kids First Continued from Page 12 fairly rigorous schedule of care in order to reverse the neural patterning the baby has learned. It is important that your forms also ask about the child’s APGAR score – a numeri- cal value assigned immediately after birth, and, again, at five minutes. The optimal score should be 10. Anything less generally indicates a degree of birth trauma – not a good thing. Most moms will not remember their baby’s exact score – you may need to have the birth records faxed to you from the hospital/birth centre where the child was born. As well, even if the child is no longer an infant, it is important to ask mom about feeding habits as a baby – bottle fed ver- sus breastfed. If the child is still an infant, explain the benefits of breastfeeding. La Leche League (website, www.llli.org) can help you with this. Pay attention to any difficulty a mom may have (or have had) with breastfeed- ing – for example, if the baby is/was be- ing fussy, feeding on one side, etc. This is a huge clue. It means that a baby is un- comfortable turning the head to one side – generally a side-effect of a difficult delivery – and is very important as it indicates the presence of subluxation. These are some of the things that you want to chat with the mom about – even if the child is not an infant. The reason is that the majority of health problems seen in adults have their origins in childhood. I really enjoy this aspect of a child’s visit – the emphasis is not on symptoms but on how their body is functioning. Remember you are teaching your patients. The mom should be aware that this is not yet another medical examination. This is different. To this end, don’t use techno-babble moms can’t understand. WhO’S MORE NERVOuS? OK. You’ve done the consultation with her child, and mom was cool about the whole thing – even if you’ve been nervous about it. But why are you nervous, now? It’s only a child! What makes it worse is that the mother of the child you are about to check, appears to be really calm and relaxed – while you are totally embarrassed that you cannot get out the words you want. I mean, here you are, a grownup, with a college education 28 • CANAdiAN ChirOPrACTOr | JUNE 2009 and a degree, and you feel totally intimi- dated by this very short and cute seven- year-old in front of you. To make matters worse, she asks straight out; “Why are you sweating?” Here is where you, a rational-thinking, well-adjusted adult – one who has spent years studying the art and science and phi- losophy of chiropractic – start to babble effusively. This seems to be a common scenario for many a doctor who is not accustomed to seeing children. Relax. The more children you see, the easier this will become – like anything else! That is why they call it “practice.” YOuR VISIT WITh ThE ChILD It is best to approach the child with dig- nity, respect, warmth, and as their equal. Depending on the age of the child, you may want to approach your young munchkin from the perspective of play- time – not cool if the child is over seven years young because you’ll definitely be labelled as uncool. Have fun with kids – they are generally not as “cerebrally constipated” as adults are. I usually ask a young five- to seven- year-old girl, for example, how many boy- friends she has. You’ll be amazed at the an- swers you’ll get. This tends to lead to some discussion between the mom and her child – I sit back and enjoy the banter! Make certain mom and her child un- derstand what you mean by “subluxation.” There are spinal subluxation models that exist for use with kids – you can use these to help with your description. Dr. Jeanne Ohm’s “power-on” and “power-off” anal- ogy works well here! I ask children: “This is power-on and this is power-off. Which is better?” You’ll always get the correct an- swer! Even two-year-olds get this. What is most amazing though, is that moms will get it also! ThE ChILD’S CONSENT Here is where I ask the child: “I’m going to check you to see if your power is on. Would that be OK?” It is very important to ask the child for their permission to examine him/her. Re- member: respect and dignity are key here. You never, ever, want to force a child to do anything they are uncomfortable with. PREPARINg FOR ThE EXAMINATION Now, you are ready to start the examination. Make certain that you are well equipped to see children. If you use gowns, your little patients should be gowned in their own cool gowns! This speaks well of you and your office! As well, have a very flexible doll close at hand in case you need to explain what you mean by the forces of delivery, and the role they play in causing vertebral subluxations. This doll is also very handy in showing mom the stresses on the baby in cases of in-utero constraint. Make it as graphic as is needed to make your point without evoking any fear. I’ll hold the doll horizontally, facing the mother for in- stance, and bend the doll in such a way that it shows a definite spinal curve, in order to explain a “transverse lie” to mom. I haven’t yet met a mother who does not get the idea that to correct a spine that has been trapped in such a position might take a bit of time. The important thing here is to make mom understand what you see and what you find. We are told that this is a very dif- ficult thing to do. Nonsense. It’s not that difficult at all. All you need to do is place yourself in the shoes of the parent. How would you like to be talked to? As an equal? Absolutely! With techno-babble? No! How would you, as the child, like to be handled? With great respect? Yes! At their level? Of course! I suggested earlier, in this article, that you ask the child permission to examine them right after. Here is what I say: “I’m going to check to see if your power is on. Would that be OK?” The child will most often say “OK” and you can begin. Notice the words I’ve used. “Most often”. At times, the child will not give con- sent to be examined. Sometimes you may need to reschedule the exam until he/she is OK with it. Please remember that the “power on-off” approach works well with two- to 12-year- olds – don’t try it with someone who is 14. You’ll be labelled as a “loser”, and totally uncool – not a good way to build trust! OK…You are ready to begin….the cute seven-year-old is standing on the floor, in her gown, and her mother and she are waiting for your direction. Here we go… • Please look for part 2 of “Kids First” in the July/August issue, where Dr. Ressel will continue discussing a child’s first chiropractic examination. www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor June 2009: Page 28
