been found to be as high as 70%, with an average start age of 10, in a sample of elite youth tennis players (Jayanthi, Dechert, Durazo, Dugas, & Luke, [<reflink idref="bib37" id="ref14">37</reflink>]). In addition, around 36% of high school athletes were classified as highly specialized and another 28% moderately specialized, in a recent study (Bell et al., [<reflink idref="bib6" id="ref15">6</reflink>]). However, prevalence rates are impacted by the classification method used and the sample's sport type, age, sex, school size, and location (Bell et al., [<reflink idref="bib6" id="ref16">6</reflink>], [<reflink idref="bib7" id="ref17">7</reflink>]; Miller et al., [<reflink idref="bib51" id="ref18">51</reflink>]; Post et al., [<reflink idref="bib59" id="ref19">59</reflink>]).</p> <p>With approximately 60 million youth ages 6 to 18 participating in organized athletics in the U.S., sport specialization constitutes a major public health concern (DiFiori, Benjamin, Brenner, & Gregory, [<reflink idref="bib22" id="ref20">22</reflink>]). The discussion concerning early sports specialization is centered on two central issues: whether specialization favors optimal performance and whether it increases the risk of maladaptive outcomes (Reider, [<reflink idref="bib62" id="ref21">62</reflink>]). Researchers from various sub-disciplines of higher education in kinesiology (i.e., exercise physiology, sport sociology, sport psychology, motor development, and biomechanics) have examined both aspects of the specialization debate, including: the efficacy of specialization training, physiological and psychological effects, pros and cons, and alternative sport participation pathways. Thus, multiple sub-disciplines of kinesiology have been integral to informing the knowledge base as well as the public discourse on sport specialization (Landers, Carson, & Blankenship, [<reflink idref="bib42" id="ref22">42</reflink>]; Smith, [<reflink idref="bib69" id="ref23">69</reflink>]). There is also a growing number of position statements, from major medical organizations, warning against specialization due to both psychological and physical health concerns (e.g., see Table 1; Jayanthi & Dugas, [<reflink idref="bib38" id="ref24">38</reflink>]).</p> <p>Table 1. Specialization position statements.</p> <p> <ephtml> <table><thead><tr><td>Medical Organization</td><td>Position Statement</td></tr></thead><tbody><tr><td>American Medical Society for Sports Medicine (DiFiori et al., <xref ref-type="bibr" rid="bibr22">2014</xref>, <italic>Clinical Journal of Sports Medicine</italic>)</td><td>"Early sport specialization may increase the risk for overuse injury and burnout and should be avoided at younger ages."</td></tr><tr><td>American Academy of Pediatrics (Brenner, <xref ref-type="bibr" rid="bibr10">2016</xref>, <italic>Pediatrics</italic>)</td><td>"Young athletes who specialize too soon are at risk of physical, emotional, and social problems."</td></tr><tr><td>American Orthopaedic Society for Sports Medicine (LaPrade et al., <xref ref-type="bibr" rid="bibr43">2016</xref>, <italic>The Orthopaedic Journal of Sports Medicine</italic>)</td><td>"Early sport specialization is not a requirement for success at the highest levels of competition and is believed to be unhealthy physically and mentally for young athletes."</td></tr><tr><td>National Athletic Trainer's Association (Valovich et al., <xref ref-type="bibr" rid="bibr74">2011</xref>, <italic>Journal of Athletic Training</italic>)</td><td>"In addition to the potential for repetitive microtrauma and overuse injury, specialization in 1 sport may be associated with... psychological or socialization issues, and ultimately burnout."</td></tr></tbody></table> </ephtml> </p> <p>On a practical level, specialization research is essential to inform stakeholders in the sport system (i.e., coaches, parents, athletic directors, physical educators, clinicians, sport governing bodies, athletes) of the potential benefits and risks of different sport participation pathways for youth's athletic and personal development. Conversely, researchers argue that sport science information is not being disseminated to these groups and/or is misunderstood or ignored (Gould, [<reflink idref="bib28" id="ref25">28</reflink>]). This is problematic considering the goal of higher education in kinesiology to inform the public on issues of health, safety, and well-being relative to physical activity (Block, [<reflink idref="bib9" id="ref26">9</reflink>]). Moreover, a greater understanding of the impact of specific sport contexts and training characteristics on athletes' development is critical to the formation of prevention and intervention programs and subsequently, to ensuring developmentally-appropriate and positive experiences for youth athletes (Chase & DiSanti, [<reflink idref="bib13" id="ref27">13</reflink>]). Therefore, this article will primarily focus on posited outcomes of specialization, with extant theoretical and empirical support, in addition to gaps in knowledge, discussed below.</p> <hd id="AN0141751483-2">Theoretical framework for sport specialization</hd> <p></p> <hd id="AN0141751483-3">Performance perspective</hd> <p>The notion that early specialization is the optimal path to achieve elite performance originated from talent development studies utilizing experts from multiple domains (e.g., chess, musicians, and artists). Researchers argued that inter-individual variation in proficiency of task-specific skills and overall performance is due to differences in quantity and quality of training, not innate skill (Chase & Simon, [<reflink idref="bib14" id="ref28">14</reflink>]; Ericsson et al., [<reflink idref="bib25" id="ref29">25</reflink>]). In regards to quantity, 10 years (Chase & Simon, [<reflink idref="bib14" id="ref30">14</reflink>]) or 10,000 hours (Ericsson et al., [<reflink idref="bib25" id="ref31">25</reflink>]) has been proposed as the minimum requirement to attain elite status. Furthermore, training should be <emph>deliberate practice</emph>, an activity undertaken with the goal of increasing performance, requiring cognitive and/or physical effort, and promoting positive skill development. Key to the early specialization trend, researchers argue that the earlier deliberate practice starts, the higher the level of performance an individual will attain as theoretically latecomers cannot catch up due to constraints of deliberate practice (e.g., slow increase in volume over time; Ericsson et al., [<reflink idref="bib25" id="ref32">25</reflink>]). However, findings from a meta-analysis suggest that deliberate practice only explains about 18% of the variance in sport performance (Macnamara, Hambrick, & Oswald, [<reflink idref="bib46" id="ref33">46</reflink>]).