Document Type

Journal Article

Publication Title

Journal of Integrative and Complementary Medicine

PubMed ID



Mary Ann Liebert, Inc. Publishers


School of Arts and Humanities




Aus-ACA / the American Chiropractic Association (Council on Chiropratic Pediatrics) / Clinical Compass / Australasian Institute of Chiropractic Education (AICE) / ICA / Texas Chiropractic College / NCMIC Foundation


Keating, G., Hawk, C., Amorin-Woods, L., Amorin-Woods, D., Vallone, S., Farabaugh, R., . . . Thompson, R. (2023). Clinical practice guideline for best practice management of pediatric patients by chiropractors: Results of a Delphi consensus process. Journal of Integrative and Complementary Medicine. Advance online publication.


Objective: To build upon existing recommendations on best practices for chiropractic management of children by conducting a formal consensus process and best evidence synthesis. Design: Best practice guide based on recommendations from current best available evidence and formal consensus of a panel of experienced practitioners, consumers, and experts for chiropractic management of pediatric patients. Methods: Synthesis of results of a literature search to inform the development of recommendations from a multidisciplinary steering committee, including experts in pediatrics, followed by a formal Delphi panel consensus process. Results: The consensus process was conducted June to August 2022. All 60 panelists completed the process and reached at least 80% consensus on all recommendations after three Delphi rounds. Recommendations for best practices for chiropractic care for children addressed these aspects of the clinical encounter: patient communication, including informed consent; appropriate clinical history, including health habits; appropriate physical examination procedures; red flags/contraindications to chiropractic care and/or spinal manipulation; aspects of chiropractic management of pediatric patients, including infants; modifications of spinal manipulation and other manual procedures for pediatric patients; appropriate referral and comanagement; and appropriate health promotion and disease prevention practices. Conclusion: This set of recommendations represents a general framework for an evidence-informed and reasonable approach to the management of pediatric patients by chiropractors.



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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.