Reviewing Head Games, the sports concussion docudrama from director Steve James of Hoop Dreams fame, proved to be a tough assignment.
Each time I watched the movie, first at a "premiere red carpet" sneak preview in Boston back in June 2012, and twice again on DVD in the fall of 2012, I tried to put myself in the position of the average viewer; not only to put to one side the deep knowledge I have of the film's subject as a result of covering concussions in youth sports for MomsTEAM for the past twelve years (now 14 years), but also my professional relationships with three of the film's principals, Chris Nowinski, former Harvard College football player, ex entertainment wrestler, and concussion educator and advocate, neurosurgeon Robert Cantu, MD, and Executive Producer, Steve Devick.
Ultimately, I concluded that it was an exercise in futility. I am simply just too close to the subject to be an objective, disinterested observer. Indeed, I realized that I would actually be doing readers of MomsTEAM a disservice if I did not review Head Games through the lens of my own knowledge and experience.
So, what then, did I think of the movie?
Unfortunately, I came away from each viewing of the movie more disappointed than the last.
Perhaps it is because I am a born-and-bred New Englander who values straight talk, and who relies on Yankee ingenuity and a can-do attitude to find solutions to the many challenges youth sports parents face on a daily basis, but Head Games was not the solution-driven movie, and hence not the documentary, I was hoping it would be.
I was hoping for a movie that didn't use - as countless other books and television documentaries had already done (and, with the release in October 2013 of PBS Frontline's "League of Denial" have done since) - the suicides of former NFL players Andre Waters and Mike Webster, and University of Pennsylvania football captain Owen Thomas, and the autopsies of their brains that showed them to have been afflicted with a devastating degenerative neurological disease called chronic traumatic encephalopathy (CTE) [1], to strongly suggest that all athletes who play contact or collision sports for any length of time, whether or not they have ever been diagnosed with a concussion, are at significant risk of developing CTE. [For an article by MomsTEAM Senior Editor, Lindsey Barton, exploring the question of whether the media has been ahead of the science on CTE, click here [2].]
I was hoping for a movie that would do more than bash the National Football League, yet again, for the way it failed to address the issue of concussions for so many years, although I don't begrudge Mr. Nowinski and New York Times reporter Alan Schwarz (listed as an Associate Producer of the movie) the right to take at least partial credit for being the "Davids" trying to fell the NFL's "Goliath." Again, this is a theme that is, of course, front and center in Frontline's "League of Denial," with Messrs. Nowinski and Schwarz featuring prominently.
I was hoping for a movie that did more than explain, for the umpteenth time, that the reason such a small percentage of the concussions athletes suffer actually end up being reported and, more importantly, treated, is that the culture of contact and collision sports, from Pee Wee to the pros, tells athletes to keep quiet, to play through concussion symptoms, and to return to play before their brains have been given a chance to fully heal, all because they are "warriors" needed on the field of battle. I was hoping for a movie that would explain how, instead of changing the culture - which, I submit, is never going to happen, the solution may be to work around the problem altogether, by using technology to help identify concussed athletes instead of waiting in vain for them to begin honestly self-reporting their symptoms or relying on the ability of sideline personnel to spot signs that an athlete is concussed. I came away disappointed.
I was hoping for a movie that talked about the steps that are already being taken to reduce the number of concussions in youth sports, such as through education and teaching kids how to tackle without using their heads, or eliminating checking in youth hockey until age 13. I came away disappointed.
I was hoping for a movie that recognized that meeting the challenges concussions pose requires every stakeholder in youth sports to work together, whether it be parents, coaches, educators and reform advocates like Mr. Nowinski and myself, the national governing bodies of sports, or the doctors, athletic trainers, and neuropsychologists charged with the responsibility of identifying and treating concussed athletes and either clearing them to return to play or advising them to retire. I came away disappointed.
I was hoping for a movie that did more than instill fear in the minds of parents, and ask them, as one recent tweet from the Sports Legacy Institute put it, to "freak out about head injuries in sports," but offered solutions - of which there are plenty, by the way - and hope that there is a way forward. I came away disappointed.
I was hoping for a movie that didn't have parents leaving the theater thinking that they had essentially only two choices: either not allow their kids to play contact or collision sports at all (as Mr. Nowinski advocates), or, at the very least, not until high school (as Dr. Cantu recommends), or choose to play a dangerous game of "Russian roulette" with their kids' future, as Mr. Nowinski so colorfully put it, by letting them play contact or collision sports in the face of what Head Games would have them believe were very high odds that they would end up, sooner or later, with permanent brain damage at the very least, or, worst case, developing CTE, losing their memory, and ultimately developing early dementia or committing suicide. I came away disappointed.
