Chiropractic Pediatric
Care Guidelines

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

You may want to explore the shift away from Guidelines (usually containing numbers/suggested treatment time frames, that are often mistakenly applied as arbitrary limits) to “Best Practices” (clinical judgments regarding patient care that are informed by the best evidence and balanced by patient complexity and provider experience to improve the quality and reduce the costs of care).

Evidence-based Practice This page provides information about interpreting the various statistical tests utilized in journal articles, and contains other information regarding Evidence-based Practice.

Best Practice Initiative Explore the shift from Guidelines, often containing numbers/ suggested treatment time frames, to “Best Practices”, which are clinical decisions informed by the best evidence available, and balanced by patient complexity and provider experience.

Guidelines Page Our original Guidelines section contains a compendium of Guidelines from around the World, as well as a selection of articles about the need for, and frequent misuse of these Guidelines.

	Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process Integr Complement Med 2024 (Mar); 30 (3): 216–232 ~ FULL TEXT Chiropractors are concerned with the assessment, diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system and the potential effects of these disorders on general health for people of all ages. [1, 2] Although other types of health care providers, such as physical therapists, treat musculoskeletal symptoms in children (patients 3] chiropractic is the most common complementary and integrative medicine practice used by children in the United States [4] and is also commonly used by children around the world, including in Australia. [5] In Australia, the best estimates are that chiropractors provide care to more than 30,000 child patients (0–18 years old) every week. [6] According to a 2017 scoping review, ?8% of chiropractic patients are 18 years of age and under. [7] Manual care for children is most often sought for the treatment of musculoskeletal (MSK) conditions. [8]
	Best Practices & Practice Guidelines International Chiropractors Association (2018) ~ FULL TEXT These Best Practices and Practice Guidelines, written for and by International Chiropractors Association members, contained herein, are evidence-based suggestions for appropriate care of patients seeking chiropractic care. While no guideline can replace the clinical decisions made by a chiropractic practitioner in the course of caring for an individual patient’s health problem, the suggestions contain herein, are based on the best available published evidence. Any approach, by a practitioner, that is different from these ICA-BPPG Guidelines, does not necessarily mean that the approach in question was below the standard of care. However, any chiropractic practitioner, who adopts a course of action different from these ICA-BPPG Guidelines, is advised to keep sufficient patient records to explain why such an action was undertaken.
	Attitudes and Opinions of Doctors of Chiropractic Specializing in Pediatric Care Toward Patient Safety: A Cross-sectional Survey J Manipulative Physiol Ther. 2016 (Sep); 39 (7): 487–493 ~ FULL TEXT Compared with 2014 Agency for Healthcare Research and Quality physician referent data from medical offices, pediatric DCs appear to have more positive patient safety attitudes and opinions. Future patient safety studies need to prospectively evaluate safety performance with direct feedback from patients and compare results with these self-assessed safety attitudes, as well as make further use of this survey to develop a comparable database for spinal manipulation providers.
	Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process J Evid Based Complementary Altern Med. 2016 (Apr); 21 (2): 110–114 ~ FULL TEXT An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received.
	Best Practices for Chiropractic Care of Children: A Consensus Update J Manipulative Physiol Ther. 2016 (Mar); 39 (3): 158–168 ~ FULL TEXT Chiropractic is a health care profession concerned with the diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. [1] Chiropractic care is the most common complementary and integrative medicine practice used by children in the United States. [2] A recent Gallup survey found that approximately 14% of US adults reported that they had used chiropractic care in the prior 12 months, that more than 50% had ever used a doctor of chiropractic (DC) for health care, and that more than 25% would choose chiropractic care as a first treatment for neck or back pain. [3] The findings from this survey also were consistent with a previous study that found that patients use chiropractic services in different ways, sometimes for treatment and sometimes for health promotion. [4] This is an update of the 2009 Consensus Document titled: Best Practices Recommendations for Chiropractic Care for Infants, Children, and Adolescents
	A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children J Manipulative Physiol Ther 2015 (Nov); 38 (9): 713–726 ~ FULL TEXT The literature showed that tensile strength differences have been observed between pediatric and adult specimens. A preliminary model of care including pediatric SMT technique adaptation based on patient age is proposed, which may possibly contribute to further knowledge of safety and clinical implications for SMT for children and infants.
	Best Practices Recommendations for Chiropractic Care for Infants, Children, and Adolescents: Results of a Consensus Process J Manipulative Physiol Ther. 2009 (Oct); 32 (8): 639–647 ~ FULL TEXT There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature concluded that there is not yet a substantial body of high quality evidence from which to develop standard clinical guidelines. The purpose of this project was to develop recommendations on "best practices" related primarily to the evaluation and spinal manipulation aspects of pediatric chiropractic care; nonmanipulative therapies were not addressed in detail. These recommendations have been updated by the 2016 article: Best Practices for Chiropractic Care of Children: A Consensus Update

Return to GUIDELINES

Since 3–26–2017

Updated 6-22-2024