HISTORICAL PERSPECTIVES OF CHILDREN'S CLINICS

Robbin R. Doermer Student Number: 000016547 Advisor: Dr. Patrick Montgomery July 18, 2011

ABSTRACT

Introduction: Many advancements have been made in chiropractic pediatrics since chiropractic began in the nineteenth century. There were three key children's clinics that recognized the need to help sick and disabled children back to health through chiropractic care. As the need became more widely recognized; three organizations were formed dedicated to the advancement in chiropractic pediatrics, through providing information, education, and research. Several well-referenced, compressive text-books have now been written on chiropractic pediatrics and are used in chiropractic colleges and by field doctors. There are so many influential people within the scope of chiropractic pediatrics, it is important to pay homage to our chiropractic pediatric pioneers and then focus on the current trends today.

Methods: Historical data was collected by reviewing several chiropractic journals (such as, The Chiropractic Journal, Chiropractic History, Journal of the ACA, , , and The American Chiropractor); “Prairie Thunder: Dr. Leo L. Spears and His Hospital”, a book written by William Rehm and published by the Association for the ; and a review of several web sites for Kentuckiana Children’s Center, Oaklahaven Children’s Center, The International Chiropractic Pediatric Association (ICPA), Academy Council of Chiropractic Pediatrics, The International Chiropractors Association (ICA), The American Chiropractic Association, and Chiro.org.

Discussion: The three key children's clinics that recognized the need to help sick and disabled children back to health through chiropractic care were The Free Children's Clinic, Kentuckiana Children's Center, and Oklahaven Children’s Chiropractic Center. As the need became more widely recognized; the three organizations that were formed dedicated to the advancement in chiropractic pediatrics were The International Chiropractic Pediatric Association (ICPA), The American Chiropractic Association's Council on Chiropractic Pediatrics (also known as the ACA Pediatrics Council), and the International Chiropractors Association Council on Chiropractic Pediatrics (also known as the ICA Pediatrics Council).

Results: The need has became more widely recognized for the advancement in chiropractic pediatrics, through providing information, education, and research.

Conclusion: Many advancements have been made in chiropractic pediatrics since chiropractic began in the nineteenth century. Chiropractic Children’s Clinics have proven to be beneficial to the sick and disabled children who have run the gamut of traditional medicine and have lost hope. I feel it would be beneficial if more children’s clinics were to open near all the chiropractic colleges. We would be able to reach more children in need of chiropractic care, it would create a greater awareness in the community and educated the general public about chiropractic care for families, and it would provide more opportunity for the chiropractic student to learn.

Key Words: chiropractic pediatrics, ACA Pediatrics Council, ICA Pediatrics Council, ICPA, DICCP, Kentuckiana, Oklahaven, Spear's Free Children's Clinic

INTRODUCTION

Many advancements have been made in chiropractic pediatrics since chiropractic began in the nineteenth century. There were three key children's clinics that recognized the need to help sick and disabled children back to health through chiropractic care. These three clinics were The Free

Children's Clinic, which was opened in 1932; Kentuckiana Children's Center, founded in 1957; and Oklahaven, which opened in 1962. As the need became more widely recognized; three organizations were formed dedicated to the advancement in chiropractic pediatrics, through providing information, education, and research. These organizations are the International Chiropractic Pediatric Association (ICPA), The American Chiropractic Association's Council on Chiropractic Pediatrics (also known as the ACA Pediatrics Council), and the International Chiropractors Association Council on Chiropractic Pediatrics (also known as the ICA Pediatrics Council). There are so many influential people within the scope of chiropractic pediatrics, it is important to pay homage to our chiropractic pediatric pioneers and then focus on the current trends today.