What I came away feeling is that Head Games is, instead, is a slick, powerful, well-produced movie, boasting superb cinematography, editing and music (kudos to Billy Corgan of Smashing Pumpkins fame), directed by a master story-teller and agent provocateur (James); a movie clearly intended to evoke in viewers an emotional response, not a rational one; and a movie which is likely to leave many of us who are working hard to meet the concussion challenge in order to make youth sports safer feeling like we had just watched a 90-minute infomercial for Chris Nowinski, the Sports Legacy Institute and the Center for the Study of Traumatic Encephalopathy.
Instead of charting a way forward, instead of advancing the message that, because there is so much about head trauma that we don't know, the most reasonable approach at this point is to post a yellow "Proceed with Caution" sign while we do what we can to reduce the exposure of young athletes to head trauma and redouble our efforts in concussion protection and risk management, education, research, product development, and treatment, the movie just tries to scare the daylights about of people.
My fear is that the audience Head Games is trying to reach - the parents, coaches, and players who haven't been following the concussion issue all that closely up to now - will come away thinking instead that the road sign that has been posted in front of them is a huge red "Stop" sign.
To those who have read any of the countless articles about head injuries in sports in the national and local media or watched in recent years any of the concussion documentaries on CNN, HBO or PBS, Head Games: The Movie plows already familiar ground. Here again are the stories of athletes who have been forced to retire from their sport - or are one concussion away from retirement - after suffering multiple concussions (Andre Waters says he "stopped counting at 15"). All of the athletes featured in Head Games candidly admit that they did not tell anyone about their initial or lingering symptoms, were allowed to keep playing despite such symptoms, or returned to the field or rink before their brains had fully healed.
Needless to say, the adverse effect on their health is predictably negative. All of the brains in which Drs. Ann McKee and Bennet Omalu found the dark stains of tau protein characteristic of CTE were, with the exception of Penn football player Owen Thomas, of professional athletes who played for many, many years longer, and presumably sustained many more diagnosed and undiagnosed concussions and sub-concussive hits than the average high school football, hockey, lacrosse, or soccer player. Yet there is only the briefest of mentions of this vitally important fact.
Despite quick disclaimers at various points through the movie, Head Games is intent on reinforcing in the viewer's mind a link between playing contact or collision sports and CTE, and between CTE and suicide. For every statement that the research on CTE is in its early stages, or that connecting some of the dots "isn't supported by the science," it seems there are ten heart-rending and emotional stories about athletes who have committed suicide and later found to have suffered from CTE (Andre Waters, Mike Webster, Owen Thomas, etc.), or, like Mr. Nowinski and some retired NFL players, are at high risk of CTE. The scenes of Thomas's father visiting his grave, of Penn head athletic trainer and MomsTEAM expert, Eric Laudano, holding back tears in talking about Thomas, and of Mr. Nowinski, Drs. Cantu, McKee, and Stern telling the widow of a former boxer that his autopsy was positive for CTE, pack an emotional wallop, to be sure.
At the same time, Dr. Cantu admits in the film that, tragically, there is a "huge gap" between that hype and the science, that the brains Dr. McKee has been slicing and examining under her microscope represent a "very selective sample," and that, we have "no idea" of the prevalence of CTE." As an excellent recent article on ESPN.com [3] reported, most of those involved in the study of CTE caution against a rush to judgment and are unwilling to connect the dots quite yet.
"I've seen [CTE research teams] present their data at meetings and they talk about the limitations of it," says Kevin Guskiewicz, PhD, ATC., Kenan Distinguished Professor at the University of North Carolina, and head of its Center for the Study of Retired Athletes and Director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center. He blames the CTE hysteria, not on the researchers, but on the media. "I'll just be honest," he told ESPN.com's Mike Fish, "they sensationalize it, and it all is about ‘Every former player that plays for more than five seasons must have this.' ... We have been moving a bit too quickly. We need to get more prospect[ive] studies that are going to really identify whether there is a cause-and-effect relationship. Because right now all we are doing is looking at a cross section of a relatively small group of players that are based on case reports and not scientific studies," he observes.
