Minister’s message

Rowan Stringer’s death in 2013 as a result of multiple concussions sustained while playing rugby, leading to Second Impact Syndrome, was preventable. The lessons learned from this tragedy have been carried forward through Ontario’s implementation of the 21 recommendations of the Rowan’s Law Advisory Committee and continue to stand as the foundation of Ontario’s ongoing efforts to improve concussion safety.

With these recommendations substantively implemented and the delivery of a small number of concussion data-focused initiatives ongoing as part of our commitment to continuous improvement, I am pleased to present the eighth annual and final Minister’s Progress Report on Rowan’s Law (Concussion Safety), 2018 (“Rowan’s Law”).

Together with partners across the sport system in Ontario, we have made significant progress in advancing concussion safety. Ontario has implemented Canada’s first concussion safety legislation, Rowan’s Law (Concussion Safety), 2018, and invested over $1.5 million since 2018 to put in place a comprehensive system of supports to help protect amateur athletes. These include concussion awareness resources for individuals of all ages and abilities, Codes of Conduct, Removal-from and Return-to-Sport protocols, a Coach’s Toolkit, a Concussion Spotter Tool, and a dedicated provincial concussion web portal, among many others.

I want to thank Neil Lumsden for his unwavering commitment towards improving concussion safety during his time as Ontario’s Minister of Sport. Through his leadership, concussion safety has become an integral part of building safer sport environments for participants of all ages and abilities. Ontario’s entire sport system has greatly benefited from his support, vision, and persistent efforts to ensure that athletes can participate in sport with greater confidence, safety, and care.

This final report highlights the progress achieved to date and sets out the Ministry of Sport’s strategic transition from project-based initiatives towards embedding concussion safety within the core operations of ministry programs and policies. This shift reflects the maturity of Ontario’s concussion safety framework and the need to sustain the momentum built to date through a system-wide approach.

Ontario now stands as a national and international leader in concussion safety because of our shared efforts to build a stronger culture of safety in sport, one that helps ensure that athletes, parents, coaches, and officials know when to suspect a concussion and how to respond appropriately. The core message of Rowan’s Law is one that I will personally continue to carry into conversation with counterparts across Canada and around the world to demonstrate that culture change is possible.

I extend my sincere gratitude to the members of the Rowan’s Law Concussion Working Group for their leadership, insight, and unwavering commitment since their mandate to advise the Government of Ontario on the implementation of the 21 recommendations. Its members have played a critical role in strengthening concussion safety for athletes across Ontario through expert advice, collaboration, and sustained commitment, and will continue to shape how we protect athletes and students for years to come. Ontario remains deeply committed to carrying forward Rowan’s legacy and ensuring that her story continues to drive meaningful, lasting change.

This is not the end of Rowan’s legacy. It is the beginning of its next step, which will endeavour to ensure that concussion safety is actively engrained into the fabric of sport in our province.

The Honourable Brian Saunderson

Minister of Sport

Introduction

Rowan Stringer’s legacy: changing the culture of sport

Rowan’s Law (Concussion Safety), 2018 (“Rowan’s Law”) is a landmark achievement for Ontario and remains the first and only comprehensive concussion safety legislation in Canada. The legislation was introduced in response to the tragic death of Rowan Stringer, a 17-year-old high school rugby player from Ottawa, who died on May 12, 2013.

In the six days leading up to her final game on May 8, 2013, Rowan is believed to have sustained at least two head injuries while playing rugby. Unaware that she had suffered concussions, she continued to play. During her third game in six days, Rowan was tackled, and she hit her head and collapsed on the field. She later died from Second Impact Syndrome, a rare but catastrophic swelling of the brain caused by re-injury before a previous injury has healed. Although Rowan had experienced persistent headaches and shared her symptoms with friends, her concussions went undiagnosed, and those around her were unaware of the seriousness of her condition.

In 2015, a Coroner’s Inquest into Rowan’s death identified significant gaps in concussion prevention and management in youth sport, including the absence of concussion legislation and a coordinated system in Ontario. The verdict issued 49 recommendations directed to governments, school boards, and sport organizations, with a central call for Ontario to enact legislation—Rowan’s Law—to establish consistent standards for concussion safety.

In response, the Ontario government acted quickly. In 2016, a private member’s bill established the Rowan’s Law Advisory Committee, composed of experts in concussion safety and injury prevention, to advise on implementing the Inquest’s recommendations. The Committee’s report, tabled in 2017, emphasized the need for a cultural shift around head injuries and proposed 21 recommended actions across awareness, prevention, detection, management, and surveillance.

Rowan’s death underscored the urgent need for clearer concussion education, improved awareness, and stronger protections for amateur athletes. In response, Ontario introduced Rowan’s Law in 2018 to help change the culture of sport and prioritize athlete safety.

Under Rowan’s Law, athletes, parents and guardians of athletes under 18, coaches, team trainers, and officials are required to review concussion awareness materials annually before participating in or serving within a sport organization. These measures have contributed to strengthened sport safety across Ontario by improving recognition of concussion symptoms and reducing pressure on athletes to continue playing after a head injury.