DISCUSSION

THE FREE CHILDREN'S CLINIC

In August 1932, Dr. Leo Spears began operating the first large-scale free children's clinic in chiropractic. The demands became so great, he reported, that soon he was forced to employ six chiropractors at $1 an hour to take care of the increasing patient load which had grown to more than 300 children a day. The free clinic operated from 6 to 8 P.M. on Monday, Wednesday and Friday. Using federal relief guidelines, any indigent child under the age of 12 was eligible.1 Dr. Leo had introduced the profession to his concept of free children's clinics at the annual meeting of the National Chiropractic Association (NCA) in Hollywood, California, in August of 1935. The idea was so enthusiastically received he wrote monthly columns for several years in The Chiropractic Journal. Entitled “Children's Clinics,” the columns were a guide for movement that within the first year saw 125 free clincs established nationwide.2 Leo Spears was considered a dynamic achiever in the face of adversity. This 1921 Palmer graduate built the profession's first large hospital complex and had plans for an institution that would have been among the largest healthcare facilities in existence.3 For his class yearbook, Dr. Spears wrote the following: I never stopped doing a thing because somebody else said it was wrong. Nor did I keep on because somebody said it was right – I did my own thinking! I always persisted when I knew it was right, and when I found I was wrong I acknowledged it. Above all, I always kept my word. When I said I would do a thing, I did it, when I thought I couldn't do it, I said so. I always tried to treat other people as I would have them treat me. I never wasted my time, but put every minute to good use. In the last analysis, I never made excuses, I made good.2,4

KENTUCKIANA CHILDREN'S CENTER

Since its inception, Kentuckiana Children's Center operated as an outpatient clinic, providing evaluation and treatment by a multidisciplinary staff, as well as a special education program for children with special needs. Both programs were designed to serve the “whole” child and his or her individual needs. The program was designed to assist the child in developing at his or her own rate of speed, manifesting the use of innate abilities and the child's fullest potential to help him or her to be a productive and happy human being.5 In 1954, Dr. Golden began to formulate the idea for Kentuckiana. She saw the need for children with multiple handicaps to receive chiropractic care and began to organize local DCs and laypeople to open a clinic that would provide free care to these children, most of whom came from families that were financially strapped. The following year, the Kentucky legislature chartered Kentuckiana Children's Center in Louisville. It was set up as a private, nonprofit, nonsectarian charitable organization to provide direct services free of charge to physically and mentally challenged children in need of health and special opportunities. The center opened its doors to patient care in 1957 and slowly began to grow and expand its scope of treatment. Under Dr. Golden's reign, Kentuckiana became a unique chiropractic institution: providing free chiropractic care for challenged children; combing chiropractic care with a school for children with special needs, and providing that care free to the families that could not afford care; Kentuckiana also developed the first postgraduate two-year intern program in pediatrics.6 The early days of Kentuckiana were difficult. The Kentucky Medical Society attempted to close down the center. Articles in the Louisville Courier Journal appeared with critical commentary from MDs seeking to discredit Dr. Golden and the center.7 Dr. Golden recalls: “I had to be extra cautious about everything, especially records. Some of our staff became perturbed at me because I was so strict. I would not let us be closed down based on technicalities. I said every record has to be in order so that if a medical doctor tries to come in and close us down, the records would support our activities. I had always told the girls that if anyone wants to see a record, just pick them at random. So they came in and reviewed the records, and the conclusion was that I had better records than they did.” Dr. Golden invited the press out for a tour to see for themselves. “(The press) tried to be objective,” she ventured, but the Kentucky Medical Society went so far as to try to thwart Kentuckiana's efforts to gain support from the United Way. Why? “They considered us nothing but cultist,” Dr. Golden explained. “That was the image they were trying to position in the minds of the people. But the community could see our good work, and that's why we were able to stay open.”8 Attorney George McAndrews, the attorney in Wilk et al. vs. AMA et al., used the examples of harassment of Kentuckiana by the Kentucky Medical Society in the Wilk case as further evidence of the medical establishment's campaign to destroy the chiropractic profession. It was just one more piece of damning evidence against orthodox medicine that led chiropractic to victory in Wilk. As a result of this trial, the American college of Surgeons made a payment of $200,000 to Kentuckiana, which was used for expansion of its facilities.7,9 Dr. Golden earned her “DC” from Palmer School of Chiropractic in 1942 and conducted a private practice for more than a decade before opening the children's center. Some call her the “Mother Teresa of Chiropractic.” For more than 40 years Lorraine M. Golden, DC, gave her heart and her time to the care of the poor – specifically, to mentally and physically handicapped chi;dren whose families could not afford her services. Her legacy remains in Kentuckiana Children's Center in Louisville, KY., which continues to serve children's healthcare needs.10 Dr. Golden retired as Executive Administrator in May, 1998 after 41 years of devoted service.11