</p> <p>Proponents of specialization argue that sport diversification is not sufficient for long-term elite success as it does not allow for optimally designed training loads to maximize physiological and psychological adaptations (Baker, Cobley, & Fraser-Thomas, [<reflink idref="bib4" id="ref34">4</reflink>]). However, while a positive relationship between practice and level of achievement is well-established, there is little evidence suggesting training must be intensive in one sport (Baker et al., [<reflink idref="bib4" id="ref35">4</reflink>]). Côté and colleagues ([<reflink idref="bib17" id="ref36">17</reflink>]) argued that to attain elite status only 3,000 of the 10,000 total hours of deliberate practice need to be sport-specific training (i.e., specialization). Supporting this claim, self-reports from collegiate, national, and international athletes indicate participation in multiple sports during the <emph>sampling years</emph> (ages 6–12; Baker et al., [<reflink idref="bib4" id="ref37">4</reflink>]), single-sport specialization at an older age, and later attainment of career milestones (i.e., starting sport, participation in first competition, etc.), compared to their peers (Brenner, [<reflink idref="bib10" id="ref38">10</reflink>]; Cobley & Baker, [<reflink idref="bib16" id="ref39">16</reflink>]; Güllich & Emirch, [<reflink idref="bib31" id="ref40">31</reflink>]; Malina, [<reflink idref="bib47" id="ref41">47</reflink>]; Marek, [<reflink idref="bib48" id="ref42">48</reflink>]; Moesch, Elbe, Hauge, & Wikman, [<reflink idref="bib52" id="ref43">52</reflink>]). These findings were further supported with longitudinal testing and were consistent across sport type. However, the aforementioned findings may not be applicable to sports in which peak performance occurs before full physical maturation, such as gymnastics and figure skating (Côté et al., [<reflink idref="bib19" id="ref44">19</reflink>]; Law, Côté, & Ericsson, [<reflink idref="bib44" id="ref45">44</reflink>]). In addition, much of these data are limited by a subset of sports, small sample sizes, retrospective design, and exclusion of younger athletes (Jayanthi, Pinkham, Dugas, Patrick, & LaBella, [<reflink idref="bib40" id="ref46">40</reflink>]). While further research is warranted, extant findings suggest that early specialization is not necessary and potentially detrimental to attaining elite status in the majority of sports.</p> <p>Not only is sampling an alternative pathway to attaining elite status, preliminary research suggests that it may facilitate <emph>transfer</emph> of fundamental cognitive and motor skills between sports (Baker et al., [<reflink idref="bib4" id="ref47">4</reflink>]). According to some sport science researchers, diversification during early phases of growth stimulates generic physiological adaptations (i.e., diverse motor skills, training of opposing muscle groups, and increased flexibility patterns), which may facilitate the development of specialized physical capacities and superior overall athleticism (Baker & Côté, [<reflink idref="bib5" id="ref48">5</reflink>]; Myer et al., [<reflink idref="bib53" id="ref49">53</reflink>]). Furthermore, the varied learning stimuli inherent in multi-sport participation may enhance adaptive skills such as assessment of personal and environmental variables (Güllich & Emrich, [<reflink idref="bib31" id="ref50">31</reflink>]). These theoretical assumptions are supported by the inverse relationship between the number of practice hours needed to attain national team status and the span of one's early sporting experiences in a sample of Australian athletes (Baker, [<reflink idref="bib3" id="ref51">3</reflink>]). However, the extent of transfer may depend on the degree of information processing and/or physical conditioning similarity between sports (Baker et al., [<reflink idref="bib4" id="ref52">4</reflink>]). Nevertheless, there was no difference in highest success attained (i.e., level of ranking) between athletes who trained in multiple related sports versus unrelated sports, and all sports include motor skill refinement, speed, agility, strength, and endurance to some extent (Güllich & Emrich, [<reflink idref="bib31" id="ref53">31</reflink>]). Cumulatively, research findings suggest that sampling is an alternative pathway to reach elite performance and may provide the performance benefit of transfer of cognitive and motor skills.</p> <hd id="AN0141751483-4">Development perspective</hd> <p>Given the posited significant implications for youth athletes' performance and well-being, the primary focus of this review is the relationship between sport specialization and psychological and physical health outcomes (Côté et al., [<reflink idref="bib19" id="ref54">19</reflink>]; DiFiori et al., [<reflink idref="bib22" id="ref55">22</reflink>]; Wiersma, [<reflink idref="bib77" id="ref56">77</reflink>]). Proponents of sport sampling argue that performance-based theories ignore important developmental, psychosocial, and motivational factors (Baker & Côté, [<reflink idref="bib5" id="ref57">5</reflink>]). Alternative pathways to elite status may optimize affective, physical, and social development, necessitating a careful cost-benefits analysis of each path (Côté et al., [<reflink idref="bib19" id="ref58">19</reflink>]; DiFiori et al., [<reflink idref="bib22" id="ref59">22</reflink>]).</p> <p>There are numerous theoretical frameworks illustrating different paths to elite performance. The most prominent model, Côté et al.'s ([<reflink idref="bib17" id="ref60">17</reflink>]) Developmental Model of Sport Participation (DMSP), proposes two distinct pathways, sampling and early specialization (Côté, Horton, MacDonald, & Wilkes, [<reflink idref="bib18" id="ref61">18</reflink>]). In contrast to specialization, sampling involves participation in multiple sports, high amounts of deliberate play, and low amounts of deliberate practice. The DMSP does not argue entirely against specialization but rather suggests that elite status can also be attained via sampling in early childhood, specializing (balanced deliberate play and practice and reduced involvement in other sports) between ages 13 and 15, and then investing (high amount of deliberate practice, low amount of deliberate play, and focus on a single sport) at age 16 (Côté et al., [<reflink idref="bib18" id="ref62">18</reflink>]). Furthermore, specialization in late adolescence (i.e., American high school years, approximately age 15) or after is a normative sport experience and therefore, may not be associated with the same risks as specialization at an earlier age (Côté et al., [<reflink idref="bib18" id="ref63">18</reflink>]; Wiersma, [<reflink idref="bib77" id="ref64">77</reflink>]). Whereas, early specialization (i.e., single-sport specialization at or before age 12) is posited to carry significant health risks due to its occurrence before puberty. Pre-pubertal athletes are still rapidly developing their motor, sensory, cognitive, and emotional/social skills and consequently, are less likely to safely and successfully meet the demands of specialization (Côté et al., [<reflink idref="bib19" id="ref65">19</reflink>]; DiFiori et al., [<reflink idref="bib22" id="ref66">22</reflink>]; Wiersma, [<reflink idref="bib77" id="ref67">77</reflink>]). While intensive sport participation post-puberty still carries risks, athletes in late adolescence are theoretically better matched for the demands of sport. These athletes possess the necessary cognitive, physical, social and emotional skills to understand the benefits and costs of sport specialization, make an informed, independent decision, and properly invest in highly specialized training when warranted (Côté et al., [<reflink idref="bib19" id="ref68">19</reflink>]).</p> <hd id="AN0141751483-5">Psychosocial variables of interest</hd> <p>While included as a major risk of specialization in both developmentally-based, theoretical models and major position statements, limited extant research exists on the relationship between specialization and psychosocial outcomes such as burnout, self-determined sport motivation, sport stress, resilience, and social support. Therefore, the purpose of the current paper is to review the limited psychological data in the context of the more well-known physical data to inform relevant stakeholders, derive practical implications, and provide future directions for research.