Today, age-appropriate concussion education resources developed under the Rowan’s Law brand are widely accessible and prominently displayed when Ontarians seek information online, supporting access to accurate and consistent guidance.

Ontario also commemorates Rowan’s Law Day each year on the last Wednesday of September to promote concussion awareness and reinforce a culture of safety in sport. Since its introduction, Rowan’s Law has played a central role in shifting attitudes, increasing understanding, and embedding safer practices across the sport sector.

The ongoing commitment of Rowan Stringer’s family, sport organizations, the Rowan’s Law Concussion Working Group members, coaches, parents, educators, and community partners continues to sustain Rowan’s legacy and support a safer sport system for future generations.

The impact of Rowan’s Law

Reflections and lessons learned

The delivery of Rowan’s Law demonstrates that meaningful progress requires sustained effort over time through continuous development and refinement. While certain objectives could be achieved early in implementation, others required longer-term commitment, coordination, and resources to realize their full impact. Experience also showed that legislation alone is insufficient to drive lasting change; shifting the culture of sport in Ontario depended on consistent, reinforced public education and awareness efforts to embed concussion safety as a shared and enduring priority across the sport system.

Driving culture change – reflections on concussion safety delivery

Rowan's Law has become an integral part of Rugby Ontario's commitment to participant welfare and concussion awareness initiatives. Given the physical nature of contact rugby and the severity of concussion injuries, it is extremely important to understand what a concussion is, how to recognize the signs and symptoms, the proper protocol for diagnosis and treatment, and where to find key resources. Rowan's Law has not only steadily increased the awareness and education of concussion and brain injuries throughout our province, but it has also positively impacted how we manage athletes after a suspected head injury through enhanced removal-from-play and return-to-play protocols at all levels of play. We have invested in reporting tools and concussion data surveillance through the support of the Ontario Government, and this is helping to keep athletes in the game.

Myles Spencer Rugby Ontario CEO 

Ontario Women’s Hockey Association (OWHA) sincerely thanks the Stringer Family, the Province of Ontario and the many individuals who have worked in support of Rowan’s Law. We pay tribute to Rowan, a great person and athlete who contributed so much in her life and has left a powerful legacy that resulted directly in saving lives and sustaining quality in countless other lives. Through Rowan’s Law, there is an ongoing, mandatory educational process in the OWHA that reminds athletes and stakeholders of the importance of recognizing and managing potential concussions. It creates awareness that a concussion is truly a brain injury that comes in many ways and stays with the individual. Before Rowan’s Law, many people did not realize that if they sustained a concussion from school sport, a car accident or other activities that they needed to report to their hockey team and ensure Return-to-Play Protocols were in place. This is one of the most powerful and effective safety and risk management initiatives we have seen in over 50 years of girls’ and women’s hockey in Ontario. We thank Rowan and her family for their positive impact on people.

Fran Rider President, Ontario Women’s Hockey Association 

Athlete safety has always been a priority for ONPARA, and Rowan's Law has helped ensure that concussion education and awareness remain an important part of our programs. It has provided a clear, consistent framework that supports athletes, coaches, officials, volunteers, and families in recognizing and appropriately responding to concussions. This is especially important in parasport, where education and clear protocols help ensure that athletes can participate with confidence in a safe and supportive environment. While there is always more work to do, Rowan's Law has played an important role in strengthening the culture of safety in sport, and we appreciate the Province's continued commitment to protecting athletes at every level of participation.

Doug Hannum Executive Director, Ontario Para Network 

Coaches on the front line: changing the game

The Ministry’s ongoing commitment to coach education and concussion management continues to strengthen safe sport across Ontario. As best practices and research evolve, it is vital that coaches have access to current, evidence-informed training and resources. By equipping coaches and designated persons with the knowledge and tools to confidently implement return-to-play protocols, we are helping create safer experiences for athletes in every context. As Ontario’s hub for coaching resources and support, we are pleased to continue partnering in support of Rowan’s Law and the important role coaches play in fostering safe, positive sport environments.

Jeremy Cross Executive Director, Coaches Association of Ontario 

Having baseline concussion education is incredibly important for all young athletes. It helps you understand the injury, know when it's safe to return to sport, and follow the proper recovery protocols. After my first concussion, I fell backwards in my sport chair and hit my head. Because of the education and protocols in place through Rowan's Law, I knew the right steps to take. Without that knowledge, it would have been much harder to manage my recovery properly.

Kady Dandeneau Athlete, Wheelchair Canada Basketball 

Rowan's Law has helped change the way we think about concussions in rugby. It's made it easier to speak up, look out for each other, and put our health first. Rowan’s Law is known not just in Ontario but across Canada, making a real difference for athletes. We want to play our game as safely as possible without long-term consequences, and Rowan’s law has made huge progress towards that goal.

