Minister’s Year Seven Progress Report on Rowan’s Law (Concussion Safety), 2018

Minister’s message

Ontario remains a leader in concussion safety in our country, and I am pleased to present the seventh annual Minister’s Progress Report on Rowan’s Law (Concussion Safety), 2018.

Rowan’s Law was born out of tragedy, but it has become a driving force for changing the way we look at concussions in the sport sector. It is a testament to the power of advocacy and the importance of prioritizing health and safety in sports, rather than winning at any cost. This report highlights the progress we have made in concussion awareness, prevention, and management, and outlines our ongoing efforts for improvement, particularly in research.

I am deeply committed to this cause, not only as the Minister of Sport, but also as an individual who understands the profound impact of concussions. As a personal contribution to concussion research, I have pledged to donate my brain to the Canadian Concussion Centre supported by the Concussion Legacy Foundation Canada (CLFC) to help advance research on brain injuries. I was fortunate to have had a long career in sports, playing football at the university and professional levels. While I avoided any long-term effects from concussions, many of my teammates have not been as lucky. I want to help find out why, so that we can deepen our understanding of brain injuries and find better ways to protect future generations of athletes.

I would like to extend my sincere thanks to the Rowan’s Law Concussion Working Group for their invaluable contributions, expertise, and dedication to guiding the implementation of the Rowan’s Law Concussion Advisory Committee recommendations. I continue to advocate to my federal, provincial, and territorial counterparts to look at the work that has been done through this group and urge them to look to Ontario as an example of what they can achieve for athletes across our country. Ontario remains ready and willing to help carry this legislation across Canada.

I applaud the leadership of Parachute Canada for convening the National Concussion Summit in Toronto during National Concussion Awareness Week (September 22–28, 2024). This important event brought together key stakeholders from the health and education sectors across Canada, and served as a forum for collaboration, knowledge-sharing, and the advancement of evidence-based strategies to improve concussion safety across the country.

Together, we will continue to build a safer environment for all athletes, ensuring that their passion for sports does not come at the cost of their health. I encourage everyone to read this report and join us in our mission to make sports safer for everyone.

The Honourable Neil Lumsden
Minister of Sport

Rowan’s Law background

Leading the charge for concussion safety in Canada

Rowan’s Law (Concussion Safety), 2018 (“Rowan’s Law,” “the Act”)

Rowan’s Law is groundbreaking legislation; the first and only of its kind in Canada. It was enacted following the tragic death of Rowan Stringer, a teenage rugby player from Ottawa, who succumbed to second impact syndrome in 2013. This condition involves severe brain swelling caused by a subsequent injury occurring before a previous concussion has fully healed. While playing the sport she loved — rugby — Rowan experienced three head injuries within six days, unaware of the severity of her condition.

Rowan’s online search history revealed that before she passed, she was trying to research the symptoms of a concussion. This highlights the importance of having current and accessible information at the fingertips of all Ontarians. Ontario’s concussion webpages include a wealth of information including educational resources made for various age groups in multiple languages.

The goal of Rowan’s Law is to increase concussion awareness reducing the risk of concussions and changing the conversation. The Act and its regulation establish mandatory requirements for the annual review of concussion awareness resources by athletes, parents/guardians of athletes under 18 years of age, coaches, team trainers, and officials before registering or serving within a sport organization. Rowan’s Law has improved sports safety in Ontario by helping individuals recognize signs of a concussion and reducing the pressure to play after a head injury.

Each year, in memory of Rowan, Ontario commemorates Rowan’s Law Day on the last Wednesday in September. This day is dedicated to raising awareness about concussions in sports. Since its inception, Rowan’s Law has significantly transformed the culture of sport and sport safety in Ontario.

The dedication and collective efforts of those involved in this impactful legislation — Rowan Stringer’s family, the sport organizations, the Rowan’s Law Advisory Committee, coaches, parents, schools — all ensure that Rowan’s legacy lives on through safer sports practices for future generations.

The Impact of Rowan’s Law

Impact in schools: empowering young minds

In May 2025, the Ministry of Sport spoke to students from the Don Mills School where Rowan’s Law and concussion safety were at the top of the discussion. The presentation highlighted the importance of brain safety, gave students practical tips on how to protect themselves from concussions and taught them how to manage a concussion if they ever experience one.

Accessible educational resources are essential in protecting young brains. By understanding the risks and signs of a concussion, children, youth and young adults can make informed decisions on and off the field. This early education helps start lifelong habits that contribute to their overall well-being and safety. At the session students were asked to draw or write about how Rowan’s Law helps keep brains safe and healthy. Some of this art is featured on the cover of this report. Here are a few additional images and passages from the students at Don Mills school.