</p> <hd id="AN0141751483-6">Burnout</hd> <p>One of the major psychological concerns of sport specialization is athlete burnout, a prominent topic in sport science research and practice. Burnout is the multidimensional, psychological syndrome of reduced sense of accomplishment, sport devaluation, and emotional and physical exhaustion (Raedeke, [<reflink idref="bib61" id="ref69">61</reflink>]). Reduced sense of athletic accomplishment includes perceived inefficacy and negative evaluations of one's sport achievements and/or performance. Sport devaluation involves negative attitudes and loss of interest in regards to sports/sport participation. Exhaustion refers to both psychological and physical fatigue due to the demands of training and competition (Raedeke, [<reflink idref="bib61" id="ref70">61</reflink>]). Multiple theories on antecedents and the development of athlete burnout exist. The most prominent theory, Smith's ([<reflink idref="bib70" id="ref71">70</reflink>]) cognitive-affective model, suggests that burnout is the result of chronic psychosocial stress from a perceived disparity between sport demands and coping resources. Therefore, the high demands of specialization (i.e., high training loads and time requirements) and low coping resources (i.e., low social support and autonomy) may contribute to maladaptive physiological and psychological responses. In addition to a stress perspective, other models of burnout are applicable to the specialization environment. Coakley ([<reflink idref="bib15" id="ref72">15</reflink>]) proposed that stress may not be the primary cause of burnout, but rather a symptom. Taking a sociological perspective, he argued that burnout results from the social organization of high performance sport in which young athletes often develop a unidimensional identity and lack autonomy relative to training decisions.</p> <p>Based on these prominent models of burnout, researchers and medical organizations have posited a maladaptive relationship between specialization and burnout due to a variety of theoretical components of the specialization experience (i.e., chronic stress, overtraining, and excessive coach/parental pressure) (DiFiori et al., [<reflink idref="bib22" id="ref73">22</reflink>]; Jayanthi & Dugas, [<reflink idref="bib38" id="ref74">38</reflink>]; Jayanthi et al., [<reflink idref="bib39" id="ref75">39</reflink>], [<reflink idref="bib40" id="ref76">40</reflink>]). Many of these factors, such as competing outside of one's age group, have previously been associated with high levels of burnout (Gould, Udry, Tuffey, & Loehr, [<reflink idref="bib29" id="ref77">29</reflink>]). However, minimal data exist on the direct relationship between specialization and burnout. One study found that youth athletes classified as <emph>specializers</emph> reported higher levels of the burnout dimension emotional exhaustion versus those classified as <emph>samplers</emph> (Strachan, Côté, & Deakin, [<reflink idref="bib72" id="ref78">72</reflink>]). Furthermore, researches often conflate burnout and drop out/withdrawal, two highly correlated but distinct concepts, as support for a maladaptive relationship between specialization and burnout (Jayanthi & Dugas, [<reflink idref="bib38" id="ref79">38</reflink>]; Jayanthi et al., [<reflink idref="bib39" id="ref80">39</reflink>], [<reflink idref="bib40" id="ref81">40</reflink>]). For example, increased rates of sport attrition in youth athletes who began sport participation at an earlier age and engaged in higher training volumes than their peers, is widely cited in specialization literature (Baker et al., [<reflink idref="bib4" id="ref82">4</reflink>]; Fraser-Thomas, Côté, & Deakin, [<reflink idref="bib26" id="ref83">26</reflink>]; Jayanthi & Dugas, [<reflink idref="bib38" id="ref84">38</reflink>], [<reflink idref="bib39" id="ref85">39</reflink>]; Jayanthi et al., [<reflink idref="bib40" id="ref86">40</reflink>]; Wall & Côté, [<reflink idref="bib76" id="ref87">76</reflink>]). Given the prominent claims, lack of empirical support, and significant implications for athlete well-being, further research on the specific relationship between specialization and athlete burnout is warranted.</p> <hd id="AN0141751483-7">Self-determined sport motivation</hd> <p>Since specialization is characterized by high amounts of <emph>deliberate practice</emph>, activities that may not always be inherently enjoyable, a lack of intrinsic motivation or amotivation is a prominent psychological concern. Intrinsic motivation refers to performing an activity for the inherent interest, enjoyment, and satisfaction with the activity itself, whereas amotivation refers to a lack of motivation, feelings of incompetence, and perceived lack of control. According to Ryan and Deci's ([<reflink idref="bib65" id="ref88">65</reflink>]) self-determination theory, motivation is influenced by the three psychological needs of autonomy (sense of personal choice and control), competence (feeling effective in one's environment), and relatedness (feelings of belonging and connection to others). In turn, these psychological needs are impacted by the social environment (e.g., coach-athlete relationship) and therefore, may be impeded by factors characteristic of the specialization environment (i.e., limited peer interaction and high expectations) (Côté et al., [<reflink idref="bib18" id="ref89">18</reflink>], [<reflink idref="bib19" id="ref90">19</reflink>]; Jowett et al., [<reflink idref="bib41" id="ref91">41</reflink>]; Ryan & Deci, [<reflink idref="bib65" id="ref92">65</reflink>]). For example, Padaki et al. ([<reflink idref="bib56" id="ref93">56</reflink>]) found that extrinsic influences (i.e., low autonomy) are prevalent in specialized athletes, with 22% of single-sport athletes reporting being told not to participate in other sports by a coach, versus only 8% of multi-sport athletes.</p> <p>Risk factors in the specialization environment are of concern given that the nature of one's motivation (i.e., the degree of self-determination) impacts both psychological (i.e., burnout) and behavioral (i.e., dropout) outcomes (Ryan & Deci, [<reflink idref="bib65" id="ref94">65</reflink>]). For example, Gould et al. ([<reflink idref="bib29" id="ref95">29</reflink>]) found that lacking input in training decisions (i.e., low autonomy) and playing in higher age divisions (i.e., decreased relatedness), factors often characteristic of specialization, were associated with higher levels of amotivation and subsequently, increased burnout and dropout. Similarly, McFadden, Bean, Fortier, and Post ([<reflink idref="bib49" id="ref96">49</reflink>]) found that early specializers in hockey reported higher psychological needs dissatisfaction (perceived inadequacy of autonomy, competence, and relatedness) compared to recreational athletes, positively predicting mental illness and negatively predicting mental health. In contrast, <emph>deliberate play</emph> (a characteristic of sampling) potentially stimulates intrinsic motivation, an outcome posited to be more adaptive in promoting persistence despite failures/challenges and sport commitment (Baker et al., [<reflink idref="bib4" id="ref97">4</reflink>]; Pelletier, Fortier, Vallerand, & Briere, [<reflink idref="bib58" id="ref98">58</reflink>]; Ryan & Deci, [<reflink idref="bib65" id="ref99">65</reflink>]). However, Russell and Symonds ([<reflink idref="bib64" id="ref100">64</reflink>]) found that young adults who specialized in a single youth sport reported higher intrinsic motivation to know (the desire to learn new skills) versus those who sampled multiple sports. While another study found that specialization status did not have a significant effect on sport motivation (Russell, Dodd, & Lee, [<reflink idref="bib63" id="ref101">63</reflink>]).</p> <p>Based on the aforementioned mixed findings, researchers argue that deliberate practice may not be inherently maladaptive for an athlete's sport motivation, but rather dependent on factors in the sport environment (e.g., outcome or task-centered focus, support of autonomy, peer relationships, coaching style). Therefore, further research on the specialization-motivation relationship and potential moderating factors is warranted, especially given the detrimental effects of the posited psychological (i.e., burnout) and behavioral (i.e., sport attrition) outcomes on both athletes' performance and well-being.