OKLAHAVEN CHILDREN'S CHIROPRACTIC CENTER

Oklahaven began as Children's Chiropractic Health Center of Oklahoma in response to the needs of chronically ill children in 1962. The center specializes in the treatment of neurologically disorganized children. Nursing difficulties, colic, ear aches, failure to thrive, developmental delays, asthma, arthritis, ADD, ADHD through the autistic spectrum, and cerebral palsy are just a few conditions that have been successfully treated. Oklahaven has continued to operate through private donations without federal, state or United Way funding.12 The center was founded as a private, nonprofit organization by a volunteer group of six doctors of chiropractic. They were Dr. Raymond E. Cook, Dr. Melvin Wayne Clark, Dr. H. J. Lynch, Dr. Ed Lynch, Dr. J. C. Getteys, and Dr. Bob Baker. When these doctors met again, six more joined the group, including Dr. Eva Thompson, Dr. Antonio Guadagno, Dr. Kent Carder, Dr. Orville S. Witt, Dr. Lou Santelli and Dr. John R. Carver. At the third meeting the group grew to eighteen. In 1973 the name changed to Oklahaven Children's Chiropractic Center and moved into a clinic donated by doctors Ruth and Orville Witt.13 In 1977, Drs. William and Bobby Doscher assumed responsibility for the center's daily operations. Dr. Bobby became president and CEO at the time of Dr. Witt's death in 1981. As the center grew, another facility was purchased in 1993. The new center is more centrally located, and allows for future expansion to treat more children, to conduct research, and to educate people about the benefits of the natural, drug-free health care of chiropractic.14 Dr. Bobby Doscher received her Doctor of Chiropractic from Palmer College in Davenport, Iowa, and later became a Doctor of Naturopathy. She has been chosen “One of the Twelve Great Women in the History of Chiropractic” and the “Woman Chiropractor of the Year” for the Centennial Year of the Chiropractic Profession in 1995 by the World Congress of Women Chiropractors. She has received numerous Humanitarian Awards for her unwavering dedication to healing the children and for natural healthcare. The Center has received national and international recognition and support during Dr. Bobby’s 30-year tenure. She lectures at chiropractic colleges, numerous conferences, and has been invited to serve the severely sick children in such places as Jordan, Guatemala, Mexico, Honduras, Austria, Russia, Poland, Germany, Netherlands, and Ireland.15

INTERNATIONAL CHIROPRACTIC PEDIATRIC ASSOCIATION (ICPA)

The International Chiropractic Pediatric Association (ICPA) is the oldest and largest non-profit organization of its kind. The ICPA was founded by Larry Webster, D.C. in 1986. He developed the Webster Technique; also known as the Webster Breech Turning technique and later named the Webster In-Utero Constraint Technique. This technique allowed a baby in a breech presentation to turn to the vertex position. The technique is still being taught by instructors of the ICPA's 120 hour certification program.16 Dr. Webster's vision and passion in working with children had a major impact in redirecting the profession to care for more children. Its membership is composed of over two thousand chiropractic doctors and students around the world. The mission of the ICPA is to provide education, training, and support research on chiropractic care in pregnancy and throughout childhood.17 The ICPA offers a diplomate program. The purpose of this Diplomate Program is to offer doctors of chiropractic the educational and clinical experience to confidently and proficiently care for pregnant women and children.18 In order to achieve the diplomate status, the doctors must complete 360 hours of post-graduate training in the area of family wellness, including specific studies and clinical competence for infants, children and the care in pregnancy. Upon completion of these hours, each candidate needs to successfully pass a comprehensive examination and then is awarded a Diplomate in Pediatrics from the Academy Council of Chiropractic Pediatrics.19 The Academy Council is composed of an outstanding Board of Directors and Advisory Board. The Academy Board members are a select group of doctors who have been actively involved in chiropractic pediatrics for at least 20 years. They bring both clinical and academic expertise to the Academy Board. The Advisory Board has been selected to assist the Board in continued collaboration and advancement of the Academy.20

INTERNATIONAL CHIROPRACTORS ASSOCIATION COUNCIL ON CHIROPRACTIC PEDIATRICS (ICA PEDIATRIC COUNCIL)

