‘Diversity is being invited to the party. Inclusion is being invited to dance’. (Verna Myers)

The problem: barriers to playing mainstream youth football

Over approximately 20 years, both authors have felt fortunate to have had the opportunities to develop clinical and research interests in para sports and para football (soccer). Many years ago, the lead author was asked if a young footballer could play mainstream football with a prosthesis and whether another child with disability could play mainstream football outside of their prescribed age group. This led to collaborative efforts with The Football Association (FA) in England and the development and refinement of solutions to ensure that inclusion, diversity and equity are championed across football in England, promoting regular participation by as many as possible.

The aim: equity, diversity and inclusion for all children wishing to play football

Much like school year groups which are arranged according to birth dates, in most countries children’s sport and football are also organised by a similar system, meaning that children play with peers of similar age and maturity.1 However, some children may have physical or mental health issues, significant psychosocial challenges, or simply be schooled in a year below their prescribed age group and unable to play football with their peers. If these children were to play in their ‘prescribed’ year group, they may experience discrimination, not enjoy football and lose interest in the game, resulting in them giving up on football and missing out on all the physical, mental and social benefits of sport and regular physical activity.

Some children and adults may also wish to play mainstream football with a prosthesis. The global rules of football are set by the International Football Association Board (IFAB), and Law 4 states that ‘a player must not use equipment or wear anything that is dangerous’ and mandates referees to inspect for potentially dangerous equipment and decide on safety.2 This leaves a situation where a footballer may be prevented from playing football with a prosthesis if a referee suspects a safety risk to the athlete or other footballers in that match. Prior to 2014, there were examples of inconsistency in these safety assessments and examples where footballers felt discriminated.

The process: new rules and guidance drafted to provide dispensation

To formally address these challenges, the lead author convened two small panels to draft rules and guidance that were approved by FA legal advisors. They were shared with local county football associations in England and made publicly accessible via the FA website around 2015. Since then, any child can apply for dispensation to play ‘down’ in a different year group according to the rules and must supply supporting evidence from an independent professional (eg, teacher, nurse, doctor, psychologist, physiotherapist), which confirms the rationale for the application in accordance with dispensation rules. If a child is schooled a year below their ‘prescribed cohort’ at school, then they are permitted to play with their peers if they wish, only needing to supply brief dated evidence from the school confirming they are schooled ‘out of cohort’.3

As awareness has grown, so has the number of applications. In 2013, there were nine applications, and by the 2022 season there were approximately 300. For 2023, over 830 applications have been submitted. All applications with valid rationale in accordance with the rules and supporting independent evidence will be approved. With growing numbers of applications each year, there are challenges, but the development of a secure online portal to streamline this process has helped greatly. The portal also has an option of consent to being contacted by FA para football talent staff during an application if a child has an eligible impairment, opening up new opportunities for children with disabilities. The number of applications annually for footballers wishing to play mainstream football with a prosthesis is much lower (approximately 5–10 applications).4 These require a brief information form and photos of the prosthesis to be submitted by email, along with a letter from the prescribing orthotist confirming suitability to use the prosthesis for football. The application is assessed by an independent medical advisor, primarily to assess safety and sharp edges that may require covering/taping/additional protection. Following this, an official letter of recommendation with these details is provided to the footballer from the FA to present to a referee, whenever needed, to ensure no discrimination is encountered around participation.

The impact, benefit and learning from the creation of these guidelines

Although there has been no formal evaluation of these guidelines to date, anecdotally the system ensures children continue playing regular football when they might otherwise have quit. We believe that the benefits of inclusivity with regard to sporting participation are priceless, both for the children themselves as well as for their parents or carers who can see their child enjoying football with other children they consider their peers. Knowing that footballers with a prosthesis are supported to play competitive football in alignment with the IFAB safety rules also gives us great personal and professional satisfaction.

Since the guidelines were created, new challenges have led to reflections and adaptations. This year the large increase in number of applicants has resulted in delays in processing, but amendments are being undertaken to ensure quicker response times. FIFA will also include information on these guidelines in their upcoming ‘FIFA Disability Football Toolkit’ with a focus on grassroots participation.

We encourage other football associations to use similar rules in their own countries so that more children, with or without disabilities, are able to play football without discrimination. We encourage other countries and sports to consider adopting similar inclusive policies and guidance to drive a simple message in the interest of promoting physical activity through football: our sport is for all.

All current information, frequently asked questions and guidance can be found here: https://grassrootstechnology.thefa.com/support/solutions/articles/48001235147-dispensation-faqs (accessed 30 September 2023).

Ethics statementsPatient consent for publication

Not required.

Acknowledgments

We would like to thank John Stanley for his initial work and Funke Adoweru for her leadership in the development of these rules. Thank you to Keah Forino-Joseph for her ongoing supervision. Thank you to Angie Goodchild-Pain for developing and monitoring the online portal.