</p> <hd id="AN0141751483-8">Other psychosocial variables of interest</hd> <p>Sport specialization may be associated with a variety of other maladaptive psychosocial health outcomes (i.e., high sport stress, decreased resilience, and low perceived social support) due to both the relationship with burnout and inherent contextual factors of the specialization experience (Eklund & DeFreese, [<reflink idref="bib24" id="ref102">24</reflink>]). As previously mentioned, chronic sport stress is a key antecedent of burnout and therefore, may be associated with specialization due to similar environmental factors including: high training volume, competitive demands, and excessive parental/coach pressure (Gould et al., [<reflink idref="bib29" id="ref103">29</reflink>]; Smith, [<reflink idref="bib70" id="ref104">70</reflink>]). In turn, chronic stress and other specialization risk factors may decrease one's perceived resources and/or ability to cope, decreasing psychological resilience (Sarkar & Fletcher, [<reflink idref="bib66" id="ref105">66</reflink>]). Finally, the intense and high volume of training inherent in early specialization may interfere with one's ability to participate in other activities and form social relationships, leading to the development of a unidimensional identity and/or "social isolation" (Coakley, [<reflink idref="bib15" id="ref106">15</reflink>]; Wiersma, [<reflink idref="bib77" id="ref107">77</reflink>]). Highly specialized youth athletes may become overly dependent on their parents and coaches, relying on them for a sense of purpose and structure, potentially creating an unhealthy perception of relationships with adult figures (Malina, [<reflink idref="bib47" id="ref108">47</reflink>]).</p> <p>In contrast, multi-sport participation exposes youth to different psycho-social environments and social interactions with peers and adults, fostering the development and adaptation of emotional and self-regulation skills (Côté et al., [<reflink idref="bib19" id="ref109">19</reflink>]). For example, sampling a mixture of individual (e.g., tennis or track) and team (e.g., basketball or volleyball) sports may facilitate both one-on-one interaction with a coach and exposure to a broader social system with opportunities for interaction with many teammates and training partners, respectively. Furthermore, even sports with a similar structure have a unique context (i.e., sport culture, specific teammates, coaching style) and subsequently, distinct psycho-social experiences (Côté et al., [<reflink idref="bib19" id="ref110">19</reflink>]). Research has shown an association between exposure to distinct environments (including non-sport related activities) and the development of leadership skills, positive peer relationships, and well-being (Côté et al., [<reflink idref="bib19" id="ref111">19</reflink>]; Wright & Côté, [<reflink idref="bib79" id="ref112">79</reflink>]).</p> <p>Similarly, the moral development of youth specializers is also of concern as the goal of some sports may create moral tensions and ambiguities. For example, the goal of boxing is to inflict harm on one's opponent and therefore, requires at least a temporary numbness to violence (Torres, [<reflink idref="bib73" id="ref113">73</reflink>]). While specialization exposes youth athletes to a single set of values and social norms, sampling provides multiple sport contexts, potentially fostering resilience against negative social norms (Côté et al., [<reflink idref="bib18" id="ref114">18</reflink>]). Sport performance enhancement is also of concern given the aforementioned, posited increased external pressure and motivation of specialization, such as the potential for athletic scholarships (Padaki et al., [<reflink idref="bib56" id="ref115">56</reflink>]; Torres, [<reflink idref="bib73" id="ref116">73</reflink>]).</p> <p>Overall, empirical support for the purposed positive relationship between specialization and maladaptive psychological outcomes (i.e., burnout, amotivation, high sport stress, decreased resilience, and low social support) is limited. Limited extant research has found mixed results, with specialization associated with both maladaptive (psychological needs dissatisfaction) and adaptive psychological outcomes (intrinsic motivation to know; McFadden et al., [<reflink idref="bib49" id="ref117">49</reflink>]; Russell & Symonds, [<reflink idref="bib64" id="ref118">64</reflink>]). Given the mixed findings and significant implications for athletes' performance and well-being, further research is warranted, especially on potential moderating factors of the relationship between specialization and psychosocial outcomes.</p> <hd id="AN0141751483-9">Physical and behavioral outcomes of interest</hd> <p>In addition to maladaptive psychosocial outcomes, physical (i.e., injury risk) and behavioral (i.e., sport attrition and decreased physical activity) health outcomes are also of concern due to theoretically inherent factors in the specialization environment, the immature and developing body of pre-pubertal youth athletes, and the posited relationship with maladaptive psychological outcomes.</p> <hd id="AN0141751483-10">Injury risk</hd> <p>In contrast to psychological outcomes, the majority of specialization research has focused on the posited maladaptive association between specialization and increased risk of injuries, especially overuse injuries. Overuse injuries are a diagnosis attributed to a gradual onset without a specific traumatic event and are often classified as <emph>serious</emph> if sport participation is limited for one month or longer (Jayanthi et al., [<reflink idref="bib39" id="ref119">39</reflink>]). Retrospective studies indicated higher overuse injury rates for single-sport athletes versus their multisport peers (1.5- to 4-fold increase; Hall, Barber, Hewett, & Myer, [<reflink idref="bib32" id="ref120">32</reflink>]; Jayanthi et al., [<reflink idref="bib37" id="ref121">37</reflink>]). However, findings are mixed in regard to acute injuries (injuries caused by a single, traumatic event) with some studies finding no association while others demonstrated a dose-dependent effect of similar magnitude to overuse injuries (Jayanthi et al., [<reflink idref="bib39" id="ref122">39</reflink>]; McGuine et al., [<reflink idref="bib50" id="ref123">50</reflink>]; Post et al., [<reflink idref="bib60" id="ref124">60</reflink>]). Mixed findings may partially be attributed to sampling limitations, with research focused on current athletes and those reporting to sports medicine clinics. A different distribution may be expected from samples of urgent care, emergency room, or orthopedic clinic patients. However, the findings may also be due to the strong relationship between overuse injuries and training volume and pattern (Jayanthi et al., [<reflink idref="bib39" id="ref125">39</reflink>]).</p> <p>High training volume is one of the most prominent injury risk factors of sport specialization due to increased exposure with the high number of hours of practice and/or competition. Independent of high school athletes' classification as a single or multisport athlete, a linear relationship between exposure and risk of injury was found for a wide variety of sports (Loud, Gordon, Micheli, & Field, [<reflink idref="bib45" id="ref126">45</reflink>]). Athletes with a prior injury reported participation in organized sports for more hours per week and months per year than athletes without a history of injury, even when controlling for age and gender (Post et al., [<reflink idref="bib60" id="ref127">60</reflink>]). Therefore, to minimize injury risk different training volume guidelines have been proposed, including: no more than 16 hours per week, 8 months of the year, or a 2:1 ratio of weekly hours of organized sport activity to free play (Bell et al., [<reflink idref="bib6" id="ref128">6</reflink>], [<reflink idref="bib7" id="ref129">7</reflink>]; Jayanthi et al., [<reflink idref="bib39" id="ref130">39</reflink>]; Olsen, Fleisig, Dun, Loftice, & Andrews, [<reflink idref="bib55" id="ref131">55</reflink>]; Post et al., [<reflink idref="bib60" id="ref132">60</reflink>]). However, some researchers argue that the total number of competitions in a season may be a more accurate measure of participation volume given the large inter-sport variation. In addition, researchers have found a greater risk of injury during competitions versus practice, potentially due to inadequate rest and recovery, especially with same-day competitions (Bell et al., [<reflink idref="bib7" id="ref133">7</reflink>]; DiFiori et al., [<reflink idref="bib22" id="ref134">22</reflink>]; Myer et al., [<reflink idref="bib53" id="ref135">53</reflink>]; Post et al., [<reflink idref="bib59" id="ref136">59</reflink>]).