Taylor McKnight Rugby World Cup Silver Medalist 

Researchers and experts: a shared responsibility

When I began chairing the Rowan's Law Advisory Committee, we were driven by a single, painful truth: Rowan Stringer's death was preventable. That knowledge shaped everything that followed — legislation; concussion awareness resources; codes of conduct; removal-from-sport and return-to-sport protocols now embedded in schools and sport organizations across Ontario. Leading the Working Group gave me the privilege of watching legislation become practice: coaches asking the right questions after a hit, parents recognizing the warning signs, athletes feeling safe to say 'something's wrong.' Rowan's Law didn't just change policy — it changed culture. Every September, on Rowan's Law Day, I'm reminded that this work is really about one family's courage turning grief into protection for thousands of young athletes. I'm deeply proud of what Ontario has built, not because the job is finished, but because we've proven that a province can put athlete safety ahead of the game. My hope is that this progress keeps pushing outward — into every locker room, every rink, every field — until concussion safety is simply how sport is done, not just in Ontario, but across the country

Dr. Dan Cass Executive Vice-President and Chief Medical Executive, Sunnybrook Health Sciences Centre 

Rowan’s Law has raised the profile of concussion safety like nothing else I have seen or been a part of in my career to date. Beyond the direct increase in awareness and development of concussion prevention/management policies, it has positioned Ontario (and Canada) as an international leader in this field and has helped put concussion on the radar of major research funding bodies and academic organizations. Rowan’s Law continues to positively impact a wide range of stakeholders in healthcare, sports communities and society more broadly, and I am very grateful for the much-needed spotlight it has placed on concussion and traumatic brain injury.

Dr. Matthew Burke Cognitive Neurologist and Medical Director of Sunnybrook Health Sciences Centre's Traumatic Brain Injury Recovery Program 

Rowan’s Law has made Ontario a leader in concussion safety by creating clearer expectations across sport, schools, and community settings. Its impact is seen not only in stronger awareness of concussion prevention, but also in the practical systems now in place to support safe removal, return to school, and return to physical activity.

For Ophea, Rowan’s Law represents what is possible when legislation, education, and practical implementation come together. In schools, it has helped reinforce the importance of clear protocols, consistent safety standards, and practical resources that support educators and school boards in helping students participate safely in physical activity and school sport.

Ontario’s leadership continues to influence practice beyond the province. Through Ophea’s work with partners in Ontario and jurisdictions that draw on the Ontario Physical Activity Safety Standards in Education, Rowan’s Law has helped reinforce the value of consistent, practical approaches to concussion safety across Canada.

The next phase is about sustaining this progress. Continued attention to implementation, visibility, student voice, and emerging needs will help ensure Rowan’s Law remains active in practice, not just in policy. Ophea is proud to have contributed to this work and remains committed to advancing concussion safety for students and athletes across Ontario.

Chris Markham Executive Director & CEO, Ophea 

Parachute Leaders in Injury Prevention has been part of the journey to Rowan’s Law from its inception, honouring the memory of Rowan Stringer and her family. The strength and commitment of Gordon and Kathleen Stringer, the collaboration across government departments of health, sport and education, and the inclusion of concussion, sport and coaching experts, as well as nonprofits and charities with expertise in injury prevention and school safety over the past six years has moved the needle toward making a positive impact on concussion safety for athletes across Ontario. There have been significant positive changes to grow the awareness of the preventability, recognition, and management of concussion using the 21 recommendations of the Rowan’s Law Advisory Committee to guide these efforts. Fostering a culture of safety takes time and requires a commitment to sustained resources and attention to ensure the progress continues. We look forward to being part of these efforts so athletes in Ontario live long lives to the fullest.

Pamela Fuselli President & CEO, Parachute 

The Ministry was given the responsibility for activating recommendations from the Rowan Stringer coroner’s inquest. I had recommended the inquest to Rowan’s parents and attended the inquest as a special adviser. The jury made 49 recommendations to prevent what happened to Rowan which was death from Second Impact Syndrome due to previously unrecognized concussions. It is prevented by preventing the second impact which causes major brain swelling which can almost never be successfully treated by neurosurgeons like me. The only “treatment” is to prevent the second concussion, which is almost always in sports. The Ministry of Sport shouldered the major responsibility but was assisted in carrying out the jury’s 49 recommendations. The Ontario Ministry of Sport aided by the Education and Health Ministries accepted the responsibility of preventing this syndrome from happening again to a youngster playing sports. From my vantage point as a member of the Minister’s Committee, I commend the Ministry for its excellent work to educate students and school staff about prevention of concussions. Indeed, over the years since Rowan’s death they have educated everyone involved with student sports including university level athletes, high school and elementary school students and their parents, teachers, coaches, trainers, and referees, and school boards about recognition and prevention of concussions. My daughter is a TDSB elementary school teacher, and was my on-site investigator reporting to me about the messages about Rowan Stringer’s picture hanging in the hall of every school in which she taught as an occasional teacher.

Charles H. Tator OC, PHD, MD FRCSC Professor of Neurosurgery, University of Toronto, 
Division of Neurosurgery, Toronto Western Hospital,
Founder, ThinkFirst Canada and Parachute Canada; Director, Canadian Concussion Centre 

Ontario’s concussion safety journey

Year by year

2013

Rowan Stringer’s death

On May 12, 2013, Rowan Stringer tragically died as a result of what are believed to be at least two undiagnosed concussions sustained while playing rugby, leading to Second Impact Syndrome.

2014

Policy change for school boards

In March 2014, Ontario’s Ministry of Education releases Policy/Program Memorandum 158: School Board Policies on Concussions.