Coaches on the front line: changing the game

The ongoing investment of the Ministry of Sport for coaches and concussion management is essential. With evolving topics like concussion, it is important to equip the front line of sport, our coaches, with the most up-to-date knowledge and skills to help keep participants safe. These enhanced resources will ensure coaches and designated persons continue to implement appropriate return to play protocols for their sport. As Ontario’s hub for coaching resources and support, we look forward to our continued work together to support Rowan’s Law and coaches as they lead the way in creating safer sporting environments.

Jeremy Cross, Executive Director, Coaches Association of Ontario

Researchers and experts: A shared responsibility

Thanks to ongoing research, we know more than ever about concussions. It is critically important that this growing knowledge translates into efforts to better protect the health and wellbeing of Ontarians, especially our children and youth. Rowan’s Law is a powerful vehicle to make this happen. Parachute is pleased to work with the Government of Ontario and partners to ensure concussion prevention, detection and management is guided by the most current evidence and best practice.

Pamela Fuselli, President and CEO at Parachute

Rowan Stringer and her family have transformed our approach to brain injuries in Canadian sport. The leadership of the Ontario government is ensuring that her legacy will live on through Rowan’s Law, Canada’s only concussion legislation. At Concussion Legacy Foundation Canada, we are proud to build on Rowan’s legacy by providing critical support services, advancing research, and empowering athletes and their families to prevent brain injuries before they occur. We are grateful for our ongoing partnership with the Ministry of Sport, which is creating a safer sports culture by prioritizing the brain health and long-term well-being of every Ontarian athlete.

Tim Fleiszer, Executive Director, Concussion Legacy Foundation Canada

Implementation of Rowan’s Law

Year one

September 2018 to September 2019

Eleven recommendations implemented:

• July 1, 2019: Sections of the Act and Regulation came into force:
  • mandatory education (such as concussion awareness resources)
  • codes of conduct
  • proclamation of annual Rowan’s Law Day (in force March 7, 2018)
  • minister’s progress reports (in force September 25, 2019)
  • Related amendments to the Education Act proclaimed (Recommendation #1)
• Evaluation of Policy Program Memorandum (PPM) 158 in schools (Recommendation #4)
• Codes of Conduct (Recommendation #5)
• Annual concussion training for coaches (Recommendation #8)
• Coach’s tool kit (Recommendation #11)
• Teacher candidate exposure to concussion awareness (Recommendation #12)
• Concussion website (Recommendation #13)
• Sustained marketing and awareness campaign (Recommendation #14)
• Annual concussion awareness education event in schools (in PPM 158) (Recommendation #16)
• Established mandatory concussion education for relevant school staff (in PPM 158) (Recommendation #17)
• Creation of Concussion Partners Committee (Concussion Working Group) (Recommendation #21)

Year two

September 2019 to September 2020

Two recommendations implemented:

• Updated PPM 158 for School Boards (tied to amendments made to the Education Act as part of Recommendation #1)
• Developed concussion education modules for students for delivery in schools (Recommendation #15)

Year three

September 2020 to September 2022 (Extended due to COVID-19 pandemic)

Five recommendations implemented:

• January 1, 2022: Remaining sections of the Act and Regulation pertaining to removal-from-sport and return-to-sport came into force (Recommendation #1)
• Field of Play Inspection Guidelines for sport organizations (Recommendation #6)
• Concussion spotter tool for higher risk sports (Recommendation #7)
• Confirmed existing codes should be used when submitting claims to Ontario Health Insurance Plan (OHIP) (Recommendation #10)
• Enhanced professional development for health care professionals (Recommendation #18)

Year four, five and six

September 2022 to September 2025

Three recommendations in progress:

• Ministry of Health to collate and share concussion incidence data annually (Recommendation #2)
• Amateur sport delivery partners should collect and report concussion incidence data (Recommendation #3)
• Investment in electronic data collection/sharing tool about incidents at field of play (Recommendation #9)

Ongoing

• Sustained concussion awareness promotion (Recommendation #14)
• Work with Federal-Provincial/Territorial partners towards achieving a national harmonized approach to concussions in school/non-school environments (Recommendation #19)
• Work with First Nations leaders to support goals of increased safe participation in amateur sport and concussion management (Recommendation #20)

Year six achievement highlights

Ontario leads national dialogue on concussions

In August of 2025, Minister Lumsden attended the Federal-Provincial-Territorial (FPT) Ministers’ Conference in Newfoundland, where Ontario had dedicated time on the agenda to present its progress on Rowan’s Law. This included updates on the implementation of the 21 recommendations and a call to action to all jurisdictions to prioritize concussion safety and implement legislation similar to Rowan’s Law.