</p> <p>Other risk factors inherent in sport specialization, as identified by researchers in multiple kinesiology sub-disciplines, include: repetitive physiological stress, early development of technical skills, decreased age-appropriate unstructured free play, and higher competitive demands (Myer et al., [<reflink idref="bib53" id="ref137">53</reflink>]). Due to the focus on a single sport, specialization training often involves repetition of specific movement patterns, resulting in a lack of diversity in adopted neuromuscular patterns, imbalances in muscle strength and flexibility, movement asymmetry, impairments in dynamic balance, and repetitive loading of the same structures, all of which increase one's risk of injury (Bell et al., [<reflink idref="bib6" id="ref138">6</reflink>]; DiFori et al., [<reflink idref="bib22" id="ref139">22</reflink>]; Jayanthi et al., [<reflink idref="bib39" id="ref140">39</reflink>]; Miller et al., [<reflink idref="bib51" id="ref141">51</reflink>]). Of major concern for youth athletes is repetitive exposure to excessive rotational forces (e.g., pitching, swimming, or golfing) and/or early development of technical skills (e.g., kick serve in tennis) due to the increased stress placed on the developing body and subsequent risk of fractures prior to growth plate closure (Marek, [<reflink idref="bib48" id="ref142">48</reflink>]; Myer et al., [<reflink idref="bib53" id="ref143">53</reflink>]). Finally, the negative relationship between unstructured free play and injury rate may partially be accounted for by the association between increased training volume and decreased free play. Furthermore, the slower pace and relatively low intensity of free play, as well as the development of a wide range of neuromuscular skills, may decrease the risk of injury and aid in injury prevention, respectively (Jayanthi et al., [<reflink idref="bib39" id="ref144">39</reflink>]; Myer et al., [<reflink idref="bib53" id="ref145">53</reflink>]).</p> <p>A maladaptive relationship between the psychosocial and physical risks of early sport specialization has also been posited. Williams and Andersen ([<reflink idref="bib78" id="ref146">78</reflink>]) suggest a positive relationship exists between the severity of an athlete's stress response (cognitive appraisal of psychosocial variables and physiological and attentional changes) to a demanding situation, and his/her probability of injury. Therefore, the combination of high demands (e.g., training load) and low coping resources (e.g., decreased social support) of sport specialization may contribute to both maladaptive physiological and psychological responses (i.e., injury and burnout, respectively).</p> <p>Research has illustrated a positive relationship between injury and burnout, with higher global burnout scores for athletes who have sustained an athletic injury versus those who have not. In addition, currently injured athletes reported higher levels of emotional and physical exhaustion (Hughes, [<reflink idref="bib36" id="ref147">36</reflink>]). This maladaptive burnout-injury relationship could be due to the demands of injury rehabilitation, a loss of athletic identity post-injury, and/or perceived pressure or expectations to play while injured (Cresswell & Eklund, [<reflink idref="bib20" id="ref148">20</reflink>]; Grylls & Spittle, [<reflink idref="bib30" id="ref149">30</reflink>]). However, currently injured athletes have also reported lower burnout scores versus their uninjured teammates, especially on the dimension of exhaustion, suggesting injury may provide a break from intensive sport involvement (Grylls & Spittle, [<reflink idref="bib30" id="ref150">30</reflink>]). The number of injuries may be a moderating factor, with a possible cumulative effect of multiple injuries, especially on the dimension of reduced sense of sport accomplishment (Cresswell & Eklund, [<reflink idref="bib20" id="ref151">20</reflink>]; Grylls & Spittle, [<reflink idref="bib30" id="ref152">30</reflink>]). However, this effect has not been consistently found and may be dependent on the injuries being located on the same body segment, warranting further research (Hughes, [<reflink idref="bib36" id="ref153">36</reflink>]).</p> <p>While retrospective studies limit the ability to control for the effect of high training volumes, both theory and empirical research suggests that specialization is an independent risk factor for injury (Jayanthi et al., [<reflink idref="bib39" id="ref154">39</reflink>]; McGuine et al., [<reflink idref="bib50" id="ref155">50</reflink>]; Pasulka, Jayanthi, McCann, Dugas, & LaBella, [<reflink idref="bib57" id="ref156">57</reflink>]; Reider, [<reflink idref="bib62" id="ref157">62</reflink>]). Research has demonstrated a positive, dose-dependent effect of the degree of specialization on injury risk, especially serious overuse injury, even when controlling for age and time spent in organized sport (Jayanthi et al., [<reflink idref="bib39" id="ref158">39</reflink>]; Myer et al., [<reflink idref="bib53" id="ref159">53</reflink>]; Pasulka et al., [<reflink idref="bib57" id="ref160">57</reflink>]; Post et al., [<reflink idref="bib60" id="ref161">60</reflink>]). In addition, a prospective study found that both moderate and highly specialized athletes had a higher incidence of lower-extremity injuries (50% and 85%, respectively) than low or non-specialized athletes, even when controlling for sex, age, sport, competition volume, and injury history (McGuine et al., [<reflink idref="bib50" id="ref162">50</reflink>]).</p> <p>Early specialization (high intensity, year-round training in a single sport at or before age 12) may carry even greater risks, above and beyond specialization, due to the immature skeleton and developing body (Côté et al., [<reflink idref="bib18" id="ref163">18</reflink>]; Wiersma, [<reflink idref="bib77" id="ref164">77</reflink>]). During critical periods of physical development, joints and connective tissue are tight and inflexible due to slower growth rates relative to bone, hindering their ability to resist excess stress (Dalton, [<reflink idref="bib21" id="ref165">21</reflink>]). In addition, muscle and tendon lengthening often exceeds the rate of muscle hypertrophy, requiring muscles to increase their force production by about 30% to produce movement and subsequently, increasing the force transferred to tendons. Together these biomechanical principles suggest that repetitive, intense activity multiplies the baseline injury risk of pre-pubertal athletes (Smucny, Parikh, & Pandya, [<reflink idref="bib71" id="ref166">71</reflink>]).