To his credit, Dr. Cantu, both in the ESPN article and in Head Games, also urges caution in drawing conclusions from the "very skewed sample of brains" that his group has been looking at. The problem is that, when Dr. Cantu, like Dr. Guskiewicz, blames the media for over-hyping the possible links between concussion, CTE, and suicide, his words ring hollow, because his restraint is not shared by his colleague, Mr. Nowinski, who is only too happy to connect some of the dots in order to paint a much, much more one-sided and scary picture, one in which, he suggests, we can "create 500,000 cases of CTE" and, somehow, "everybody's okay" with that. It is Mr. Nowinski's overheated rhetoric, I believe, which viewers of Head Games are much more likely to remember, not Dr. Cantu's more qualified, cautious and careful approach.
One of the things Head Games does well is dramatizing (and in one particular instance, perhaps over-dramatizing) one of the major challenges faced every day by those involved in concussion education, as MomsTEAM and I have been for the past 11 years: educating parents, coaches, athletic trainers, administrators, and players to take the health risks that concussions pose seriously.
I know first-hand, as Alan Schwarz of the Times says, that too many people simply "don't want to believe" the problem is as serious as it is, and that this stick-your-head-in-the-sand attitude is pervasive at all levels of sport. It should come as no surprise to anyone involved in youth sports that even Chayse Primeau, the 14-year-old hockey-playing son of Keith Primeau, whose NHL career was cut short by concussions, says he "would rather not know" about concussions, and that even such NHL veterans as Danny Briere of the Philadelphia Flyers say that concussions are something players don't really "want to talk about."
For anyone who has been involved in concussion education as long as I have, the scene in Head Games in which Mr. Nowinski is shown giving a lecture to a half-filled high school auditorium - half-filled, he notes, because the football coach had decided to schedule a mandatory weight-training session for his players at the same time as the lecture - is apocryphal. When the school's head athletic trainer accuses him of engaging in scare tactics by failing to mention that many athletes don't suffer adverse long-term health consequences from playing contact and collision sports, Nowinski's frustration boils over. He chastises the AT for a "terrible argument" (likening it to those who used to complain that all the talk about cigarette smoking causing lung cancer didn't recognize that lots of people who smoked didn't get the disease), says he fears for the AT's job because of his blasé attitude about concussions, and walks off the stage in a huff mumbling "I'm going to go back to Boston."
Leaving aside for the moment whether the scene is all that flattering to Mr. Nowinski, as it puts on display a darker side to his personality that we don't see anywhere else in the movie, leaving the impression with the viewer that he may be more bully than educator, the problem once again is that, unlike the link between cigarette smoking and lung cancer, which is now clear beyond peradventure, the link, at least between concussion and CTE, has not yet been proven. The result is that Mr. Nowinski's curt dismissal of the athletic trainer's statement as a "terrible argument" rests on drawing a conclusion from the data that the data simply doesn't support.
The movie does an excellent job of driving home the message that the very culture of violent, contact and collision sports such as football, ice hockey, lacrosse, and, yes, even soccer, leads many athletes, when they suffer hits that leave them disoriented and seeing stars, to respond by deciding to be tough, hide their symptoms from everyone, and keep playing. What is on full display in Head Games, and is a point made clear by virtually every athlete and former athlete who appears on screen, is the "warrior" culture of contact and collision sports, a culture which undoubtedly represents one of the biggest single obstacles to tackling the concussion challenge before us. As Gene Atkins, a former New Orleans Saints' player, tells us, when he suffered concussion symptoms, he simply didn't want to come out of the game. The sad result, as the movie shows us, is memory problems so severe that Mr. Atkins can no longer even correctly recite in order the months of the year.
Mr. Nowinski admits that he was "seeing stars" all the time he played football, and later as a wrestler in the WWE. Knowing what he knows now, he is amazed that he was "gladly exposing myself" to repeated concussions for 19 years. We learn that it isn't just football and hockey players who hide their symptoms. Former Olympic and World Cup soccer player, Cindy Parlow Cone, admits that she probably suffered over 100 concussions (if "seeing stars" is considered a concussion), while 15-year-old soccer player, Mary Rounce, tells of her determination to continue her pursuit of Olympic and World Cup glory, despite having suffered 4 concussions. "I'm pretty good at being tough," says Rounce.