The International Chiropractors Association (ICA) is the world's oldest international chiropractic professional organization representing nearly 8,000 practitioners, students, chiropractic assistants, educators and lay persons world-wide dedicated to the growth and development of the chiropractic profession based on its fundamental principles and philosophy. The ICA has a long and distinguished history. It was established in 1926 in Davenport, Iowa by Dr. B. J. Palmer who served as ICA president till his death in 1961. Since then other leaders have emerged to carry ICA and the profession forward, but always remaining true to the principles and philosophy on which it was founded, fighting to preserve its unique identity as a separate, distinct and drugless health care profession.21 The ICA Pediatric Council is one of the specialty departments of the International Chiropractors Association.22 It was established in 1993 to bring together doctors of chiropractic who have a special interest caring for children and pregnant women.23 It was also in 1993 that the ICA Pediatric council developed and established the Diplomate in Chiropractic Pediatrics (DICCP). The DICCP program includes 30 modules of 360 classroom hours over a 3-year period. It also includes a one weekend rotation at the Kentuckiana Children’s Center for special needs children in Louisville, Kentucky. The curriculum is designed to balance academic knowledge with clinical applications. The goal of the program is to ensure that by the time the doctor completes the full course they have the knowledge, competency and skills to care for children and pregnant women appropriately, effectively and to the highest professional standards.24 Writing of research projects/papers are mandatory. Research writing is included so doctors may increase their analytical skills and become competent in designing, conducting and publishing their findings. Candidates must complete the full 3-year program, all assignments/projects, and pass the final internal exam to be eligible to sit for the DICCP Board Examination. This Board examination is conducted once a year by the International College of Chiropractic Pediatrics and consists of two parts -- written and oral. Testing is conducted by several examiners. All candidates who successfully pass the Board examination are awarded the DICCP (Diplomate in Clinical Chiropractic Pediatrics) credential. Diplomates must complete 24 hours of continuing education in chiropractic pediatrics every three years in order to maintain their diplomate status. Diplomates who have been in practice for a certain number of years, present and publish research papers, teach at the postgraduate level, and contribute in any significant way to advancing chiropractic care for children and improving patient care, may achieve the distinction of a Fellow in Clinical Chiropractic Pediatrics (FICCP). Fellowship is not automatic and is decided by a panel of Fellows on the Board.25

THE AMERICAN CHIROPRACTIC ASSOCIATION’S COUNCIL ON CHIROPRACTIC PEDIATRICS (ACA PEDIATRICS COUNCIL)

The American Chiropractic Association was founded in 1922, and in 1930 merged with the Universal Chiropractors Association to form the National Chiropractic Association (NCA). In 1963, the NCA was reorganized, once again under the title of the American Chiropractic Association. The ACA is a professional organization representing Doctors of Chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of Doctors of Chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, they accomplish their mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment and by carrying out a dynamic strategic plan to help ensure the professional growth and success of Doctors of Chiropractic. The ACA and its members seek to transform health care from a focus on disease to a focus on wellness.26 The ACA Pediatric Council is the American Chiropractic Association’s youngest specialty council. It was established in 2005. Their goal is to support their members who take care of children in their chiropractic practices, and to promote the acceptance and advancement of pediatric care.27 In 2007, at the ACA National Chiropractic Legislative Conference, the ACA House Delegates recognized the International College of Chiropractic Pediatrics (ICCP) as the board that certifies pediatrics for ACA and so recognizes the diplomate program, the DICCP, developed and established by ICA.28

CHIIROPRACTIC PEDIATRIC TEXTBOOKS In 1910, D.D. Palmer released the earliest publication that validated the adjusting of children: The Chiropractor’s Adjusstor. In 1924, Dr. Craven wrote about the care of children in the text Chiropractic Hygiene and Pediatrics. Additionally, technique chapters were written in 1968 by Dr. Clarence Gonstead and in1976 Dr. Denis Stierealt. The ICA has self published two textbooks: Joan Fallon’s Textbook on Chiropractic & Pregnancy, and Peter Fysh’s Chiropractic care of the pediatric Patient. The first Comprehensive textbook on this subject published by Lippincott Williams & Wilkins is Pediatric Chiropractic, edited by Dr. Greg Plaugher and Dr. Claudia Anrig. More than 30 authors contributed to this 19-chapter textbook, which features over 1,000 illiustrations. It is used in chiropractic colleges and field doctors. Neil Davies’ Chiropractic Pediatrics: A Clinical Handbook is a comprehensive pediatric textbook with chapters contributed by the medical community. It is well-referenced and useful. Chiropractic colleges introduced pediatrics as part of their respective ciriculums as early as 1915 (West Coast Chiropractic College in Oakland, California). Pediatric programs continued to be implemented from 1912 to 1948 in the majority of the chiropractic colleges, and continue to this day.29 CONCLUSION

