Chiropractic Care for Children?

A reply to the Archives of Pediatrics article by the (former)
Research Director of the International Chiropractic Pediatric Association (ICPA)
I would like to applaud your publication for printing "Chiropractic Care for Children" by Lee ACC, Li DH and Kemp KJ. (See below) It is an admirable attempt to educate your readers about chiropractic methods of health care. However, there are several inaccuracies, which should be addressed. This letter was (later) published in Arch Pediatr Adolesc Med. 2000 (Oct); 154 (10): 1063

Chiropractic Care for Children
Arch Pediatr Adolesc Med 2000 (Apr); 154 (4): 401–407 ~ FULL TEXT
Considerable numbers of children and adolescents seek chiropractic care. Children made an estimated 20 million visits to DCs in 1993. According to a 1994 survey, DCs were the alternative practitioners most often consulted by pediatric patients. Although most adults (83%) consult DCs for musculoskeletal conditions, children frequently visit DCs for respiratory problems, ear, nose, and throat problems, and general preventive care. Common pediatric conditions treated by DCs include otitis media, asthma, allergies, infantile colic, and enuresis. However, randomized controlled clinical trials of chiropractic care for pediatric conditions are rare. One of the first such trials reported that chiropractic care offered no significant benefits for pediatric patients with asthma.

Kids Need Chiropractic, Too!
This page is a collection of articles by various authors about the need for, safety, and the benefits of chiropractic care for children.

Prevalence of Nonmusculoskeletal Complaints in Chiropractic Practice:
Report From a Practice–based Research Program
Cheryl Hawk, DC, PhD, Cynthia R. Long, PhD, Karen T. Boulanger
J Manipulative Physiol Ther 2001 (Mar); 24 (3): 157–169
The following characteristics made patients more likely to present with nonmusculoskeletal chief complaints: being less than 14 years of age; being female; presenting in a small town/rural location; reporting more than 1 complaint, especially nonmusculoskeletal complaints; having received medical care for the chief complaint; and having first received chiropractic care before 1960.

Epilepsy and Seizure Disorders: A Review of Literature
Relative to Chiropractic Care of Children
J Manipulative Physiol Ther 2001 (Mar); 24 (3): 199–205
This article reviews 17 reports of pediatric epileptic patients receiving chiropractic care, and concludes that "Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients."

Risk Assessment of Neurological and/or Vertebrobasilar Complications
in the Pediatric Chiropractic Patient
Journal of Vertebral Subluxation Research (JVSR) 1998; 2 (2): 73–78
Reports suggest that chiropractic accounts for a large percentage of visits to alternative health practitioners. Moreover, pediatric patients represent a significant proportion of these visits. In light of this trend, it is important to evaluate the risk potential to the pediatric patient presenting for chiropractic care. This paper has reviewed literature concerning the occurrence of neurological and/or vertebrobasilar (N/VB) complications in patients receiving either specific chiropractic adjustments and/or non–specific manipulations of the spine.

APA PRESIDENTIAL ADDRESS:
Holistic Pediatrics = Good Medicine
Kathi J. Kemper, MD, MPH
PEDIATRICS 2000 (Jan); 105 (1) Supplement: 214–218
The author reasons to pediatricians that: "In most pediatric surveys, chiropractic is the number one therapy or alternative therapist seen by children." and that: "Another provider on the horizon always makes medical practitioners feel a bit threatened, and I think that is particularly so with chiropractors." She then suggested: "This growing presence leads me to make a couple of radical suggestions. First, we should begin to work with chiropractors and to talk with them about the things that we know and have learned about child health supervision. The majority of chiropractors in the United States belong to the American Chiropractic Association, and they do primarily focus on low back pain. Their treatment of children focuses on well–child care and health promotion. It will help us to share with chiropractors what we have learned about what does work: about safety seats, immunizations, hot water temperature, and poison control centers (as examples). The other key item is letting them know the real truth about immunizations and how helpful they are."

Children in Crashes
Daniel J. Murphy, DC, DABCO
Dynamic Chiropractic – October 5, 1998
Many of the concepts that pertain to adults in motor vehicle collisions also apply to children, including the basic principles of inertial acceleration/deceleration injuries, preparedness prior to impact, and rotation of the head or trunk prior to impact. Overall, studies indicate that the pattern of injury among children involved in motor vehicle collisions is similar to that of the general population.

Study Finds Benefits for Colic with Chiropractic Spinal Manipulation
Foundation for Chiropractic Education and Research (FCER) ~ December 7, 1999
The first controlled randomized clinical trial involving the chiropractic management of infantile colic has just been published by a research group in Denmark at Odense University and in private practice. Although previous studies dating back over the last 10 years have been encouraging, this is the first demonstration of the clear clinical advantage conferred upon infants by spinal manipulation as compared to a control group given dimethicone, commonly used in medical treatment of colic.

A Feasibility Study of Chiropractic Spinal Manipulation Versus Sham Spinal Manipulation
for Chronic Otitis Media with Effusion in Children
J Manipulative Physiol Ther 1999 (Jun): 22 (5): 292–8 ~ FULL TEXT
Recruitment for a randomized controlled trial is feasible and could be enhanced by medical collaboration. Patients and parents are able and willing to participate in a study comparing active SMT and placebo SMT. Parents were extremely compliant with the daily diaries, suggesting that similar quality-of-life and functional status measures can be successfully used in a larger trial. We found the objective outcomes assessment involving tympanometry and otoscopy extremely challenging and should be performed by experienced examiners in future studies.