Here, once again, the problem with Head Games, in my view, is that it highlights athletes who are outliers, who are better than most at hiding their symptoms, who have a higher pain threshold, who so competitive that they continue to play despite - or is it because? - their brains are scrambled.
More troubling is that while the movie identifies the problem - chronic under-reporting of concussions by athletes and the difficulty sideline personnel often face in spotting concussed athletes, especially at the youth and high school level - it doesn't offer any real hope for a solution to that problem. Instead, Mr. Nowinski simply wonders "how can we let kids play" when most school and youth sports programs don't have observers on the sidelines and in the booth like the NFL whose sole job is to look for athletes with signs of concussions, and Dr. Cantu says that it could be argued that sports programs that can't afford to have athletic trainers or other trained medical personnel on the sidelines perhaps shouldn't be fielding teams in contact or collision sports at all.
Completely missing from the movie is any mention of the advances in technology, particularly products designed to alert sideline personnel through the use of accelerometers (e.g. hit sensors) embedded in helmets, chin straps, mouth guards, or sweatbands, or even put in an athlete's ears, to hits hard enough to possibly cause a concussion so he or she can be checked out.
Nor does Head Games include any mention of the King-Devick Test (KDT), co-invented by one of the movie's Executive Producers, Steve Devick, a simple two-minute test of rapid eye movement which has been found in two studies (one of college athletes [4], and another that included both high school- and college-age rugby players [5]) to be a an accurate "remove-from-play" sideline concussion assessment tool, so much so that no less an authority than Dr. Cantu himself recommends use of the test as part of the battery of baseline and post-concussion tests in his new book, Concussion and Our Kids [6].
As first reported by Slate.com [7], and confirmed in an e-mail from Mr. Devick, one of the early rough cuts of Head Games did include footage on KDT, which was not included in the final version. While I understand that leaving the KDT footage on the cutting room floor was the decision of the director, Mr. James, who, according to an email from Mr. Devick, had "complete creative control" over the movie, and while inclusion would undoubtedly have exposed Messrs. James and Devick to charges of conflict of interest (which the Slate reviewer made anyway, based on the rough cut that it was mistakenly sent), it was, in my view, unfortunate that viewers were deprived of the benefit of knowing about the test, and the progress being made towards reliable sideline assessment of concussion. I am left to wonder whether the real reason it was not included is that it detracted from the message the director sought to convey. A concussion might be a little less scary to parents if they knew that there was a test that a trained health care professional could administer on the sports sideline to determine whether an athlete should be allowed to continue playing or be sent for a more complete assessment.
Head Games does a good job of showing how conflicted many parents feel about letting their kids play football, hockey, and other contact and collision sports. Asked whether he would let his son play football, Penn's Eric Laudano begins to answer, but ends up just shrugging his shoulders with a sheepish look on his face. The mother of an elementary-school age football player in Chicago says all that a parent can do is hope and pray. Even knowing what he knows about concussions, former NFL player Keith Primeau says he "doesn't live in fear" of his kids being injured playing sports, and that seeing the enjoyment on their faces "is enough for me."
Once again, however, my major criticism of the movie is that, as I noted earlier, the movie ends up presenting parents with what amounts to a Hobson's choice: pull their kids out of contact or collision sports, depriving them of the chance to play a sport they love, or let them play knowing that, no matter the benefits of such sports, the risk of concussion will always be a Sword of Damocles hanging over their head.
Short of banning kids playing contact and collision sports before age 14 (an absolutist position from which Dr. Cantu has retreated somewhat in Concussions and Our Kids), he and Mr. Nowinski, to their credit, offer one very practical solution (dare I say, a no-brainer, and one which I support completely): reduce the amount of total brain trauma kids sustain, especially at an early age when their immature brains, weaker neck muscles, and over-sized heads, combined with a slower rate of recovery, make them particularly vulnerable to the potentially significant long-term effects of traumatic brain injury and repeated sub-concussive blows.
Dr. Cantu and Mr. Nowinski correctly highlight the irony of the NFL being the only league that allows just one full-contact practice per week, but high school players - whose developing brains are much more at risk of long-term injury from concussion and repeated sub-concussive blows - are somehow allowed to knock helmets four days a week. There is "no way that should be happening," says Mr. Nowinski. I agree. {Editor's note and update: an increasing number of state high school athletic associations [8] have, since 2013, begun imposing limits on full-contact practices]
For my money, too much of the movie is spent sensationalizing the concussion issue. The soundtrack is alternatively gloomy and scary; the quick-cut montages of vicious helmet-to-helmet hits knocking athletes senseless (which subtly reinforces one of the biggest concussion myths, that most concussions involve a loss of consciousness or signs of concussions that are immediately and clearly observable by sideline personnel if they were only looking, or, in some cases, by 35 million television viewers) are scary; the language is often scary and clearly designed to instill fear in the minds of viewers and send them screaming from the theater to pull their kid off the football field.
