Core Competencies of the Certified Pediatric Doctor of Chiropractic
Written by Editor   
Sunday, April 16, 2017 12:43 PM
Want to know what is expected of a chiropractic pediatrician?  The purpose of this study was to develop an outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic. 

Chiropractic undergraduate educational curriculum includes training in many specialty areas, including sports, neurology, nutrition, radiology, and pediatrics, to name a few. This training supplies the necessary skills for all doctors of chiropractic to provide basic care within each specialty. As the chiropractic profession has grown and matured, specialty certifications have developed for those doctors of chiropractic wishing to further their education and skills in specific areas of practice. Becoming a certified specialist requires advanced training and passage of a specialty-specific certification examination. One such specialty is the field of chiropractic pediatrics.

Usage of the services of a doctor of chiropractic by the pediatric population has increased. In 2008, the Centers for Disease Control and Prevention reported chiropractic/osteopathic was the most common form of provider-administered complementary or alternative medicine used by children in the United States. A recent update to this survey found the percentage of children receiving chiropractic/osteopathic manipulation has increased from 2.8% in 2007 to 3.3% in 2012. The most recent practice analysis by the National Board of Chiropractic Examiners found the percentage of pediatric patients in US practices has increased from 9.7% in 1991 to 17.4% in 2014. A recent study of 20 European countries found children represented 8.1% of European chiropractic practices.

Two postgraduate pediatric diplomate programs have been developed within the chiropractic profession in the United States, with additional programs in the United Kingdom and Australia. In 1993, the first program was developed by the International Chiropractors Association’s (ICA) Council on Chiropractic Pediatrics. This program offers a Diplomate in Clinical Chiropractic Pediatrics (DICCP). In 2002, a second program, the Diplomate in Pediatrics from the Academy Council of Chiropractic Pediatrics (DACCP), was organized by the International Chiropractic Pediatric Association (ICPA). A doctor of chiropractic who completes one of these programs and passes a board examination is referred to in this report as a “Certified Pediatric Doctor of Chiropractic” (CPDC). These postgraduate programs entail between 280 and 400 hours of training taken over 2 to 3 years.

The purpose of this study was to utilize an expert Delphi panel to develop consensus-based core competencies for the CPDC. This panel was composed of a diverse group of chiropractic pediatric specialists from across the broad spectrum of the chiropractic profession to ensure all viewpoints were represented. An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment.

It is expected that the Certified Pediatric Doctor of Chiropractic will:

Possess a working knowledge and understanding of the anatomy, physiology, neurology, psychology, and developmental stages of a child.

  • Recognize known effects of the prenatal environment, length of the pregnancy,and birth process on the child’s health.

  • Identify and evaluate the stages of growth and evolution of systems from birth to adulthood.

  • Appraise the clinical implications of developmental stages in health and disease, including gross and fine motor, language/communication, and cognitive, social,and emotional skills.

  • Recognize normal from abnormal in these areas.

  • Possess an understanding of the nutritional needs of various stages of childhood.

Recognize common and unusual health conditions of childhood.Identify and differentiate clinical features of common physical and mental pediatric conditions.

  • Identify and differentiate evidence-based health care options for these conditions.

  • Identify and differentiate clinical features and evidence-based health care options for the pediatric special needs population.

Be able to perform an age-appropriate evaluation of the pediatric patient.

  • Take a comprehensive history, using appropriate communication skills to address both child and parent/guardian.

  • Perform age-appropriate and case-specific physical, orthopedic, neurological,and developmental examination protocols.

  • When indicated, utilize age-appropriate laboratory, imaging, and other diagnostic studies and consultations, according to best practice guidelines.

  • Appropriately apply and adapt these skills to the pediatric special needs population.

  • Be able to obtain and comprehend all relevant external health records.

  • Formulate differential diagnoses based on the history, examination, and diagnostic studies.

Establish a plan of management for each child, including treatment, referral to, and/or co-management with other health care professionals.

  • Use the scientific literature to inform the management plan.

  • Adequately document the patient encounter and management plan.

  • Communicate management plan clearly (written, oral, and nonverbal cues) with both the child and the child’s parent/guardian.

  • Communicate appropriately and clearly with other professionals in the referral and co-management of patients.

Deliver skillful, competent, and safe chiropractic care, modified for the pediatric population, including but not limited to:

  • Manual therapy and instrument-assisted techniques including manipulation/adjustment, mobilization, and soft tissue therapies to address articulations and/or soft tissues.

  • Physical therapy modalities.

  • Postural and rehabilitative exercises.

  • Nutrition advice and supplementation.

  • Lifestyle and public health advice.

  • Adapt the delivery of chiropractic care for the pediatric special needs population.

Integrate and collaborate with other health care providers in the care of the pediatric patient.

  • Recognize the role of various health care providers in pediatric care.

  • Utilize professional inter-referral protocols.

  • Interact clearly and professionally as needed with health care professionals and others involved in the care of each patient.

  • Clearly explain the role of chiropractic care to professionals, parents,and children.

Function as a primary contact, portal of entry practitioner who will.

  • Be proficient in pediatric first aid and basic emergency procedures.

  • Identify and report suspected child abuse.

Demonstrate and utilize high professional and ethical standards in allaspects of the care of pediatric patients and professional practice.

  • Monitor and properly report side effects/adverse events.

  • Recognize cultural individuality and respect the child’s and family’s wishes regarding health care decisions.

  • Engage in lifelong learning to maintain and improve professional knowledge and skills.

  • Contribute when possible to the knowledge base of the profession by participating research.

  • Represent and support the specialty of pediatrics within the profession and tothe broader healthcare and lay communities.