Annual concussion report

The Ministry of Health (MOH) worked in partnership with Public Health Ontario (PHO) 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. A fulsome epidemiological report (PDF), published on PHO’s website, along with a concise summary of sport-related concussions will be available in fall 2025 and updated annually. These efforts are a starting point to help assess the extent of concussion incidents and inform future policies and practices to enhance concussion prevention.

Updates to the Health Care Providers Information Sheet

The Ministry of Health has made updates to the Health Care Providers Information Sheet.

Updates to this information sheet include:

• Aligned language with the latest Amsterdam Consensus Statement on Concussion in Sport.
• Medical tools, resources and links were updated to ensure they were current and aligned with national guidelines. The information sheet can be found online at Rowan’s Law: Information for health care providers.

Research on concussion incidence at the field of play

The Ministry of Sport implemented a pilot project with four Provincial Sport Organizations (PSOs) from April 1, 2024, to March 31, 2025. The goal of this pilot was to collect specified concussion-incidence data at the field of play. This project aimed to test the usefulness of collecting data at the field of play, identify trends and assess the impact of concussion safety measures put in place through Rowan’s Law (Concussion Safety), 2018.

The Province of Ontario will leverage the insights gained from this pilot to inform our future strategies for ongoing data surveillance and concussion safety measures.

Funding for enhanced concussion awareness

In May of 2024, Ontario provided $163,000 in funding to Parachute to update the Government of Ontario’s concussion awareness resources to align with the latest Amsterdam Consensus Statement on Concussion in Sport, Canadian Guideline on Concussion in Sport and Canada’s Living Guideline for Pediatric Concussion. This makes sure the information is current, evidence-based and effective in promoting concussion safety.

The Amsterdam Consensus Statement on Concussion in Sport, developed during the 6^th International Conference on Concussion in Sport held in Amsterdam and published in 2023, presents the most current scientific understanding of sport-related concussion based on systematic reviews and expert consensus, ensuring that they reflect the latest evidence and best practices in the field. The Canadian Guideline on Concussion in Sport provides recommendations covering concussion prevention, detection and management for athletes of all levels, from grassroots to high performance, and across all ages, including children, adolescents, and adults.

The following resources are available at Ontario.ca/ConcussionResources:

Updated Guidelines:

• Based on the Amsterdam Consensus Statement on Concussion in Sport (2022).
• Recommendations are evidence-based, covering all age groups and levels of sport participation.

Multilingual E-Booklets:

• Age-appropriate concussion education. Available in English, French and 17 additional languages:
  • ages 10 and under
  • ages 11-14
  • ages 15 and up
  • students and athletes of all abilities

Educational Videos:

• Focus on concussion prevention, detection and management.
  • Ages 10 and under
  • Ages 11–14 years
  • Individuals 15 and up

Interactive E-Module:

• Updated for teens and adults.
• Designed to enhance engagement and retention of concussion safety information.

Removal and Return-to-Sport Protocol Templates

• Offer clear, step-by-step guidance for safe removal and return after a concussion.
• Require medical clearance from a physician or nurse practitioner before resuming unrestricted participation in training, practice or competition.
• Ensure athletes, parents/guardians, coaches, and designated personnel are informed and involved.

Resources to better support coaches on the front line

In 2024, The Ministry of Sport provided $45,100 in funding to the Coaches Association of Ontario (CAO) to update its ’Coach’s Concussion Toolkit’ to align with the 2022 Amsterdam Consensus Statement on Concussion in Sport recommendations.

Since February 2025, coaches have had access to updated resources on the Coaches Association of Ontario Website, including detailed protocols and educational materials designed to assist coaches in identifying and managing concussions effectively. By integrating the latest scientific findings and expert consensus, the resources will enhance the coaches’ ability to safeguard athletes’ health and well-being.

Additionally, CAO focused on making sure these updated resources are more accessible to Franco-Ontarians and individuals with hearing impairments. The project recognized the importance of reaching diverse audiences and ensuring that all coaches, regardless of language or physical ability, had access to vital concussion awareness information.

On March 6, 2025, CAO hosted a webinar training session for coaches and designated persons. The live webinar had over 300 live attendees with hundreds more able to access the recording and resources post session.

