Fallon, JM; Vallone, S; Treatment Protocols for the Chiropractic Care of Common Pediatric Conditions: Otitis Media and Asthma Journal of Clinical Chiropractic Pediatrics. 1997 Jan ; 2(1): 113-5

Abstract: Objective: With increasing numbers of children being brought to alternative health care practitioners, the majority of whom are chiropractors, it is imperative that the chiropractic profession work toward establishing consensus treatment guidelines for the management of common childhood conditions. The purpose of this paper is to present the results of a survey of chiropractors enrolled in the first three-year postgraduate course in chiropractic pediatrics. The survey sought to establish if consensus existed with respect to the modalities these doctors used to treat two of the most common childhood disorders seen by chiropractors: otitis media and asthma. Method: Thirty-three (33) doctors of chiropractic enrolled in the first year of a three-year postgraduate course in chiropractic pediatrics were surveyed to determine which management protocol they most commonly employed in the care of children with either otitis media or asthma. Consensus was established at a level where seventy-five percent (75%) of the respondents used a particular approach. Additional data was gathered with respect to the chiropractic college attended, size of pediatric practice, and number of years in practice. Results: Thirty-three (N=33) doctors of chiropractic participated in the survey. For otitis media, twenty-four (24) specific treatment modalities were identified. Twelve (12) modalities reached consensus in that they were utilized by at least seventy-five percent of the respondents. Of the twelve (12), sixty-seven percent (67%) of the modalities represented manual adjusting procedures, seventeen percent (17%) dietary changes, eight percent (8%) soft tissue manipulation, and eight percent (8%) supplementation. For asthma, twenty-one (21) modalities were cited. Eight (8) modalities reached consensus. Of the eight (8) that reached consensus, fifty percent (50%) represented evaluative procedures, twenty-five percent (25%) manual adjusting procedures, thirteen percent (13%) dietary changes, and thirteen percent (13%) soft tissue manipulation. The average number of pediatric visits per week was 14.7 with 6.8 for otitis media and 4.1 for asthma. The average number of years in practice was 8.2 with a median of 7.5. The doctors graduated from 10 different chiropractic colleges. Conclusions: Several interesting patterns emerged from the results of this survey. The first was that of the primary therapeutic modalities employed by the chiropractor, spinal adjusting was the most commonly used for both asthma and otitis media. The second was the identification of certain areas of the spine to which adjustments were most frequently applied for each of these two conditions. The third was the significant number of non-spinal adjustment modalities used and the high frequency of usage by the survey group. It should be reiterated that the survey was taken as doctors entered the post-graduate program and is therefore not reflective of the training provided by the program. These results may therefore be more representative of therapeutic modalities generally in use by the profession at large. However, the sample size is small and inadequate to form any generalizations. This study in no way addressed the efficacy of the treatment modalities reported. Further research needs to be undertaken to evaluate each of the modalities as single entities before any specific claims can be made. Once the research has been completed in those areas, further attempts at consensus, and establishment of standard treatment approaches for these conditions can be undertaken.