2015

Coroner’s inquest

In June 2015, the Office of the Chief Coroner releases its Verdict of the Coroner’s Jury regarding the death of Rowan Stringer, which includes 49 recommendations made to the federal government and Ontario ministries, school boards and sport organizations.

2016

Establishing the Advisory Committee

In September 2016, the Rowan’s Law Advisory Committee is established following the proclamation of the Rowan’s Law Advisory Committee Act, 2016 to provide advice to the Government of Ontario on how to implement the jury’s recommendations.

2017

Final Report of the Advisory Committee and passing Bill 193

In September 2017, the Rowan’s Law Advisory Committee releases its report, including 21 legislative and non-legislative recommendations for government action to improve concussion safety in amateur competitive sport.

In December 2017, the Government of Ontario introduces Bill 193, Rowan’s Law (Concussion Safety), 2017 and seeks public feedback for 45 days through the Ontario Regulatory Registry. With the completion of its mandate, the Rowan’s Law Advisory Committee is dissolved.

March 2018 to September 2019

Year one of recommendations implementation

  • Phase 1 Sections of the Act and Regulation came into force: (Recommendation #1)

    In March 2018, Rowan’s Law (Concussion Safety), 2018 is passed and receives Royal Assent with unanimous support. Section 5 of the Act is proclaimed immediately to make Rowan’s Law Day the last Wednesday of each September. A consultation paper seeking feedback on the general nature of potential regulations under Rowan’s Law (Concussion Safety), 2018 is posted on Ontario Regulatory Registry.

    On July 1, 2019, the first phase of Rowan’s Law came into force, establishing requirements related to concussion awareness and prevention. The legislation requires sport organizations to implement a Concussion Code of Conduct and to obtain annual confirmation, prior to registration, that athletes under 26 or their parents or guardians, coaches, and team trainers review approved Concussion Awareness Resources and the sport organization’s Concussion Code of Conduct. Officials are required to confirm review of Concussion Awareness Resources only, while postsecondary athletes of all ages are required to confirm review of both the resources and their institution’s Concussion Code of Conduct.

    Amendments to the Education Act, also proclaimed on July 1, 2019, authorize the Minister of Education to require publicly funded school boards, school authorities, and provincial and demonstration schools to implement and comply with concussion policies and guidelines aligned with Rowan’s Law (Concussion Safety), 2018.

    The amendments also empower the Minister to make regulations, consistent with Rowan’s Law, and to support alignment of concussion policies across education settings including private, First Nations–operated, and federally operated schools, where applicable.

  • Evaluation of Policy Program Memorandum (PPM) 158 in schools (Recommendation #4)

    Since 2015, Ontario school boards implemented concussion safety requirements under Policy/Program Memorandum (PPM) 158. Following Education Act amendments and consultations, the Ministry of Education updated and re-issued PPM 158 as a mandatory policy aligned with Rowan’s Law for the 2019–20 school year. To support implementation, the ministry provided guidance and commissioned research to assess policy application and impacts on concussion-related health care visits, using the findings received in summer 2019 to inform implementation efforts.

  • Codes of Conduct (Recommendation #5)

    Under Rowan’s Law, sport organizations established Concussion Codes of Conduct that set clear expectations for participant behaviour and met regulatory requirements. Organizations ensured that athletes, parents or guardians of minors, coaches, and team trainers reviewed and acknowledged the code before registration. To support implementation, the Government of Ontario collaborated with Parachute Canada to develop and publish a standardized Concussion Code of Conduct template for use or adaptation by sport organizations.

  • Annual concussion training for coaches (Recommendation #8)

    Ontario collaborated with the Coaches Association of Ontario, the Ontario Physical and Health Education Association (Ophea), and other partners to educate coaches on Rowan’s Law and promote enhanced concussion training. Coaches are encouraged to complete the National Coaching Certification Program’s Making Head Way module in addition to the mandatory annual review of approved Concussion Awareness Resources required under Rowan’s Law. Since September 2018, thousands of Ontario coaches have completed the free, evidence-based e‑learning module, which provides comprehensive training aligned with current concussion guidelines.

  • Coach’s tool kit (Recommendation #11)

    A Coach’s Concussion Toolkit Working Group was established to help ensure coaches have timely access to practical concussion resources. Comprised of representatives from the sport and education sectors and partner ministries, the working group developed an electronic toolkit that promoted consistent concussion protocols across sport settings. The toolkit supports prevention, identification, and response to suspected concussions and is aligned with the Canadian Guidelines on Concussion in Sport. In 2023, the Ministry of Sport provided the Coaches Association of Ontario with $50,000 in funding to enhance the Toolkit with additional interactive videos outlining the duties of a ‘designated person’ and how to implement the Removal-from-Sport and Return-to-Sport protocols.

  • Teacher candidate exposure to concussion awareness (Recommendation #12)

    Beginning in the 2018–19 school year, the Ministry of Education includes concussion-related content in workshops delivered as part of the Professional Development Program for Teacher Candidates. The Professional Development Program for Teacher Candidates is offered to teacher candidates across all faculties of education in Ontario and provides tools and resources to inform future teachers about changes in the curriculum and ministry priorities.