The successful implementation of this project ensures coaches across the province are now better equipped with the knowledge and tools necessary to prevent, detect and manage concussions. This initiative plays a key role in creating safer sporting environments and promoting a culture of awareness and prevention.

Data integration for traumatic brain injury research and mental health

To study potential differences in patterns of health service use and mental health-related outcomes after sports- and recreation-related traumatic brain injury (SR-TBI) compared to TBI from all other causes, the Ministry of Sport funded Concussion Legacy Foundation (Canada) Inc. (CLFC) $52,500 to partner with the Centre for Addiction and Mental Health (CAMH) to conduct a retrospective cohort study to identify all incident cases of SR-TBI and TBI from all other causes treated in hospital from January 2010 to December 2019 in Ontario.

Over a 10-year period in Ontario, the data found:

• SR-TBI accounted for over one-third of all cases of TBI
• hospitals attended to approximately 46,000 incident cases of SR-TBI per year
• the number people seeking help after both SR-TBI and TBI of all other causes peaked in the first 30 days after injury

Read the full report (PDF).

Concussion awareness resources to support concussion safety in schools

With support from the Ministry of Education, the Ontario Physical and Health Education Association (Ophea) continues to update and maintain the concussion protocol and safety resources to support concussion awareness, prevention, detection and management in Ontario schools. This includes updates to align with the Amsterdam Consensus Statement on Concussion in Sport, 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.

2024 Rowan’s Law Day across Ontario

We have achieved remarkable progress in raising awareness and educating youth and young adults about concussion safety since 2018. Rowan’s Law Day, which falls on the last Wednesday in September each year, is a powerful reminder of the importance of concussion safety.

In 2024, our digital toolkit, featuring email signatures, hashtags, virtual meeting backgrounds, and posters with the “Hit. Stop. Sit.” logo was shared widely. Government webpages on Rowan’s Law made up 52% of URLs shared, amounting to 47,618 impressions online.

Throughout Ontario, schools, hospitals, and sports organizations continue to organize events to promote concussion safety awareness. Iconic landmarks such as the CN Tower, Niagara Falls, the Big Nickel, and the Toronto and Ottawa city signs were illuminated in purple, which was Rowan’s favourite colour, in her memory.

On Wednesday September 25t^h, 2024 — Rowan’s Law Day — during a Blue Jays game, Minister Lumsden delivered a message about Rowan’s Law Day and concussion safety, which was displayed on the jumbotron. The evening was not solely about the Jays’ victory! Ongoing efforts like this ensure that Rowan’s legacy continues to inspire and educate the public on the importance of concussion awareness, prevention, detection and management.

Rowan’s Law holds significance in all aspects of sports, on and off the field, because knowing how to respond to a concussion can truly save your life and the lives of those around you. We invite the entire community to join us in this important mission.

Here are some ways you can get involved throughout the year:

Participate in local events:

Attend, organize or volunteer at concussion awareness events hosted by schools, hospitals and sports organizations.

Share on social media:

Use our digital toolkit to spread the word. Share posts, use dedicated hashtags, and update your profile with virtual meeting backgrounds and posters featuring the “Hit. Stop. Sit.” logo.

Educate yourself and others:

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

Advocate for safety:

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

Call to Action

A national commitment to concussion safety

Rowan’s tragic passing revealed critical gaps in how concussions were understood and managed in amateur sports. Ontario responded with compassion and resolve. Through Rowan’s Law, we established a comprehensive legal and policy framework.

We continue to urge all provinces and territories across Canada to adopt legislation modeled on Rowan’s Law. The need for a harmonized, national approach to concussion safety is clear. Every young athlete, regardless of where they live, deserves the same level of protection, education, and care.

Let us honour Rowan’s legacy not only in memory, but in action. By working together, we can ensure that her story leads to lasting change across the country. Let this be the moment we unite to make sport safer—for everyone.

Rowan’s Law Concussion Working Group

A commitment to athlete safety

The Rowan’s Law Concussion Working Group is a dedicated group of knowledgeable and passionate people providing invaluable advice to the Ontario government on implementing the committee’s recommendations found in the Rowan’s Law Advisory Committee Report.

The ministry extends heartfelt thanks to all current and former members of the Rowan’s Law Concussion Working Group for their dedication, impactful contributions and unwavering commitment to the health and safety of Ontario athletes.

The collective efforts of these dedicated individuals have positioned Ontario as a national leader in concussion prevention, awareness, detection and management. Their commitment has transformed a tragic loss into a powerful movement for change, ensuring that Rowan’s legacy lives on through safer sports practices for future generations.

Current 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

Action item status