Is there research backing the use of chiropractic care to help children with developmental issues?

Chiropractic Care for Children's Development: Insufficient Evidence to Support

There is no credible research evidence supporting the use of chiropractic care to help children with developmental issues, and current clinical guidelines recommend against its use due to lack of proven benefit and potential safety concerns.

Evidence from Clinical Guidelines

Recommendations Against Chiropractic for Pediatric Conditions

The American Academy of Otolaryngology-Head and Neck Surgery explicitly states no recommendation for complementary and alternative medicine (CAM), including chiropractic manipulation, for treating pediatric conditions due to absence of scientific evidence documenting efficacy and an uncertain balance of benefit and harm 1.

• Small pilot studies examining chiropractic treatments for middle ear conditions in children failed to show clinically or statistically significant benefits 1, 2.
• The guideline notes that while a case series of 332 children treated with chiropractic manipulation for ear infections did not mention side effects, quadriplegia has been reported following spinal manipulation in an infant with torticollis 1.
• There are no randomized, controlled trials with adequate sample size on the efficacy of chiropractic care for pediatric conditions like otitis media with effusion 2.

Safety Concerns in Vulnerable Populations

The American College of Rheumatology conditionally recommends against chiropractic therapy in their 2022 guidelines, citing potential cervical spine complications, perceived lack of benefit, burden, and costs 1.

What Actually Works for Developmental Issues

Evidence-Based Early Intervention for Developmental Delays

For children under 3 years with confirmed developmental concerns (such as autism spectrum disorder), the American Academy of Pediatrics recommends 1:

• Combination of developmental and behavioral approaches that integrate behavioral analysis techniques with developmental theory
• Active family involvement as co-therapists with appropriate supervision and training
• Targeted interventions addressing specific deficits (language skills, joint attention, emotional reciprocity)
• Early initiation as soon as diagnosis is seriously considered, ideally before age 3 years

Motor Delay Evaluation

For motor developmental delays, the American Academy of Pediatrics provides a structured approach 1:

• Standardized developmental screening at 9-, 18-, and 30-month visits
• Specific motor milestone assessment at each visit (rolling, sitting, standing, walking)
• Referral to appropriate specialists (physical therapy, occupational therapy, neurology) when delays are identified
• Timely diagnosis to inform prognosis, service planning, and monitoring for associated disorders

Current State of Pediatric Chiropractic Research

Limited and Inconclusive Evidence

Recent systematic reviews acknowledge 3:

• Limited data with a range of findings and often no definite conclusion regarding benefits of chiropractic care in children
• Paucity of evidence supporting chiropractic benefits for pediatric developmental issues
• Research has investigated both musculoskeletal and non-musculoskeletal conditions with no definitive conclusions

Practice Patterns vs. Evidence

Despite lack of evidence, surveys show 4:

• The most common reason parents seek chiropractic care for children is "wellness care" rather than specific developmental concerns
• Musculoskeletal conditions are the most common condition-based presentations
• No evidence supports chiropractic care for improving developmental outcomes in children

Clinical Pitfalls and Caveats

Common Misconceptions to Address

• "Wellness care" is not evidence-based: There is no research supporting routine chiropractic adjustments for promoting normal development in children 4.
• Potential for delayed appropriate care: Time spent pursuing unproven therapies may delay access to evidence-based interventions that have demonstrated efficacy 1.
• Safety considerations: While serious adverse events appear rare, they have been documented, particularly in infants 1.

What to Tell Parents

When parents inquire about chiropractic care for developmental concerns 3:

• Discuss all complementary therapies openly to provide optimal guidance focused on health and safety
• Redirect to evidence-based interventions: Physical therapy, occupational therapy, speech therapy, and behavioral interventions have demonstrated benefits for developmental delays 1
• Emphasize early intervention: For true developmental concerns, proven interventions should begin as early as possible 1

Bottom Line for Clinical Practice

If a child has developmental delays or concerns, refer to appropriate specialists (developmental pediatrics, physical therapy, occupational therapy, speech therapy) who can provide evidence-based interventions rather than chiropractic care 1. The absence of quality research supporting chiropractic care for pediatric development, combined with documented safety concerns and the availability of proven alternatives, makes it an inappropriate recommendation for this indication 1, 2, 3.