  • Concussion website (Recommendation #13)

    On May 13, 2019, the Government of Ontario launched the Rowan’s Law branded Concussion webpage portal to increase public awareness and provide centralized access to concussion-related information. The webpages share Rowan Stringer’s story and serve as a repository for approved concussion awareness resources, a sample Concussion Codes of Conduct, and additional tools supporting concussion prevention, identification, and management. The webpages are a regularly updated resource to support ongoing concussion prevention efforts in Ontario.

  • Sustained marketing and awareness campaign (Recommendation #14)

    Beginning in Spring of 2019, Ontario ran a sustained marketing campaign to promote concussion safety in sport with the tagline “Hit. Stop. Sit.” which included video advertisements shown on television and in movie theatres, concussion awareness posters distributed to schools and sports facilities, and branded promotional items like hats and stickers.

  • Annual concussion awareness education event in schools (in PPM 158) (Recommendation #16)

    Policy/Program Memorandum 158 directs school boards to make available approved Concussion Awareness Resources to students, parents, employees, and volunteers to strengthen concussion awareness. School boards should also implement plans for annual concussion awareness events for students to be held on or around Rowan’s Law Day.

  • Established mandatory concussion education for relevant school staff (in PPM 158) (Recommendation #17)

    Policy/Program Memorandum 158 directs school boards to require annual concussion training for relevant school staff. A concussion e‑learning module for educators, administrators, and support staff has been developed to strengthen concussion safety in schools. The module provides practical strategies and resources to support concussion prevention, identification, and management across school settings.

  • Creation of Concussion Partners Committee (Concussion Working Group) (Recommendation #21)

    In February 2019, the Government of Ontario established the Rowan’s Law Concussion Working Group to coordinate oversight and support implementation of the Rowan’s Law initiative. Comprised largely of former Advisory Committee members with expertise in concussion prevention and best practices, the Working Group met until April 2026 to review draft regulations, Concussion Awareness Resources, promotion activities, and overall progress on implementation.

September 2019 to September 2020

Year two of recommendations implementation

  • Updated PPM 158 for School Boards (tied to amendments made to the Education Act as part of Recommendation #1)

    On September 25, 2019, the Ministry of Education released an updated Policy/Program Memorandum (PPM) 158 on concussion safety for school boards, school authorities, and provincial and demonstration schools. The updated policy reflected legislative changes since 2014 and aligned with Rowan’s Law, establishing consistent concussion safety requirements across Ontario’s sport and education sectors.

  • Developed concussion education modules for students for delivery in schools (Recommendation #15)

    The Health and Physical Education curriculum, Grades 1–8, has been updated to include mandatory learning about concussions in every grade. The 2019 Addendum to The Kindergarten Program was also issued for the 2019–20 school year and includes learning on concussions through an update to the specific expectation 24.1. The Ministry of Education also developed concussion learning modules for students in elementary and secondary schools to support student learning connected to the Health and Physical Education curriculum. The learning modules are accompanied by an educator guide to support concussion education.

September 2020 to September 2022

Year three of recommendations implementation (Extended due to COVID-19 pandemic)

  • January 1, 2022: Remaining sections of the Act and Regulation pertaining to removal-from-sport and return-to-sport came into force (Recommendation #1)

    Phase two of Rowan’s Law came into effect on January 1, 2022, following multiple deferrals in response to the COVID-19 pandemic. Phase two implementation requires sport organizations to have removal-from-sport and return-to-sport protocols in place for their athletes. These protocols require sport organizations to ensure that an athlete is immediately removed from sport if they are suspected of having a concussion and that they get medical clearance from a physician or nurse practitioner before they can return to training, practice or competition.

  • Field of Play Inspection Guidelines for sport organizations (Recommendation #6)

    Field of play inspection guidelines have been developed to help sport organizations identify and address unsafe playing environments. The guidelines supported Provincial and Multi‑Sport Organizations in creating sport‑specific inspection protocols that accounted for indoor and outdoor settings, facility types and specialized equipment to improve participant safety.

  • Concussion spotter tool for higher risk sports (Recommendation #7)

    While not required under Rowan’s Law, a “concussion spotter” is described in Ontario government guidance as a person responsible for observing participants during play and flagging potential head injuries to the designated individual identified by a sport organization under the Act. For higher risk sports, sport organizations are encouraged to have a concussion spotter present at games and practices to support the identification of suspected concussions. To support implementation, the Government of Ontario has developed a Concussion Spotter Tool outlining criteria and training considerations for establishing the role.

  • Confirmed existing codes should be used when submitting claims to Ontario Health Insurance Plan (OHIP) (Recommendation #10)

    Through the information sheet distributed to health care providers and published on the government’s Concussion Safety webpages, the Ministry of Health has highlighted the requirement to use OHIP diagnostic code 850 when submitting concussion related claims.

  • Enhanced professional development for health care professionals (Recommendation #18)

    To support health care provider professional development, the Ministry of Health has developed and distributed an information sheet outlining Rowan’s Law requirements that came into effect on January 1, 2022, and their implications for clinical practice. The resource clarified that an athlete must undergo a medical assessment by a physician or nurse practitioner and be medically cleared by a physician or nurse practitioner before returning to unrestricted sport, identified the applicable OHIP diagnostic code, and shared supporting assessment resources. The ministry has disseminated the information to relevant stakeholders and has published it on the government’s Concussion Safety webpages.

