Consensus Definition of Sport Specialization in Youth Athletes Using a Delphi Approach

Context: A single, widely accepted definition of sport specialization does not currently exist. A consensus definition is necessary to guide youth sport stakeholders on topics associated with sport specialization. Objective: To develop a consensus definition of youth sport specialization and identify elements that support the construct of specialization. Design: Delphi study. Setting: Directed surveys. Patients or Other Participants: A consensus panel of 17 experts was created to provide a broad multidisciplinary perspective on sport specialization in youth athletes. Data Collection and Analysis: The final definition was developed per an iterative process that involved 4 rounds of review. A comprehensive review of the literature and expert input supported our initial proposed umbrella definition that included 6 additional elements. The study team reviewed the results after each round, and changes were made to the definition based on panel feedback. Main Outcome Measure(s): Panel members were provided with the definition and 6 elements and then asked to rate each specific to importance, relevance, and clarity using a 4-point Likert scale. Results: In 4 Delphi consensus rounds, 17 experts reviewed the umbrella definition and 6 elements before consensus was reached. The umbrella definition and 3 of the initial 6 elements achieved greater than 80% agreement for importance, relevance, and clarity after the fourth round of review. The remaining 3 components did not reach greater than 80% agreement, even after iterative edits, and were removed. The process resulted in a final consensus definition: Sport specialization is intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities. Conclusions: A consensus-based conceptual definition for sport specialization was developed using a Delphi method. This definition has important implications for clinicians and sports medicine professionals who support youth athletes.