</p> <p>However, the link between specialization and injury risk may be moderated by different factors, including sport type and gender. In a hospital-based cohort, individual sport athletes presented with higher rates of overuse (43 versus 32%) and serious overuse (17 versus 11%) injuries, but almost half the prevalence of acute (17 versus 30%) injuries, when compared to athletes from team sports (Jayanthi & Dugas, [<reflink idref="bib38" id="ref167">38</reflink>]). These findings may be due to the highly technical nature of individual sports (i.e., high degree of sport-specific skills and repetitive loading) and subsequent increased rate of specialization, including: younger average age of specialization and higher training volumes (Pasulka et al., [<reflink idref="bib57" id="ref168">57</reflink>]). Similarly, girls may present with higher rates of overuse injuries compared to males due to their higher participation rate in individual sports, average competition volume, degree of specialization, and club sport participation rate (Pasulka et al., [<reflink idref="bib57" id="ref169">57</reflink>]; Post et al., [<reflink idref="bib59" id="ref170">59</reflink>]; Schroeder et al., [<reflink idref="bib68" id="ref171">68</reflink>]). Other proposed risk factors for girls include: earlier maturation and involvement in sports with higher eating disorders risk (i.e., figure skating, gymnastics), as early sport specialization may be a risk factor for the female athlete triad (i.e., decreased energy availability, menstrual cycle function, and bone mineral density) (Blagrove, Bruinvels, & Read, [<reflink idref="bib8" id="ref172">8</reflink>]; Wiersma, [<reflink idref="bib77" id="ref173">77</reflink>]). However, gender differences have not been consistently found (McGuine et al., [<reflink idref="bib50" id="ref174">50</reflink>]) and findings are often contradictory, with some studies demonstrating a higher injury risk for male athletes (Miller et al., [<reflink idref="bib51" id="ref175">51</reflink>]).</p> <p>Cumulatively, a relationship between early specialization and increased risk of overuse injuries has been well-established in the literature due to a variety of aforementioned risk factors. However, the relationship between early specialization and acute injuries is not as clear, with little to no increased risk found depending on study methodology. Additionally, potential moderating factors of the specialization-injury relationship, specifically sport type and gender, need to be controlled for and may serve as a promising area for future research.</p> <hd id="AN0141751483-11">Sport attrition and decreased physical activity</hd> <p>Specialization has also been associated with the maladaptive long-term outcomes of organized sport attrition and decreased physical activity, key themes of kinesiology research and practice in higher education. Around 70% of children drop out of organized sports by age 13, citing lack of fun and performance pressure as two of the top reasons (Brenner, [<reflink idref="bib10" id="ref176">10</reflink>]; Myer et al., [<reflink idref="bib53" id="ref177">53</reflink>]). Youth sport attrition is concerning given the positive relationship between youth sport participation and both adult leisure-time physical activity and sports participation (Russell & Symonds, [<reflink idref="bib64" id="ref178">64</reflink>]). Both high-school hockey players and elite youth swimmers who dropped out of sport, began sport participation at an earlier age and engaged in higher training volumes than their peers who continued (Fraser-Thomas et al., [<reflink idref="bib26" id="ref179">26</reflink>]; Wall & Côté, [<reflink idref="bib76" id="ref180">76</reflink>]). Furthermore, early specializers were less likely to participate in organized sports as adults, while sampling was positively associated with long-term sport participation (Baker et al., [<reflink idref="bib4" id="ref181">4</reflink>]; Russell & Symonds, [<reflink idref="bib64" id="ref182">64</reflink>]).</p> <p>A variety of factors have been proposed to explain the positive relationship between specialization and sport attrition, including: decreased intrinsic motivation and enjoyment, increased stress, performance pressure and expectations, high training volumes, limited peer interaction, competing at higher levels, injury, and decreased participation in other activities and unstructured free play (Côté et al., [<reflink idref="bib18" id="ref183">18</reflink>], [<reflink idref="bib19" id="ref184">19</reflink>]; Fraser-Thomas et al., [<reflink idref="bib26" id="ref185">26</reflink>]; Gould, [<reflink idref="bib27" id="ref186">27</reflink>]; Post et al., [<reflink idref="bib60" id="ref187">60</reflink>]; Wiersma, [<reflink idref="bib77" id="ref188">77</reflink>]). Additionally, some athletes may be forced to withdraw from competitive sport at an earlier age due to not making or "being cut" from teams. These athletes could potentially be missing an opportunity to develop into elite level athletes with growth, maturation, and training, as performance at one age in childhood is an unreliable predictor of later performance (Côté et al., [<reflink idref="bib19" id="ref189">19</reflink>]; Güllich & Emrich, [<reflink idref="bib31" id="ref190">31</reflink>]; Wiersma, [<reflink idref="bib77" id="ref191">77</reflink>]). Furthermore, youth who physiologically mature earlier are more likely to be chosen for selective teams and/or trained for a specific position due to their anthropometric (i.e., height, weight, muscle mass) and fitness (i.e., speed, power, aerobic endurance) characteristics. However, these individuals may no longer have the physical characteristics needed for high level play in their respective sport/position once late maturers catch up, nor the diversified training to switch to another sport/position (Horn, [<reflink idref="bib35" id="ref192">35</reflink>]). Finally, early intrinsically motivating behaviors characteristic of sampling (i.e., deliberate play) may increase one's motivation and willingness to engage in more externally controlled activities (i.e., deliberate practice), over time. In addition, sampling various sports increases the likelihood of finding a functional match between the sport and the athlete, subsequently increasing engagement and commitment. For example, world class German athletes were more likely to change their main sport throughout their career than their less successful peers (Güllich & Emrich, [<reflink idref="bib31" id="ref193">31</reflink>]). While withdrawal due to involvement in a different preferred activity is normal, withdrawal as a result of the sport environment/system (i.e., lack of enjoyment, excessive stress and performance pressure, and injury) is concerning for youth athlete's physical and mental health (Wiersma, [<reflink idref="bib77" id="ref194">77</reflink>]). Therefore, intervention studies designed to minimize risk factors of sport attrition inherent in the specialization environment and exposure to other, non-sport activities for specializers are needed.</p> <p>Sampling has also been associated with physical activity in adulthood (Côté et al., [<reflink idref="bib19" id="ref195">19</reflink>]). While results are somewhat mixed, the lack of exposure to requisite fundamental motor skills in early specialization may hinder young adults' physical activity (Russell et al., [<reflink idref="bib63" id="ref196">63</reflink>]; Russell & Symonds, [<reflink idref="bib64" id="ref197">64</reflink>]). As a result, children's ability to make an autonomous choice regarding sport participation in the future and subsequently, their opportunities for self-fulfillment are limited, violating children's right to an open future (Dixon, [<reflink idref="bib23" id="ref198">23</reflink>]). However, some researchers argue that early sport specialization may be justified if children demonstrate unusual talent in an early specialization sport such as gymnastics or figure skating. Since peak performance has been shown to occur before puberty in these sports, preventing specialization may close the window of opportunity for self-fulfillment in these sports (Dixon, [<reflink idref="bib23" id="ref199">23</reflink>]; Torres, [<reflink idref="bib73" id="ref200">73</reflink>]). Furthermore, the higher volume of deliberate play inherent in sampling may foster long-term motivation for sport/physical activity via creating a mastery or task environment in which progress is valued over performance (Côté et al., [<reflink idref="bib19" id="ref201">19</reflink>]). Despite the significant individual, societal, and ethical implications, limited research on long-term health outcomes (i.e., later in life physical activity levels) exists.