• Doyle M
• Marinus M
• Miller J

• Open Access Document
• Pediatric Chiropractic
• Practice Patterns, Physicians'

Background: Pediatric chiropractic care is increasingly being utilized worldwide; however, comprehensive data on practice characteristics remain limited. Understanding practitioner approaches, patient presentations, and outcomes is essential for evidence-based practice. This paper characterizes international pediatric chiropractic practice patterns, including practitioner demographics, pediatric patient presentations, chiropractic care approaches, perceived outcomes, and economic factors.

Methods: A cross-sectional survey was administered to chiropractors in 17 countries through professional associations and educational institutions. The survey collected data on practitioner training, pediatric patient demographics, presenting conditions, treatment techniques, perceived outcomes, and practice economics. Descriptive statistics were used to characterize practice patterns and demographics. Correlational analysis was used to examine the relationship between training levels and practice characteristics. International episode costs were compared using the Kruskal-Wallis test, given the right-skewed distribution and between-country variance. Post-hoc pairwise comparisons were conducted using Dunn’s test with Bonferroni correction to control for family-wise error rate.

Results: A total of 1,142 practitioners completed the Pediatric Practice section. Participants represented diverse geographic regions, with 61.1% having undergraduate pediatric training and 53.7% having postgraduate training. School-aged children (5-12 years) comprised the largest patient group (34.2%), followed by toddlers/preschoolers (28.7%). Common pediatric presentations varied by age: colic/crying in infants aged <3 months (45.3%), developmental concerns in 3-12 month infants (32.4%), and musculoskeletal complaints in older children (52.7%). Diversified techniques were the most commonly used (70.3%), followed by Activator methods (63.7%). Practitioners reported improvement in 94.3% of cases, with adverse events occurring in 2.1% of the cases. Episode costs showed significant international variation (Kruskal-Wallis H=185.9, p<0.001), ranging from median costs of $160 USD (Canada) to $233 USD (United States), with 66.2% of practitioners offering reduced pediatric fees and 63.7% accepting insurance coverage.

Conclusion: This international survey revealed diverse pediatric chiropractic practice patterns with high perceived success and low adverse event rates. Training levels were significantly correlated with practice volume, age specialization, and outcomes. Economic accessibility measures have been widely implemented. These findings provide valuable insights into clinical practice, education, and policy development in pediatric chiropractic care.

Author keywords: Pediatric Chiropractic; Practice Patterns; Survey Research

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