September 2022 to September 2025

Years four, five and six of recommendations implementation

  • Ministry of Health to collate and share concussion incidence data annually (Recommendation #2)

    The Ministry of Health, in partnership with Public Health Ontario (PHO), delivered the first annual report in fall 2025 to analyze administrative health data to support the development of a public report on concussion incidence in Ontario. This initiative aims to collate and share concussion incidence data annually, providing valuable insights into the prevalence and impact of concussions across the province.

  • Amateur sport delivery partners should collect and report concussion incidence data (Recommendation #3) and investment in electronic data collection/sharing tool about incidents at field of play (Recommendation #9)

    The Ministry of Sport has invested $84,300 in a pilot project with four provincial sport organizations to collect data on suspected concussions occurring during sport activities. The pilot gathered information on athlete demographics, the type of activity and movement involved, confirmed concussion cases, and the time between diagnosis and return-to-sport clearance. The initiative helped to support improved understanding of sport-related concussion incidence in Ontario, assess the impact of Rowan’s Law, and inform future concussion safety policies and procedures.

Ongoing recommendations implementation

  • Sustained concussion awareness promotion (Recommendation #14)

    Building on the successful marketing and awareness campaign launched in 2019, the Government of Ontario continues to promote concussion safety under the Rowan’s Law “Hit. Stop. Sit.” branding and actively seeks new ways to reach the next generation of athletes in Ontario, including approaches such as printed and digital materials, school visits, social media campaigns and targeted brand promotion at sports events.

  • Work with Federal-Provincial/Territorial partners towards achieving a national harmonized approach to concussions in school/non-school environments (Recommendation #19)

    At each annual Federal-Provincial/Territorial Minister’s Conference attended by the minister from each federal, provincial and territorial government responsible for sport, physical activity and recreation, Ontario’s Minister of Sport speaks to the importance of concussion safety and the need for a national harmonized approach drawing from the lessons learned delivering Rowan’s Law in Ontario. In addition, Ontario’s Minister of Sport continues to seek opportunities to engage one-on-one with counterparts from across Canada to offer Ontario’s support in improving concussion safety for athletes no matter where they practice, train, or compete.

  • Work with First Nations leaders to support goals of increased safe participation in amateur sport and concussion management (Recommendation #20)

    The Ministry of Sport continues to engage with Indigenous Sport & Wellness Ontario, the designated Provincial/Territorial Indigenous Sport Body for Ontario, to support culturally relevant dissemination of information on Rowan’s Law and concussion safety in sport. The government has also pursued opportunities to collaborate with Indigenous health care services and education organizations to raise awareness and promote concussion safety within Indigenous communities.

Year eight achievement highlights

Delivery from September 2025 to September 2026

Second annual concussion report

In March 2026, the Ministry of Health, in partnership with Public Health Ontario (PHO), released the 2026 Enhanced Epidemiological Summary on Concussion Incidence in Ontario: 2023-2024. The report builds on the 2025 edition of the public report on concussion incidence by adding 2023-2024 data and providing more detailed analysis, including Public Health Unit-level breakdowns and a summary of evidence on sport-related concussion prevention interventions. The Ministry will continue collaborating with PHO to strengthen concussion surveillance and reporting. Work is also underway on a new public-facing product for 2026 that will translate the latest provincial data into an accessible format, building on last year’s infographic. These initiatives support ongoing knowledge sharing and provide a strong foundation to advance concussion prevention policies and practices across Ontario.

Updates to the information for health care providers web portal

The Ministry of Health has made updates to the Information for health care providers content and resources housed on Ontario’s Rowan’s Law-branded concussion webpages. This refreshed content aligns with the most up-to-date expert guidance on concussion prevention, identification, treatment, and management, including new research, tools, and guides to support health care providers in treating concussions.

Resources to support concussion safety in schools

With support from the Ministry of Education, the Ontario Physical and Health Education Association (Ophea) updated and maintained the concussion protocol and safety resources to support concussion awareness, prevention, detection and management in Ontario schools This included an e-learning module on concussion safety for school staff and the Rowan’s Law Day school toolkit to support concussion awareness and knowledge building for the school community. The resources are made available and promoted to all schools, including private schools, First Nations schools and federally-operated schools.

National and international concussion safety advocacy

Bilateral engagement with the Dominican Republic

In March 2026, the Minister of Sport met with representatives of the Dominican Republic to share Ontario’s experience in delivering Rowan’s Law, and to strongly encourage the Dominican Republic to adopt a similar legislative approach for its own athletes by drawing on best practices and tools developed in Ontario. The Minister has provided an open offer for collaboration with the Dominican Republic through knowledge exchange, technical assistance, and shared leadership.

International concussion safety engagement

On May 26, 2026, Ontario hosted a one-time, virtual concussion safety engagement led by the Minister of Sport with countries participating in the FIFA World Cup 2026™ invited to participate.

