Reliability and validity of heading recall questionnaires in female youth soccer players

Abstract

Concerns regarding the long-term brain health effects of intentional heading in soccer have increased significantly, particularly concerning the developing brains of youth athletes. Quantifying heading exposure is a critical first step in risk assessment; however, best practice methods like video analysis are resource-intensive. Self-report questionnaires offer a scalable alternative, but their accuracy in youth populations remains unknown. The purpose of this study was to evaluate the reliability and validity of both season-long and weekly soccer heading recall questionnaires in youth female soccer players. Sixty-six female youth players were monitored over a single competitive season. Participants completed a recall questionnaire at the conclusion of the season or weekly throughout the season. Self-reported data were compared against direct observation/video records to determine validity and reliability (intraclass correlation coefficients, ICCs). The season-long recall questionnaire demonstrated poor reliability (ICC = 0.055). In contrast, the weekly recall questionnaire showed good reliability (ICC = 0.882). Although the weekly format was better, players consistently overestimated their heading frequency across both questionnaires. Youth players are more reliable at recalling heading exposure over a one-week period compared to a full season. However, clinicians and researchers must account for an overestimation bias. Although recall questionnaires are a viable tool for estimating exposure, they should be treated as approximations rather than precise counts of intentional soccer heading.