Mr. Nowinski tells us that if he had a 6-year old playing football, he would be "freaked out." He likens a parent who lets a kid play football to playing "Russian Roulette with their future." He suggests that we are putting our kids at "terrible risk." He asserts that, if all the concussions that players fail to report and/or that game officials and sideline observers fail to spot were actually identified, there would be so many athletes on the sideline that they would "barely be able to play the game" and that football would be "virtually unsustainable." It is clear that Mr. Nowinski feels that football is simply too dangerous to be played at all.
Mr. Nowinski asserts that if athletes were to become educated, the number of concussions would skyrocket. But while there is some evidence to support the notion that education has increased public awareness - there has been a big increase in the number of ER visits [9] for suspected concussion, for instance, although not hospital admissions, which have actually fallen just as sharply - there is also reason to be skeptical that athletes, even Ivy League-educated athletes, are going to suddenly start self-reporting concussion symptoms and voluntarily ask to be taken out of games if they know the risks if they don't. Even when athletes know the dangers of concussion, as researchers at the University of Pennsylvania recently found [10] to their dismay, they don't self-report or voluntarily come out of a game.
What few, if any, of the reviews I have read of the movie recognize is that, as dramatic and powerful as Head Games is, and as much as the director is entitled to present his particular spin on the concussion challenge we face in sports, it ultimately presents in my view, a distorted picture that doesn't fairly reflect just how far we have come over the last decade in our understanding of concussions, the ways in which the number of concussions and catastrophic head injuries can be reduced (e.g., safe tackling, proper helmet fit, strengthening neck muscles), and the important work being done by so many around the country, indeed the world, to make sports safer.
As much as I love to sing the praises of Boston, viewers are left with the impression that it is the undisputed hub of the concussion universe; that the Center for the Study of Traumatic Encephalopathy and the Sports Legacy Institute, Bob Cantu, Chris Nowinski, Ann McKee, and Robert Stern are actually, as the reviewer of the movie in Variety [11] came away from Head Games believing, the "nerve center, so to speak, of concussion research."
In point of fact, as MomsTEAM's Senior Health and Safety Editor Lindsay Barton Straus and I have been reporting for years, outstanding and critically important work in the concussion space is being done all over the country and in Canada, by among others, Steve Broglio at the University of Michigan on the biomechanics of head trauma and its lingering effects, Larry Leverenz and his colleagues at Purdue on the subtle brain trauma sustained by high school football players from repeated subconcussive hits [12], researchers at Virginia Tech and Wake Forest, whose groundbreaking research [13] on head trauma in youth football lead directly to rules being put in place by Pop Warner to limit contact to the head during practices, Dave Ellemberg at the University of Montreal on a concussion's effect on a teen's short-term memory [14], the aforementioned Dr. Guskiewicz at the University of North Carolina, by Philip Schatz and my MomsTEAM colleague, Rosemarie Moser on the importance of cognitive and physical rest [15] in concussion recovery, and by Drs. Bennet Omalu and Julian Bailes.
The movie makes only a passing reference to laws [16] now in place in forty of the fifty [now all fifty] states, (which so many, including the NFL, have worked so hard to get enacted) requiring that parents and athletes acknowledge receipt of a concussion education sheet in order for an athlete to participate that season, that athletes suspected of having sustained head trauma be removed immediately from play and not be allowed back in the same game or practice, and that require written authorization from a health care professional with concussion expertise before a concussed athlete is ultimately permitted to return to play (RTP).
While I don't necessarily agree with Mr. Nowinski's characterization of the RTP element of the laws as "being sold as the solution" to the concussion problem in youth sports, I do agree with him that the larger challenge is to do a better job identifying concussed athletes and getting them off the field in the first place. (Which is why, once again, I found it odd that the movie says nothing about hit sensors).