</p> <hd id="AN0141751483-12">Future directions</hd> <p>Continued research on sport specialization by sport science professionals is warranted. Despite prominent claims of increased risks with early specialization, empirical support is lacking as most studies have not directly assessed athletes' age at entry into single sport specialization (Post et al., [<reflink idref="bib60" id="ref202">60</reflink>]). In addition, comparison of specialization groups has been limited by the small range of reported age of specialization, attributed to a lack of significant difference in the population and/or sampling limitations (Jayanthi et al., [<reflink idref="bib39" id="ref203">39</reflink>]). For example, previous studies' use of samples of solely elite youth athletes or those at a sports medicine clinic/hospital may be overrepresenting the number of early specializers and narrowing the reported age range (Jayanthi et al., [<reflink idref="bib39" id="ref204">39</reflink>]). As a result, studies using more community-based samples are needed to get a more accurate sense of the early specialization population and prevalence. Additionally, the development of a universal definition of specialization would also aid in the obtainment of more accurate specialization prevalence rates.</p> <p>The gap in knowledge surrounding early specialization may also be attributed to limitations of current specialization measures. Currently, the most widely used measure, Jayanthi and colleagues' ([<reflink idref="bib39" id="ref205">39</reflink>]) 3-point specialization scale, does not take into account individuals who never sampled multiple sports (i.e., only played one sport throughout their athletic career), nor athletes' age of specialization. This measure also lacks factors differentiating between specializing in a high-intensity program and a less demanding environment (i.e., training volume, competition level, deliberate practice to play ratio, and participation in non-sport activities), two experiences posited to have very distinct health and behavioral outcomes (Wiersma, [<reflink idref="bib77" id="ref206">77</reflink>]). Therefore, the development of a specialization measure incorporating both participants' age of specialization and characteristics of the specialization environment is warranted.</p> <p>There is also a gap in knowledge surrounding sport-specific specialization risks versus global risks of early specialization. Previous specialization studies have not been able to include sport type in data analyses due to the wide range of sports reported. Sport-specific findings are needed as sport type may influence athletes' degree and age of specialization and subsequently, their health outcomes (Jayanthi et al., [<reflink idref="bib39" id="ref207">39</reflink>]). Comparison of sport-specific and global specialization risks is also needed to determine risk factors inherent in the specialization environment for intervention purposes. In addition, discussion of sport-specific pros and cons of specialization, including ethical concerns, is needed, especially given the variation in timing of peak performance (i.e., pre- or post-puberty). Overall, further research on both sport-specific and general considerations of early specialization is needed.</p> <p>Future research should also examine the relationship between specialization and psychosocial outcomes, especially burnout and self-determined motivation, due to the limited extant research, mixed findings, and significant implications for athletes' health and well-being. Given existing mixed findings, potential moderating factors of this relationship should also be examined such as athletes' reasons for continuing to participate in sports. In their sport commitment theory Schmidt and Stein ([<reflink idref="bib67" id="ref208">67</reflink>]) suggest that athletes who continue high sport commitment for reasons other than enjoyment (i.e., high perceived benefits, low costs, high investment, and low attractive alternatives) are vulnerable to burnout. In addition, utilizing cluster analysis based on the theoretical components of sport commitment and entrapment, Raedeke ([<reflink idref="bib61" id="ref209">61</reflink>]) was able to explain 59% of the variance in the burnout dimensions, in a sample of adolescent swimmers. In line with these theories, findings from a pilot study suggest that athletes' reasons for specializing may be a significant moderating factor, with more adaptive reasons (e.g., the pursuit of athletic excellence) associated with adaptive outcomes (e.g., decreased levels of reduced accomplishment and sport stress), and the opposite relationship for maladaptive outcomes (Waldron & DeFreese, [<reflink idref="bib75" id="ref210">75</reflink>]). While supported by theory, these findings were exploratory in nature and limited by a small sample (<emph>n</emph> = 65), warranting further examination. Therefore, further research utilizing sport commitment theory and SDT as a framework to guide the examination of the impact of athlete's reason(s) for specialization on psychological and behavioral outcomes is warranted (Ryan & Deci, [<reflink idref="bib65" id="ref211">65</reflink>]; Schmidt & Stein, [<reflink idref="bib67" id="ref212">67</reflink>]).</p> <p>In regards to physical health outcomes, further studies on acute injuries and potential moderating factors of the relationship between specialization and injury risk, such as sport type and gender, are warranted. Studies should examine potential long-term health risks of early specialization in young adults utilizing prospective, longitudinal designs with diverse samples from a variety of sports. Club sport concurrent with high school sport participation is another growing concern and promising area for future research (Post et al., [<reflink idref="bib59" id="ref213">59</reflink>]). Furthermore, research on the benefits of diversification/sampling, especially transfer of motor, cognitive, and psychological skills (e.g., throwing movements, pattern recognition, and resilience, respectively) between sports, is needed. Accordingly, kinesiology professionals in higher education are well-suited to tackle the complex interdisciplinary nature of these future specialization research questions which have important implications for youth and adolescent sport.</p> <p>Finally, intervention studies are also warranted to minimize maladaptive outcomes and ensure positive youth sport experiences. One area of focus should be multidisciplinary research on youth athletes' psychophysiological responses to specialization to inform modification of youth training and competition formats and subsequently, balance athletes' optimal performance, development, and experience (Capranica & Millard-Stafford, [<reflink idref="bib12" id="ref214">12</reflink>]; Chase & DiSanti, [<reflink idref="bib13" id="ref215">13</reflink>]). With estimates of over twenty million youth athletes classified as highly specialized in the US, proper implementation of training protocols and appropriate rest periods could prevent over two million potential injuries and save approximately two and a half billion dollars per year (Andrews, [<reflink idref="bib2" id="ref216">2</reflink>]; Post et al., [<reflink idref="bib60" id="ref217">60</reflink>]). Additionally, the role and impact of school-based physical education should be examined as some researchers suggest it may be used an alternative mechanism for development of specialized athletes' range of motor skills and movement confidence, and facilitation of sampling (Myer et al., [<reflink idref="bib53" id="ref218">53</reflink>]).