ACA on Pediatric Chiropractic Care
The American Chiropractic Association (ACA), the largest organization in the United States representing the chiropractic profession, submits the following statement to the Chiropractic Board of Australia in response to its upcoming hearing related to the safety and efficacy of chiropractic care for children.
In support of a May 23 statement issued by the Chiropractors’ Association of Australia (CAA) on the safety of chiropractic care, the American Chiropractic Association (ACA) affirms that the evaluation, diagnosis, care and management of the pediatric patient is within the scope of chiropractic care, and that pediatric chiropractic care, when administered properly, is effective, safe and gentle. ACA recognizes that the doctor of chiropractic is an important member of the integrative pediatric health care team.
According to CAA, there are more than 1 million pediatric visits to doctors of chiropractic in Australia each year. Research indicates there is also significant utilization in the United States; a 2007 study in the journal Pediatrics estimated that there are 30 million pediatric chiropractic visits annually.1 The U.S. Centers for Disease Control and Prevention (CDC) previously reported that chiropractic was the most common form of doctor-directed complementary or alternative medicine used by U.S. children.2
The safety of pediatric chiropractic care is supported in scientific literature. A 2008 study of 781 pediatric patients under 3 years of age (73 percent of whom were under 13 weeks) who received a total of 5,242 chiropractic treatments at a teaching clinic over a three-year period found no serious adverse events.3
More recently, authors of a 2014 review—spanning more than 115 years of literature—examining all published cases of serious adverse events in infants and children caused by practitioners of manual therapies concluded that “serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are exceedingly rare. There have been no cases of deaths associated with chiropractic care reported in the academic literature to date”4
Chiropractic’s safety record is further exemplified in the profession’s malpractice insurance premium rates, which are the lowest among all primary health care providers in the United States (including medical doctors and osteopaths). DCs who treat children have the same malpractice insurance rates as those who treat adults, indicating pediatric care carries no increased risk.
Contemporary evidence indicates chiropractic care for children is both safe and effective for a variety of pediatric conditions, including infantile colic. A 2012 study of colicky babies found daily crying time decreased by 48 percent in those babies who received chiropractic care compared to 18 percent in babies who received no chiropractic treatment.5 In addition, a 2011 study found that chiropractic treatment is a viable alternative approach for infantile colic and congruent with evidence-based practice.6
Moreover, parents who bring their children to a doctor of chiropractic are highly satisfied with the care and experience. In the study conducted in the teaching clinic mentioned above, 85 percent of parents reported improvement in their children’s symptoms.7
The practice of chiropractic in the United States, as in Australia, is regulated to protect patients of all ages. State chiropractic boards in the U.S. issue practice guidelines to DCs on a variety of subjects. Likewise, the Chiropractic Board of Australia has established codes and guidelines for practitioners to ensure that treatment of pediatric patients is appropriate and safe. We are confident the Board can render an appropriate decision in the case at hand based on its previously published guidance.
References
1. Vohra S, Johnston BC, Cramer K, Humphreys K. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics. 2007;119:275-283.
2. Barnes PM, Bloom B, et al. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007 National Health Statistics Reports. Centers for Disease Control and Prevention. December 10, 2008, (No. 12).
3. Miller JE, Benfield K. Adverse effects of spinal manipulation therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. Jour Manip Physiol Ther 2008;31(6):419-422.
4. Todd AJ. Carroll MT, et al. Adverse events due to chiropractic and other manual therapies of infants and children: a review of the literature. J Manipulative Physiol Ther 2015; 38(9):699-712.
5. Miller JE, Newell D, et al. Efficacy of chiropractic manual therapy in infant colic: a pragmatic single-blind, randomized controlled trial. J Manipulative Physiol Ther2012;35(8):600-607.
6. Alcantara J, et al. The chiropractic care of infants with colic: a systematic review of the literature. Explore 2011; May-June; 7(3):168-74.
7. Jevne J et al. Compensation claims for chiropractic in Denmark and Norway 2004-2012. Chiropractic and Manual Therapies 2014;22:37.