Surprisingly, the movie spends but a few minutes on how concussions are actually treated. Conspicuously absent is any mention of the increasingly common use of baseline and post-concussion computerized neurocognitive testing [17] in the management of concussions, this despite the fact that the most recent international consensus of concussion experts calls it one of the "hallmarks" of concussion management, and studies suggesting that its use may delay the return of athletes who might otherwise be allowed to return to play before they have regained full cognitive function because they self-report no concussion symptoms.
Again, according to Executive Producer, Steve Devick, one of the early rough cuts of Head Games - of which there were apparently at least five - did include a short segment on neurocognitive testing, but Mr. James elected not to include references to any post-concussion testing except for those conducted by Drs. Cantu and Master in their offices. Thus, for all the viewer knows, the only things a doctor does after an athlete suffers a concussion is to test for double vision and balance problems, and ask questions about memory and sleep problems.
I think that the movie, as a result, paints a misleading picture of how multi-faceted and multi-dimensional concussion management has become, by omitting mention of one of the most significant tools in the concussion toolbox.
Ultimately, the movie paints the concussion picture largely in black and white terms, as a battle between David (Nowinski, Cantu, Schwarz, et. al) and Goliath (the NFL). It eschews a nuanced approach which recognizes the inexact state of our current understanding of what causes concussion, what makes some athletes more susceptible to concussion and long-term injury than others, the uncertainty over just how prevalant CTE is in athletes, and a discussion of the steps that are already being taken to make all sports and recreational activities, including such as wheel and snow sports, not just contact and collision sports, safer, improve our ability to identify concussions, and to keep athletes off the field until their brains are fully healed, Head Games opts instead to play with the viewer's emotions, to freak them out, and to scare them.
In doing that director Steve James has made movie that most reviewers apparently love and that wins accolades - there is even some early Oscar buzz - but, in the end, I think it is the movie that is playing games with our heads.
Brooke de Lench is the Publisher of MomsTEAM and the author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (Harper Collins), and the producer/director of the new PBS documentary, "The Smartest Team: Making High School Football Safer" [18]
To visit MomsTEAM's comprehensive Concussion Safety Center, click here [19].
Concussion Book Reviews:
Kids, [20]Sports, and Concussion - A Guide for Coaches and Parents [20] by William P. Meehan, III, M.D. (Praeger 2011)
Ahead of the Game: The Parents' Guide to Youth Sports Concussion [21] by Rosemarie Scolaro Moser, Ph.D. (University Press of New England 2012)[21]The Concussion Crisis: Anatomy of a Silent Epidemic [22] by Linda Carroll and David Rosner (Simon & Schuster 2011).
Throwaway Players: The Concussion Crisis From Pee Wee Football to the NFL [23] by Gay Culverhouse (Behler Publications 2011)
Concussions and Our Kids: America's Leading Expert on How to Protect Young Athletes and Keep Sports Safe [6] by Robert C. Cantu, M.D. and Mark Hyman (Houghton Mifflin Harcourt 2012)
Originally posted October 1, 2012, revised June 3, 2014
Links:
[1] https://mail.momsteam.com/node/3289
[2] https://mail.momsteam.com/alzheimers/cte-media-narrative-ahead-science-say-researchers
[3] http://m.espn.go.com/wireless/story?storyId=8284473&wjb
[4] https://mail.momsteam.com/node/3776
[5] https://mail.momsteam.com/node/4959
[6] https://mail.momsteam.com/node/5390
[7] http://www.slate.com/articles/health_and_science/movies/2012/09/head_games_documentary_steve_james_new_movie_about_concussions_overstates_the_evidence_on_head_injuries_in_sports_.html
[8] https://mail.momsteam.com/health-safety/nfhs-approves-concussion-task-force-recommendations-discussion-with-state-associations
[9] https://mail.momsteam.com/node/4784
[10] https://mail.momsteam.com/node/5075
[11] http://www.variety.com/review/VE1117948387?refcatid=31&printerfriendly=true
[12] https://mail.momsteam.com/node/4492
[13] https://mail.momsteam.com/node/4671
[14] https://mail.momsteam.com/node/4636
[15] https://mail.momsteam.com/node/4973
[16] https://mail.momsteam.com/node/3015
[17] https://mail.momsteam.com/node/3385
[18] http://www.thesmartestteam.com
[19] https://mail.momsteam.com/node/305
[20] https://mail.momsteam.com/node/3575
[21] https://mail.momsteam.com/node/5032
[22] https://mail.momsteam.com/node/3839
[23] https://mail.momsteam.com/node/3761