</p> <hd id="AN0141751483-13">Conclusion</hd> <p>Despite the growing interest in sport specialization and vast theoretical hypothesizing, empirical support is lacking, especially in regards to psychological health outcomes and the unique effects of early specialization. Answers to these gaps in knowledge and a better understanding of the costs and benefits of early sport specialization could aid in the development of recommendations, guidelines, and interventions to help clinicians prevent maladaptive psychological outcomes and treat overuse injuries, educate parents, athletes, and coaches, and inform sport governing bodies' policies (Wiersma, [<reflink idref="bib77" id="ref219">77</reflink>]). Kinesiology professionals within higher education have been (and will continue to be) key agents for information, guidance, and intervention regarding sport specialization going forward.</p> <p>Accordingly, a re-imagining of youth sport and physical education, as driven by recommendations from kinesiology research, could have important implications for specialization decisions and the physical and psychological outcomes of youth and adolescent participants. Ultimately, the purpose of youth sport must be at the center of the decision-making-process regarding youth sport participation. The end goal should be appropriate long-term sport development (i.e., increase youth's physical activity, facilitate skill development, and develop a life-long appreciation for sport/physical activity) rather than early competitive success (Normand, Wolfe, & Peak, [<reflink idref="bib54" id="ref220">54</reflink>]). As all sport participation is not inherently positive, theoretically sampling most effectively promotes positive youth development via participation in a variety of contexts (Chase & DiSanti, [<reflink idref="bib13" id="ref221">13</reflink>]; Côté et al., [<reflink idref="bib19" id="ref222">19</reflink>]). Moreover, as approximately 98% of youth athletes will never reach elite status, promoting early specialization raises potential ethical concerns (Wiersma, [<reflink idref="bib77" id="ref223">77</reflink>]). In addition, early specialization may increase one's risk of maladaptive psychophysiological outcomes. For example, even minor youth injuries increase the risk of future, more severe injuries and can lead to maladaptive psychological and physical health outcomes including: depression, low self-esteem, fear, burnout, sport attrition, and decreased physical activity (Andrew et al., [<reflink idref="bib1" id="ref224">1</reflink>]; Butcher, Lindner, & Johns, [<reflink idref="bib11" id="ref225">11</reflink>]; Hughes, [<reflink idref="bib36" id="ref226">36</reflink>]). Consequently one must ask, is it ethical to put youth athletes at risk of both maladaptive short-term and long-term psychological and physical health outcomes, if only 2% will reap the posited performance benefits? 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Items – Name: Title
  Label: Title
  Group: Ti
  Data: The Costs and Benefits of Early Sport Specialization: A Critical Review of Literature
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Waldron%2C+Shelby%22">Waldron, Shelby</searchLink><br /><searchLink fieldCode="AR" term="%22DeFreese%2C+J%2E+D%2E%22">DeFreese, J. D.</searchLink><br /><searchLink fieldCode="AR" term="%22Register-Mihalik%2C+Johna%22">Register-Mihalik, Johna</searchLink><br /><searchLink fieldCode="AR" term="%22Pietrosimone%2C+Brian%22">Pietrosimone, Brian</searchLink><br /><searchLink fieldCode="AR" term="%22Barczak%2C+Nikki%22">Barczak, Nikki</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Quest%22"><i>Quest</i></searchLink>. 2020 72(1):1-18.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 18
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2020
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Information Analyses
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Athletics%22">Athletics</searchLink><br /><searchLink fieldCode="DE" term="%22Specialization%22">Specialization</searchLink><br /><searchLink fieldCode="DE" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="DE" term="%22Performance%22">Performance</searchLink><br /><searchLink fieldCode="DE" term="%22Risk%22">Risk</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Health%22">Physical Health</searchLink><br /><searchLink fieldCode="DE" term="%22Ethics%22">Ethics</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Methodology%22">Research Methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Burnout%22">Burnout</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Youth%22">Youth</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Determination%22">Self Determination</searchLink><br /><searchLink fieldCode="DE" term="%22Motivation%22">Motivation</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Injuries%22">Injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Activity+Level%22">Physical Activity Level</searchLink><br /><searchLink fieldCode="DE" term="%22Persistence%22">Persistence</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/00336297.2019.1580205
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0033-6297
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: There is a growing trend toward specialization in American youth sport, evident in the number of elite youth competitions and position statements from major medical organizations. Despite growing interest on this topic for kinesiology professionals within higher education, there is a dearth in research regarding the relationship between specialization and athlete health outcomes, especially psychosocial outcomes. This critical review describes specialization theory and the limited extant research on the costs and benefits of single-sport specialization. Topics include: (a) the proposed benefits of specialization from the performance perspective; (b) early specialization and alternative sport participation pathways; (c) the posited psychosocial and physical health risks of sport specialization; (d) ethical concerns; and (e) methodological issues and recommendations for future research. Deeper understanding of the costs and benefits of sport specialization has significant practical implications for youth athletes' performance and well-being and for other relevant stakeholders in the youth sport system.
– Name: AbstractInfo
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  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2020
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1243867
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1243867
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/00336297.2019.1580205
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 18
        StartPage: 1
    Subjects:
      – SubjectFull: Athletics
        Type: general
      – SubjectFull: Specialization
        Type: general
      – SubjectFull: Higher Education
        Type: general
      – SubjectFull: Performance
        Type: general
      – SubjectFull: Risk
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      – SubjectFull: Mental Health
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      – SubjectFull: Research Methodology
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      – SubjectFull: Youth
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      – SubjectFull: Motivation
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      – SubjectFull: Psychological Patterns
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      – SubjectFull: Injuries
        Type: general
      – SubjectFull: Physical Activity Level
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      – SubjectFull: Persistence
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      – TitleFull: The Costs and Benefits of Early Sport Specialization: A Critical Review of Literature
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