Many advancements have been made in chiropractic pediatrics since chiropractic began in the nineteenth century. Chiropractic Children’s Clinics have proven to be beneficial to the sick and disabled children who have run the gamut of traditional medicine and have lost hope. I feel it would be beneficial if more children’s clinics were to open near all the chiropractic colleges. We would be able to reach more children in need of chiropractic care, it would create a greater awareness in the community and educated the general public about chiropractic care for families, and it would provide more opportunity for the chiropractic student to learn.

REFERENCES

1. Spears, Leo L. “Children's Clinics.” The Chiropractic Journal, Sept. 1935 2. Rehm, William S. Prairie Thunder: Dr. Leo L. Spears and His Hospital. Davenport: Association for the History of Chiropractic, Inc., 2001 3. Rehm D.C., William S. “Price of Dissension: The Private Wars of Dr. Leo L. Spears, 1921-1956.” Chiropractic History, Vol. 15, No. 1, 1995 4. Rex, Erna. The Lengthening Shadow; The Story of Dr. Leo L. Spears. Golden Bell Press, Denver, 1962 5. . Valone, Sharon. “Kentuckiana's Children's Center: An Idea Before It's Time!” Journal of the ACA, May 1997 6. Editorial Staff. “Dr. Golden Retires from Kentuckiana, Dr. Sharon Vallone Appointed Acting Executive Director” Dynamic Chiropractic, September 21, 1988, Vol. 16, Issue 20 7. . Editorial Staff. “Dr. Lorraine Golden, Dynamic Chiropractic's 'Chiropractor of the Year'” Dynamic Chiropractic Canada - http://www.chiroweb.com/mpacms/dc_ca/article.php?id=37594 8. 8. Cleveland III, Dr. Carl. Champion for the children. Aug. 25, 1998 interview with Dr. Lorraine Golden 9. Painter D.C., Frank M. “The Chiropractic Antitrust Suit Wilk, et al vs. the AMA, et al” , II. Summary of Injunction Issued September 25,1987 - http://www.chiro.org/Wilk/ 10. "Dr. Lorraine Golden and the Kentuckiana experience", Chiropractic Economics – http://www.chiroeco.com/50/bonus/golden.html 11. Vallone D.C., D.I.I.C.P., Sharon. “Dr. Lorraine Golden, In Memoriam” – http://kentuckiana.org/founder.html 12. http://www.chiropractic4kids.com/index.html 13. Editorial Staff. “Celebrating 45 Years of Restoring The Lifeforce Within Our Children”, in-line With Oklahaven Children's Chiropractic Center, November 2006 14. Editorial Staff. “Oklahaven Celbrates 40 years”, Dynamic Chiropractic, Volume 29, no. 15 15. http://www.chiropractic4kids.com/staff.html 16. Ohm DC, Jeanne. “The Webster Technique – A Chiropractic Analysis and Adjustment for Pregnant Women” The American Chiropractor, November 2003 17. http://icpa4kids.com/about/ 18. http://icpa4kids.com/seminars/DiplomateMainPage.htm 19. http://www.chiropracticfamilypractice.org/diplomates.html 20. http://www.chiropracticfamilypractice.org/about_us.html 21. http://www.chiropractic.org/?p=ica/historical 22. http://www.icapediatrics.com/about-background.php 23. http://www.chiro.org/pediatrics/ 24. http://www.icapediatrics.com/files/information_about_course,_exams,_registrations.pdf 25. http://www.icapediatrics.com/members-postgrad.php 26. http://www.acatoday.org/level2_css.cfm?T1ID=10&T2ID=20 27. http://acapedscouncil.org/ACAPC-About.html 28. Hewitt DC, CST, DICCP, Elise G. “ACA Pediatric Council: Breaking New Ground”, http://www.acatoday.org/content_css.cfm?CID=2331

29. http://www.drclaudiaanrig.com/articles/Pediatric%20Chiropractic.pdf