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What is “Wellness Care”?

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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  1. What is “Wellness Care”?

  2. Medical “Well-Child Care”vs.Chiropractic “Wellness Care”

  3. Do We Have a Wellness Schedule?

  4. 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.

  5. “Matrix” Journal of Clinical Chiropractic Pediatrics …just published by Joan Fallon, D.C., F.I.C.C.P.

  6. www.brightfutures.org

  7. Anticipatory Guidance and Developmental Surveillance Are we playing our role?

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

  9. Developmental Surveillance Includes: • 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

  10. Benefit • It communicates interest in the child’s development, not just his or her physical health • Increases parent satisfaction

  11. Does this fit our paradigm?

  12. So how do we get involved? • Formal screening tools? • Parental report tools? • Casual observation? • …

  13. What does Palmer use?

  14. 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…

  15. Are parents good judges? YES! • Subtle variations in developmental tasks and behavioral activity are often detected by parents…

  16. 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

  17. 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

  18. 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

  19. 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

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

  21. Chiropractor’s Role • Participate in developmental surveillance • Utilize parental report tools • Provide for adequate follow-up • Refer to appropriate community programs

  22. References • 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.

  23. References • 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.

  24. References • 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.

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