Parent reports of chiropractic care for children: A preliminary report from 22,043 parents in Australia

By Dr Genevieve M Keating, Ph.D. in Infant and early childhood development with an emphasis in mental health and developmental disorders

Introduction
This short report is an extended abstract from a major study done in Victoria, Australia in 2020. This preliminary report is an introduction to the full report, which is in process. However, the information is so important for the profession that those on the front lines daily deserve an early warning. Watch for the full paper coming soon.

Background
The government of the state of Victoria in Australia conducted a review of chiropractic care for children under 12 years of age. Part of the review included a public survey of parents who had accessed chiropractic care for their child under 12 years of age in the last ten years. A second survey was for the public who had not accessed chiropractic care for a child under 12 years of age but had an opinion regarding the appropriateness of chiropractic care. The author was a member of the review panel and was granted permission to analyze the de-identified data for her PhD dissertation to study and report the scope, breadth, and meaning of the large data set. The review was initiated in response to significant political pressure regarding misplaced concerns that chiropractic care was dangerous and harmful. The Victorian health minister opened the survey with the following statement, “Now is the time for parents who have experienced the dangerous practice of child spinal manipulation to have a say and share their story. We won’t rest until babies are protected from practices we know to be harmful, and that we can be sure children under 12 are not being exposed to harm. The risks of spinal manipulations on newborn babies outweigh any benefits, but more needs to be known about children under 12. We need a national approach and that may involve changes to the law if necessary.”¹

Method
This study was a secondary analysis of the de-identified data collected for the review during a four-week period from the 22nd of May to the 21st of June 2019. It was a mixed methods study of parents’ experiences of chiropractic care for their children in Australia. The primary goal of the study was to give voice to the parents regarding their experiences of chiropractic care for their children. The questions addressed were: why do parents seek chiropractic care for their children, what reasons do parents cite as their reasons for seeking chiropractic care, who else do they consult for these concerns, how satisfied were parents (or their children) with the care they received, how satisfied were parents with the information provided about the care they received, what are the themes and experiences embedded in the parent’s narrative? The purpose of the secondary analysis of data was to understand parental experiences and perspectives of chiropractic care for their children and to quantify their level of support for chiropractic care for children.

Results
There were 22,043 responses from parents who had accessed chiropractic care for their children under 12 years of age in the last 10 years. An additional 4,558 responses were from interested community members who had not accessed chiropractic care for a child under 12 years in the last ten years but have an opinion about chiropractic care.

Families who accessed chiropractic care did so for various reasons, the majority for musculoskeletal concerns (48%); and concerns relating to development (40%). Much of this care (77.5%) was provided to children who were also under the care of other health professionals for their presenting concerns. The other health professionals consulted were primarily general practitioners, maternal and child health nurses, and medical specialists. The parents felt well informed and involved in the decisions about the care (99.14%). According to the parents, 98.4 % said they noticed, or their child reported, an improvement after the care was provided. The parents were overwhelmingly (99.6%) of the opinion that chiropractic care benefitted their child.

Qualitative findings
A thematic analysis of the open text questions was performed. The most common themes within the parent responses were as follows: there were over 13,000 references regarding an improvement in the child’s general health or wellbeing, over 7,000 references to an improvement in pain, and 5,379 references to sleep improvement.

Discussion
A large, well-conducted government survey such as this provides good evidence of the use and results of chiropractic care for children and corroborates other studies that support the safety and effectiveness of chiropractic care for children. Large data sets such as this provide “Real World Data” which has been suggested as the type of evidence most useful for routine clinical settings. Although higher level studies such as randomized controlled trials are ideal in certain circumstances, they provide evidence with internal validity only. A study such as this one provides evidence of external validity, that is; it applies to what occurs in wide and broad real-world clinical practices, making it applicable to routine practice.

Because of the voluntary nature of parental reports regarding benefits for sleep disorders, further and higher-level studies should be conducted into chiropractic care for childhood sleep issues.

Conclusion
This is the largest known parental response survey regarding chiropractic care for children in the world today. There is good evidence that parents utilize and appreciate chiropractic care for their children and wish to maintain open access to this care. Parents were very satisfied with their involvement in decisions about chiropractic care and reported very high levels of satisfaction with the outcomes of such care.

References:

1. Review Into Chiropractic Child Spinal Manipulation [press release]. 22 May, 2019. https://www.premier.vic.gov.au/review-chiropractic-child-spinal-manipulation