Chiropractic and Kids

Do we see children?

Yes we do – we see children at all ages.

What should I know about Chiropractic and kids (paediatrics)?

The following text below has been taken from the Australian Chiropractic Board website.

For the full article, click here.

Paediatric care by chiropractors

Training in providing chiropractic care to children is included in accredited undergraduate chiropractic education.

What parents seek

Parents typically seek chiropractic care for their children for musculoskeletal disorders. In caring for children chiropractors may provide a range of care including manipulation, dietary and ergonomic advice, exercise, counselling and other manual therapies such as massage.

What the research says

Best practice approaches to providing chiropractic care to children are published in peer reviewed literature1 . This evidence should be used to guide clinical practice and ensure chiropractors provide safe care. Current research2 indicates that the incidence of serious adverse events, either directly from manual therapy or indirectly by delayed or mis-diagnosis, is rare but real. Given the lack of good quality evidence about chiropractic care of children, more research is required to better understand this issue.

The Board’s expectations

The Board requires practitioners to make sure their clinical practice is consistent with current evidence and/or best practice approaches. Clinical experience alone is rarely adequate to support clinical decisionmaking that is contrary to current evidence and/or best practice. The Board expects practitioners to:

– discuss their proposed management plan with the parent/guardian

– inform the parent/guardian about the quality of evidence and explain the basis for the proposed treatment

– provide patients (or parent/guardian) with information about the risks and benefits of the proposed treatment and the risks of receiving no treatment

– understand that children have significant anatomical, physiological, developmental and psychological differences and needs from adults and that their management requires specific skills and expertise, including in relation to consent, examination, diagnosis, referral of ‘red flags’ 3 ‘and contraindications to care, and

– modify all care and treatment to suit the age, presentation and development of the patient.

Co-management and referral

When practitioners do not have the clinical skills and knowledge to appropriately assess and manage a particular paediatric patient, the Board expects them to refer the patient to another health care practitioner who has the appropriate skills, or to co-manage the patient with them. This should happen immediately when there are serious conditions that require urgent referral present i.e. red flags. In all cases, the patients’ best interests must be the priority.

All patients

At all times, the Board requires practitioners to:

– consider the balance of benefit and harm in all clinical decisions

– obtain their patients’ informed consent (See also section 3.5 of the Code of conduct) and

– practise in an evidence-based and patient centred manner. The Board holds practitioners to account against published standards, codes and guidelines. Practitioners must be able to justify their conduct and performance against the standards set by the Board.

1 Hawke et al, Best practices recommendations for chiropractic care for infants, children, and adolescents: results of a consensus process J Manipulative Physiol Ther. 2009 Oct;32(8):639-4

2 Vohra et al, Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics. 2007 Jan;119(1):e275- 83.

3 Red Flags are indicators of possible serious pathology that requires urgent investigation and/or intervention