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What is “Wellness Care”?. Medical “Well-Child Care” vs. Chiropractic “Wellness Care”. Do We Have a Wellness Schedule?. Spinal Check-Ups. Fysh recommends spinal check-ups for school-aged children, at least every 3 months for pre-school children, at least every 2 months

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What is “Wellness Care”?

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spinal check ups
Spinal Check-Ups

Fysh recommends spinal check-ups

  • for school-aged children, at least every 3 months
  • for pre-school children, at least every 2 months
  • for infants in the first 2 years of life, at least every month

Fysh. Chiropractic Care for the Pediatric Patient.

Arlington VA, ICACCP, 2002.


Journal of Clinical Chiropractic Pediatrics

…just published by

Joan Fallon, D.C., F.I.C.C.P.

developmental surveillance
Developmental Surveillance

“…a flexible, continuous process whereby knowledgeable professionals perform skilled observations of children during the provision of health care.”

developmental surveillance9
Developmental Surveillance


  • eliciting and attending to parental concerns
  • obtaining a relevant developmental history
  • making accurate and informative observations of children
  • sharing opinions and concerns with other relevant professionals
  • It communicates interest in the child’s development, not just his or her physical health
  • Increases parent satisfaction
so how do we get involved
So how do we get involved?
  • Formal screening tools?
  • Parental report tools?
  • Casual observation?
why use screening tools
Why Use Screening Tools?
  • State norms explicitly
  • Help as a reminder to observe development
  • Efficient way to record the observations
  • Help identify more children with delays
  • Screening tools have been shown to be more accurate estimates of children’s developmental status than clinical observation…
are parents good judges
Are parents good judges?


  • Subtle variations in developmental tasks and behavioral activity are often detected by parents…
according to glascoe 1997
According to Glascoe (1997)
  • parents are able to raise valid concerns in the detection of developmental and behavioral problems from an early age, including SDP’s
unique parental view point
Unique Parental View Point
  • ability to notice developmental issues is enhanced by their knowledge and experience of the child’s history and current situation
  • they can interpret their child’s cognitive behavior within the broad framework and context of their own family
aap guidelines
AAP Guidelines
  • Present the results of the screening
    • culturally sensitive, family-centered approach
  • Refer children in a timely fashion
    • early interventionand early childhood education programs, and other community-basedprograms
  • Determine the cause of delays
    • screen hearing and vision
  • Increase parents' awareness of DD’s and resources
doctor s role
Doctor’s Role…
  • Be able to provide adequate advice and intervention activity ideas
  • Knowledge of local area programs
    • developmental stimulation programs
    • parent-child activity groups

*Head Start and Early Head Start programs

experts agree
Experts Agree

Children and families are best served when pediatricians’ screening efforts are coordinated with tracking and intervention services available in the community.

chiropractor s role
Chiropractor’s Role
  • Participate in developmental surveillance
  • Utilize parental report tools
  • Provide for adequate follow-up
  • Refer to appropriate community programs
  • AAP Committee on Children with Disabilities. Developmental Surveillance and Screening of Infants and Young Children. Pediatrics. 2001;108(1):192-6.
  • Bethell C, Peck Reuland CH, Halfon N, Schor EL. Measuring the Quality of Preventive and Developmental Services for Young Children: National Estimates and Patterns of Clinicians’ Performance. Pediatrics. 2004;113(6):1973-83.
  • Bethell C, Peck C, Schor E. Assessing Health System Provision of Well-Child Care: The Promoting Healthy Development Survey. Pediatrics. 2001;107(5):1084-94.
  • Dobrez D. Sasso AL, Holl J, Shalowitz M, Leon S, Budetti P. Estimating the Cost of Developmental and Behavioral Screening of Preschool Children in General Pediatric Practice. Pediatrics. 2001; 108(4):913-22.
  • Fallon JM. Developmental-Behavioral Pediatrics: The Chiropractor’s Role. Journal of Clinical Chiropractic Pediatrics. 1997;2(1):122-5.
  • Glascoe FP. Parents’ Concerns About Children’s Development: Prescreening Technique or Screening Test? Pediatrics. 1997;99(4):522-8.
  • Glasco FP, Foster EM, Wolraich ML. An Economic Analysis of Developmental Detection Methods. Pediatrics. 1997;99(6):830-7.
  • Halfon N, Regalado M, Sareen H, Inkelas M, Peck Reuland CH, Glascoe FP, Olson LM. Assessing Development in the Pediatric Office. Pediatrics. 2004;113(6):1926-33.
  • Melmed ME. Talking With Parents About Emotional Development. Pediatrics. 1998;102(5):1317-26.
  • Sices L, Feudtner C, McGlaughlin J, Drotar D, Williams M. How Do Primary Care Physicians Manage Children With Possible Developmental Delays? A National Survey With an Experimental Design. Pediatrics. 2004;113(2):274-82.
  • Williams J, Holmes CA. Improving the early detection of children with subtle developmental problems. Journal of Child Health Care. 2004;8(1):34-46.