Nightline in the Dark About Chiropractic?
"Crack: Kids Head to the Chiropractor" elicits an immediate response from the profession.
By Peter W. Crownfield, Executive Editor
Our lead story in the March 12 DC
put pediatric chiropractic squarely in the spotlight. That article
reviewed, among other recent developments, a Jan. 19 USA Today article
that painted chiropractic care for children in a fairly positive light; and the latest federal CAM survey,
which showed approximately 2 million children received chiropractic or osteopathic manipulation in 2007. While our article also discussed ongoing challenges, such as attempts by third-party payers
to deny coverage for pediatric chiropractic,
the emphasis was on the apparent progress being made in terms of its acceptance.
A mere three issues later, our spotlight remains on pediatric chiropractic, but now for what leading chiropractic organizations are characterizing as a less-than-positive segment on ABC News' "Nightline" on the topic of "Baby Adjustments" (The title of the video segment posted on the Nightline Web site is actually "Crack! Kids Head to the Chiropractor," which seems to more accurately reflect its skeptical tone.) In the segment, ABC News Correspondent David Wright interviewed New York City chiropractor Dr. Beth Forgosh, and also included commentary from Lonnie Zeltzer, MD. We encourage you to view the entire video online (http://abcnews.go.com/video/playerindex?id=6994288) and ensure patients who may have seen the segment have a more accurate impression of the valuable care DCs provide to children.
Upon learning of the Nightline segment, we solicited commentary and official response from the International Pediatric Chiropractic Association (ICPA) and the American Chiropractic Association. The ICPA provided us with a statement from Dr. Joel Alcantara, ICPA research director, while the ACA forwarded us a copy of its March 12 letter to ABC News, authored by Dr. Glenn Manceaux, ACA president, and Dr. Elise Hewitt, president of the ACA Council on Chiropractic Pediatrics. In both cases, we've reprinted select passages; complete responses are available online (see Web links at the end of this article), including full references.
The ICPA Response:
"Despite the biased reporting against chiropractic by David [Wright] on ABC News ... [Dr. Forgosh] and her patients are to be commended for their honest representation on the benefits and safety of pediatric chiropractic. Despite [Wright's] claim of openmindedness on the part of [Dr. Zeltzer] towards non-allopathic therapies, her comments regarding the safety and effectiveness of pediatric chiropractic are uninformed and demonstrates her ignorance on the topic."
"We do not know the full context of Dr. Zeltzer's comment when asked by David [Wright], 'What kind of impact did that have on an infant?' and she replied, 'Well, it could paralyze the infant.' In 1998, Lee and colleagues extrapolated that over 30 million pediatric visits were made to chiropractors. The continuing popularity of pediatric chiropractic would support the notion that by 2009, pediatric chiropractic visits are in excess of this 30 million. In over 100 years of pediatric chiropractic and millions of pediatric chiropractic visits, only two articles in the scientific literature - a case of paraplegia in an adolescent girl and quadriplegia in an infant - have been associated with chiropractic spinal manipulation. Upon a more thorough reading of the articles, the two children had a pre-existing medical condition or had suffered neurological trauma prior to chiropractic care, [which questions] the placement of fault on the part of the attending chiropractors." "It is unfortunate that Dr. Zeltzer is uninformed about the chiropractic care of children. Had she done her homework, she would [have realized] that due to the unique biomechanical features of the pediatric spine, the chiropractic care of children has special considerations. In the ABC News feature, Dr. Forgosh could be observed using the Activator instrument to deliver a low-force adjustment. This is but one of the many techniques chiropractors use to deliver a safe and effective adjustment to children and adults. Who in their right mind would think that an Activator instrument could paralyze a child? As for the high-velocity, low-amplitude, thrust-type adjustments, they are modified so that a gentle force is applied to the pediatric spine. Again, Dr. Forgosh demonstrated this in her care of pediatric patients. The bottom line is, Dr. Zeltzer is not informed about chiropractic. How informed is she about the use of other types of 'alternative therapies' for children in her practice? If she claims to know these alternative therapies as well as she does about chiropractic, perhaps her pediatric patients and their parents should be wary and take their children to the appropriate practitioners for alternative care."
The ACA Response:
"[W]e would have preferred that the piece took more time to look at the research and results that support the use of chiropractic for children. Chiropractic treatments have been helpful for children with many childhood conditions, including colic, ear infections, constipation, nursing dysfunction and asthma. The story was framed with skepticism and scare tactics used to establish the supposed drama of pediatric chiropractic, when in fact, chiropractic spinal manipulation is a highly skilled treatment. In the case of children, manipulation is very gentle with modifications made in adjustive procedures to adapt to the pediatric spine.
"The medical doctor's unfounded comment about the risks including paralysis was not relevant or based on facts. Recent studies have pointed to the safety of chiropractic care for children. A 2007 systematic review of adverse events following spinal manipulation in children found only 9 serious adverse events over a 110-year period, with only 3 in the U.S. Miller, et al., found no adverse events following chiropractic care of 781 pediatric patients (75% under 4 months of age) involved in over 5,000 chiropractic treatments from 2002-2004. These statistics represent an extremely low incidence compared to any other pediatric medical interventions. "The real story is in parental and patient satisfaction, as many of the parents in your piece expressed. A 2008 study published in the Journal of Manipulative and Physiological Therapeutics followed 781 pediatric patients under 3 years of age who received a total of 5,242 chiropractic treatments at a teaching clinic in England over four years. 85% of parents reported improvements in their children's conditions."