Proposals to impose an outright ban on under-12s heading footballs in training should go hand in hand with efforts to reduce the reliance on heading in the senior game, according to the leader of an influential study into the increased risk of brain disease among players.
Amid speculation the Scottish Football Association (SFA) is close to endorsing the ban, consultant neuropathologist Professor Willie Stewart warned it was “probably not enough,” and advocated changes at all levels of the sport.
While heading has been outlawed in US youth football since 2015, Scotland would become the first European country to impose such a restriction.
A spokesman for the SFA said it had held productive discussions on “proactive, preventative measures” which had a “particular focus on younger age groups.”
There is no set timescale for the conclusion of discussions, let alone the introduction of a ban, but it is understood there is unanimity between the SFA board, the professional and non-professional game boards and medical representatives to recommend such a step. It could be in place for the grassroots season, which runs from March to November.
Last October saw the publication of the initial findings of the FIELD study, carried out by researchers at the University of Glasgow. It showed that footballers were three and a half times more likely to die of neurodegenerative disease than age-matched members of the general population.
Professor Stewart, who led the research, said that while no definitive link between head injury or impact and dementia among footballers has been established, there is enough evidence to require action to be taken now.
But he insists heading has to be curtailed at all levels of the game, not just in the youngest players.
He said: "A move to reduce head impacts in youth sports is a good idea, but I would caution that that's probably not enough.
"It's not enough just to say 'let's take heading out of the game in under-12s' I think we need to look across the entire game - amateurs, seniors, professionals - and say 'where else can we make changes to be effective?'
"And not just in football, look across all sports and think 'what could we do differently?' It's a good start, but I hope that this isn't the end, that by changing under-12s we're somehow solving the problem.
"We haven't got the cast-iron evidence of direct causality but what we have is more than enough evidence, adding up over the decades and right up to the FIELD study at the end of last year, which says there's a strong association between contact sports and development of dementia.
"And when we look at what is the common factor, exposure to head injury and head impact is the one thing that stands through.
"Now there may be other things we haven't yet recognised, but Lord knows we've been working hard to identify them and we haven't yet identified them."
Gordon Smith, former chief executive of the Scottish FA, said more needed to be done to curb the risks faced by children playing football.
He said: “We should be using plastic balls so that the young players could get the technique without having to head the ball. They'll be told that heading is part of the game as they come through, but they don't have to be heading the big balls immediately.
“You go to see younger age group games and you very rarely see the ball being headed during the games, but it’s the training aspect that needs to be changed so that younger players don’t have to head the ball a lot.”
Dawn Astle has campaigned for greater research into the issue ever since the death of her father Jeff Astle, the former West Brom and England forward, in 2002.
He died aged 59 from chronic traumatic encephalopathy (CTE). The coroner ruled that his death had been caused by the repeated trauma of heading the ball, describing it as an "industrial disease".
She welcomed the prospect of a possible ban as "a positive step" and added: "My dad's dementia started at some point didn't it?
"It's always been my belief that it manifested in my dad, although no one was aware of it, when heading footballs as a kid. Children's brains are more vulnerable because they're still growing.
"Going back to Scotland, I wished our (English) FA would do it. I hope now one (association) has they will all follow suit.
"It's not like a metatarsal injury - this is something that kills you."
The English FA's head of medicine Dr Charlotte Cowie said last month that a research task force was now conducting a review of possible changes to heading coaching and training at all levels. It is understood this does not mean banning heading, but an emphasis on quality over quantity.
The Irish FA is aware of the FIELD study.
Rangers manager Steven Gerrard believes more needs to be done to examine the link between football and dementia, but hopes heading in children's football is not completely phased out.
"I used to love heading balls, probably from the age of four," he said.
"So I wouldn't take it away from them completely because they will be watching their heroes every day on the TV, heading and scoring goals.
"But you can certainly do things; you can help them by making the balls smaller or lighter, or doing heading in a different way, without using the heavy-case balls."