The engagement was attended by international government representatives responsible for sport safety in their jurisdictions and included details on the delivery of Rowan’s Law (Concussion Safety), 2018 and Ontario's broader concussion safety approach to offer insights to participating countries on legislative approaches to improving concussion safety.

The engagement also created a forum for information sharing among participating jurisdictions on their own concussion safety approaches and helped to provide practical implementation strategies.

The engagement concluded with an open offer for further engagement with Ontario for any jurisdiction that may wish to learn more and collaborate on concussion safety delivery.

Following the engagement, the ministry also provided follow-up information on Rowan’s Law with all 48 nations participating in the FIFA World Cup as a take-away resource on what Ontario has learned through delivering this legislation and to offer insights on implementation strategies to improve concussion safety in sport.

May 2026 Minister’s conference in Toronto

The Minister of Sport took the opportunity to engage counterparts from across Canada in conversation on the importance of a national harmonized concussion safety approach during the May 20-21 Federal-Provincial/Territorial Minister’s Conference and offered Ontario’s support in delivering on legislative approaches towards improving concussion safety with Rowan’s Law as a leading model.

The Minister’s Conference is attended by the minister from each provincial and territorial government responsible for sport, physical activity and recreation, the Minister responsible for sport from Canadian Heritage, and the Minister responsible for physical activity from the Public Health Agency of Canada.

Rowan’s Law at FIFA World Cup 2026™

In partnership with Destination Ontario, the Ministry of Sport showcased Ontario’s sport and recreation system with a creative fan experience offered as part of the FIFA Fan Festival™ in Toronto during the FIFA World Cup 2026™ from June 11 to July 19, 2026. Rowan’s Law messaging appeared as part of a feature wall on getting children into sport and included logos and branding, seen by up to 20,000 visitors daily over the course of the tournament.

Reaching the next generation of amateur athletes – concussion school tour

Planning is underway to support tours to schools across Ontario to connect with the next generation of athletes and raise concussion awareness among children and youth. The tours will include recognizable Concussion Ambassadors who will share personal, lived experience with concussions in sport, as well as local education and Public Health Unit representatives from each community. Through these school tours, the ministry will build awareness of the importance of concussion safety and reinforce Rowan’s legacy by sharing her story with the next generation of young athletes across the province.

Commemorating Rowan’s Law Day 2026 across Ontario

Since 2018, significant progress has been made in raising awareness and educating youth and young adults about concussion safety across Ontario. Rowan’s Law Day, observed annually on the last Wednesday in September, continues to serve as a key provincial moment to reinforce the importance of concussion prevention and response.

This year, Rowan’s Law Day falls on September 30, 2026. As part of Rowan’s Law Day, Ontario amplified the visibility of Rowan’s Law and the importance of concussion safety through broad distribution of our digital toolkit, featuring email signatures, hashtags, virtual meeting backgrounds, and posters with the “Hit. Stop. Sit.” logo. In 2025, engagement with concussion safety content across major social media platforms through boosted posts saw webpage traffic to Ontario’s main concussion portal increase by 20 per cent and visits to Ontario’s Concussion Safety Resources increase by 23 per cent between October and December 2025 compared to the same period in 2024. Each year, Ontario will continue to widely distribute its digital toolkit to drive engagement with the core message of Rowan’s Law: knowing the signs and symptoms of a concussion and what to do when one is suspected can save lives.

Community-based engagement remains strong, with schools, hospitals, and sport organizations hosting events to promote concussion awareness throughout the province. In recognition of Rowan Stringer’s legacy, prominent landmarks including the CN Tower, Niagara Falls, the Big Nickel, and city signs in Toronto and Ottawa were illuminated in purple, her favourite colour.

Rowan’s Law continues to demonstrate the importance of concussion awareness both on and off the field, emphasizing that timely recognition and response can save lives. Ongoing public education, community participation, and advocacy remain central to sustaining Rowan’s legacy and strengthening concussion awareness, prevention, treatment, and management across Ontario’s amateur sport system.

One day of awareness is not enough. There are many ways to get involved throughout the year to advance the message of concussion safety:

Learn more:

Access Rowan’s Law and concussion safety educational resources and share this information with friends, family, and colleagues.

Act locally:

Take part in concussion awareness initiatives by attending, organizing or volunteering at events led by schools, hospitals, and sport organizations.

Be a champion:

Encourage your local sports teams and organizations to prioritize concussion safety and implement best practices.

Share broadly:

Use our digital toolkit to support concussion awareness by sharing content on social media using dedicated hashtags and updating your digital profiles with virtual meeting backgrounds and posters featuring the “Hit. Stop. Sit.” logo.

Carrying forward Rowan’s legacy

Sustaining delivery momentum

Ontario has now implemented, or substantively implemented, all 21 recommendations put forward by the Rowan’s Law Advisory Committee, with annual public reporting supporting transparency and accountability. With this success, it is now the time for a refreshed, strategic approach that supports embedding concussion safety as a foundational element of broader safety in sport priorities, ensuring sustained momentum.

This transition will reinforce Ontario’s leadership through a future-focused legislated framework that strengthens athlete protection and safety culture across all levels of sport.

