Creating an adjusting schedule for a pe-diatric patient is very important, and most chiropractors do not have a system for developing one. This is a rather large void in our profession. Children need to be taken care of as real patients. This means a proper pe-diatric history must be obtained from their parents (who fill out a Pediatric History Form), and follow-up must occur with the proper consultation. This, of course, precedes the chiropractic examination, in which the chiropractor detects vertebral sublux-ation. From that, an adjusting schedule is developed, to which strict adherence is necessary, followed by regular re-examinations to monitor and update the correction of the vertebral subluxation. When it comes to developing a pediat-ric adjusting schedule, every child needs to be taken care of as an individual. There is no "one size fits all" adjusting schedule or recipe technique. A chiropractor must evaluate the needs of every individual child. One thing we never, ever do is to develop an adjusting schedule based on a child's symptoms or condition. If we try to do that, we will have an incomplete correction of the child's spinal problems. I can remember an example of a doctor from Hawaii who consulted with me on one of his patients. He described to me a 13-month-old child who was learning to walk. The child had an internally rotated foot, and kept tripping over himself. When 1 inquired about the child's history, the doctor revealed the patient first came in at four-months-of-age with ear infections. The chiropractor adjusted the child two or three times. The ear infection cleared up and the chiropractor dismissed the patient. Nine months later, the patient was back with problems. I would contend that. because the chiropractor dismissed the child when the symptoms cleared up, he never fully addressed the child's vertebral subluxation. This condition progressed over the ensuing nine months, resulting in a new problem. The lesson here is we never want to set an adjusting schedule based on the symptoms or condition. Instead, the adjusting schedule must be based on the following important factors: • Severity of the vertebral sub-luxation complex • The chronicity of the vertebral subluxation • The child's lifestyle and how he or she responds to care These factors are determined by preparing a thorough history and performing a thorough examination on the patient. The examination in- eludes motion palpation, static palpation, postural analysis, surface EMG, infrared thermal scanning, leg checks and other analytical procedures. Depending on the objective findings from those tests, the chiropractor will compare them to his or her experience and determine an appropriate adjusting schedule. For some children, it might be twice a day; for others, it could be once every two weeks. Everything depends on the examination. It is not some arbitrary, fictitious decision. It is based on objective findings founded on the initial examination. You might have an infant who is very subluxated from inutero constraint, stresses, and birth trauma. On the other hand, you could have children who made it through all that relatively easily, who are not all that subluxated. There is no average. It is all based on the needs of each individual child. Depending on the technique with which you are most familiar, you will want to schedule a progress exam. Most techniques will require a progress exam within 13-15 visits. At the progress exam, you will repeat all of the initial exam procedures done on the first visit. On the re-exam, they all become outcome parameters. With this information, you will be able to measure the changes in that child's spine, from visit one to visit 13. Now you will be able to see, for example, the EMG is showing the muscles are pulling 70 percent more on one side than the other in the first visit, as opposed to their pulling only 30 percent on the thirteenth visit. The infrared thermal scan was three standard deviations above normal on the first visit, as opposed to two, on the second exam. The areas of fixation in the spine, which were locked up in many directions, have now improved. And so on. You go down each of the exam findings and, finally, you can reveal to the parent that, based on all objective improvements in each of these tests, the child may be graduated from five days a week to four days a week, or three times a week to two times a week, followed by another re-exam in thirteen visits. The parents, who may have an understanding that the nervous system and healing are abstract or fictitious, now see that there is an objective, rational basis for why the adjusting schedule is being changed. It is best to always update the adjusting schedule following a re-examination. The process i- ; . :ed every 13-15 visits until maximum improvement is attained—that is, the most correction in the spine that can be measured. At that point, you may want to recommend a well-ness schedule. I will discuss this important subject in a future article. Having an adjusting schedule that is rational and logical endows the chiropractor with the confidence to know everything possible is being done to correct a child's vertebral subluxations. When children have the opportunity to have their subluxations fully adjusted, their nervous systems will work optimally, helping them to reach their own genetic potential at every level of existence, and allowing their bodies to regulate and heal themselves at an ever-higher capacity. You may reach Dr. Warner bv call- ing the offices of Future Perfect, Inc.. at (877) 295-KIDS (5437). \ '