How we engage:

This strategic shift requires a new way of seeking expert guidance and advice on how to further advance concussion safety priorities. With the original recommendations of the Rowan’s Law Advisory Committee now completed, the Rowan’s Law Concussion Working Group has fulfilled its mandate. In its place, Ontario will begin convening smaller, focused working groups on key concussion safety priorities as the need arises to bring together the right experts at the right time to effect change and drive progress. This flexible model will support ongoing sector engagement on concussion safety and broader safe sport priorities.

How we promote:

In addition to annual events around Rowan’s Law Day each September, Ontario will also be putting in place new ways to embed concussion safety awareness and promotion throughout the year by leveraging its investments in high-profile sport events, major single sport tournaments, and infrastructure. Ontario will be seeking to require visible Rowan’s Law branding and promotion opportunities as a condition of funding. This includes major events like the Summer and Winter Ontario Games held every two years with more than 5000 attendees each, major single sport tournaments, and targeted one-time major sport events like the Honda Indy and RBC Canadian Tennis Championship. Ontario will also build-in promotion of Rowan’s Law for funded sport and recreation capital projects under the province’s Community Sport and Recreation Infrastructure Fund. Ontario will also work collaboratively with Provincial and Multi-Sport Organizations to deliver similar branding and promotion at provincial championships.

How we inform:

With the completion of the 21 original recommendations and the release of this Minister’s Final Progress Report, Ontario will continue to demonstrate transparency and accountability on concussion safety with a new way of communicating progress. Beginning in 2027, the Minister of Sport will circulate an annual memo around Rowan’s Law Day with details on concussion safety initiatives delivered over the prior year to sustain awareness and momentum. This memo will ensure that key stakeholders remain informed of Ontario’s concussion safety progress and commitment to changing the culture of sport.

How we advocate:

One thing that will not change is Ontario’s continued advocacy towards encouraging all provinces and territories across Canada to adopt legislation aligned with Rowan’s Law to support a consistent, national approach to concussion safety. A harmonized framework would help ensure that more consistent levels of protection, education and care for young athletes while support access to accurate and consistent guidance, regardless of where they practice, train, or compete. Ontario will also continue to share the lessons learned delivering Rowan’s Law with international jurisdictions through opportunities created by major sport events like the FIFA World Cup 2026™ to encourage a similar legislative approach be taken around the world.

How we honour Rowan:

Together, we must honour Rowan’s legacy not only through remembrance, but through continued commitment and action. With this strategic refresh, and by working as one across communities and jurisdictions, we can transform her story into meaningful, lasting change. With a shared purpose, we have the collective opportunity to strengthen a culture of safety and continue to work to help ensure that sport is safer, more informed, and more supportive for all amateur athletes.

Rowan’s Law Concussion Working Group

A commitment to advancing athlete concussion safety

The Rowan’s Law Concussion Working Group served for seven years as a dedicated group of experienced, expert and passionate advisors to the Government of Ontario to guide the implementation of the recommendations made by the Rowan’s Law Advisory Committee in their Final Report.

Ontario’s progress to date towards changing the culture of sport and improving athlete concussion safety would not have been possible without the contributions of each of the members of the Rowan’s Law Concussion Working Group. The Government of Ontario extends its sincere thanks to all of the current and former members of the Working Group for their many contributions over these last several years. The foundation put in place through these contributions will cement Rowan Stringer’s legacy in the culture of sport and stand to further advance concussion safety in the years to come.

Members

  • Dr. Dan Cass: Executive Vice-President and Chief Medical Executive, Sunnybrook Health Sciences Centre (Chair)
  • Dr. Allison Chris: Associate Medical Officer of Health, Toronto Public Health
  • Pamela Fuselli: President and CEO of Parachute, a national charity dedicated to preventing injuries
  • Warren Hoshizaki: Director of Education, District School Board of Niagara
  • Paul Hunter: CEO, Wheelchair Rugby Canada
  • Susan Kitchen: Former Executive Director, Coaches Association of Ontario
  • Jennifer Knox: School Principal, Peterborough, Clarington, and Northumberland Centre for Individual Studies
  • Drew Laskoski: Former President, Ontario Athletic Therapist Association
  • Eric Lindros: Retired NHL hockey player, member of the Hockey Hall of Fame, and advocate for concussion research, care, and awareness
  • Chris Markham: Executive Director and CEO, Ophea
  • Fran Rider: President and CEO of the Ontario Women’s Hockey Association
  • Gordon Stringer: Rowan Stringer’s father
  • Dr. Charles Tator: Leading educator and researcher dedicated to neurosurgery and the study of injury prevention and recovery from concussions
  • Elisabeth White: Nurse Practitioner, Neurosurgery Outreach, The Hospital for Sick Children, with a role in educating the public on traumatic brain injury

Former members

  • Todd Anderson: Mixed Martial Arts (MMA) referee and police sergeant with the Regional Municipality of Niagara
  • Kent Bassett-Spiers: CEO, Ontario Neurotrauma Foundation
  • Louise Logan: Former President and CEO of Parachute, a national charity dedicated to preventing injuries
  • Dr. Rosana Salvaterra: Former Medical Officer of Health, Peterborough Public Health