A New Pediatric Chiropractic Survey Reports a 2.1% Adverse-Event Rate — Then Cites Research Showing the Real Number May Be 80 Times Higher
A January 2026 international survey of 1,142 chiropractors treating children reports high satisfaction and a reassuringly low adverse-event rate. Buried in its own discussion section is a citation revealing that when adverse events are actively tracked rather than self-reported, the rate jumps from 0.1% to 8.8% of visits — and the survey's list of what chiropractors are treating includes infant colic, feeding difficulties, and a pilot trial of spinal "adjustment" for ADHD.
What the survey found
"Clinical Characteristics of Pediatric Chiropractic Practice: An International Survey," by Matthew Doyle, Mike Marinus, and Joyce Miller, was published in the Journal of Contemporary Chiropractic (Vol. 9, Issue 1) on January 20, 2026. It surveyed 1,142 chiropractors across 17 countries — led by the United States, Canada, Australia, and the UK — about who they treat, what they treat them for, what techniques they use, and how often something goes wrong.
The headline numbers are framed favorably throughout: 94.3% of cases showed "some degree of improvement," and adverse events were reported in just 2.1% of cases. The most common techniques used on children were Diversified (70.3%) and Activator methods (63.7%) — both forms of spinal manipulation rooted in chiropractic's original "subluxation" theory, the idea that misaligned vertebrae cause disease, a concept with no basis in mainstream anatomy or physiology.
| Age group | Most common presenting complaint |
|---|---|
| Infants <3 months | Colic/excessive crying (45.3%), feeding difficulties (23.1%), sleep disturbance (18.7%) |
| Infants 3–12 months | Developmental concerns (32.4%), torticollis/plagiocephaly (28.9%) |
| Children 1–11 years | Musculoskeletal complaints (52.7%), behavioral concerns (24.3%) |
| Adolescents 12–18 | Sports injuries (41.6%), spinal pain (38.2%) |
The number that matters is in paragraph three of the discussion
⚠️ 0.1% vs. 8.8%
The survey's own safety discussion states: "Pohlman et al. demonstrated in North America that active surveillance detected adverse events in 8.8% of pediatric chiropractic visits compared to 0.1% with passive surveillance." That citation is to a 2020 cluster-randomized trial (Pohlman, Carroll, Tsuyuki, Hartling & Vohra, BMJ Open Quality) that directly compared the two reporting methods in the same pediatric chiropractic settings. Passive self-reporting — the method this new 2026 survey itself relies on — caught an adverse event in roughly 1 out of every 1,000 visits. Active, structured surveillance caught one in roughly every 11.
In other words, the very survey publicizing a 2.1% adverse-event rate is built on the same self-reporting method that its own cited literature says undercounts adverse events by roughly 80-fold.
What "adverse event," left uninvestigated, might be hiding
The survey's authors add a caveat of their own: "it is generally considered that any adverse event that does not require medical attention is not accurately defined as an adverse event, but as a side effect" — a framing that narrows what counts before the numbers are even collected. Prior systematic reviews (Todd et al. 2015; Vohra et al. 2007) have documented adverse events specific to infants and children receiving spinal manipulation, ranging from mild soreness and crying to, in rare published case reports, more serious neurological injury. None of that risk calculus changes the underlying problem the 2026 survey's own citation exposes: self-reported numbers from practitioners are not a reliable way to measure how often something goes wrong.
Treating conditions chiropractic has no business treating
Infant colic and feeding difficulties
Colic and feeding problems were the single most common reason children under three months were brought in (45.3% and 23.1% of infant visits respectively). There is no plausible anatomical mechanism by which spinal manipulation would affect an infant's digestive system, and the survey itself only manages to cite a systematic review of reviews (Ellwood et al. 2020) covering colic interventions broadly — not evidence that chiropractic manipulation specifically works for it.
ADHD
The survey's introduction cites, as supporting literature, "a recent pilot RCT investigating the effect of the chiropractic adjustment of vertebral subluxation... in children with attention deficit hyperactivity disorder." Vertebral subluxation, in the sense chiropractic uses the term, is not a phenomenon recognized in mainstream medicine or radiology. Treating a neurodevelopmental condition like ADHD by adjusting an undetectable structural abnormality is a textbook example of pseudoscientific reasoning being applied directly to children.
Who wrote it
All three authors are chiropractors or chiropractic researchers; the paper was published in a chiropractic trade journal (Parker University), and the corresponding author has previously published under the title "Chiropractic care for infants and children — there is no evidence for it and it is dangerous? A selective review of the literature and commentary" (2016) — a title whose question mark does a great deal of work. This is not independent, disinterested safety research; it is a professional association's own membership survey, self-reported by the practitioners being surveyed, about the safety of the care those same practitioners provide.
Why this fits the pattern
This is the same structure QuackeryWatch has documented across dozens of other cases: a claim of safety or efficacy that looks solid on the surface, sourced from the people with a financial and professional stake in the answer, with the actual caveats and contradicting evidence pushed down into methodology sections most readers — and most journalists covering the "high satisfaction" headline — will never reach. See our related pages on fatalities linked to CAM practices and the chelation-for-autism overview in our Dubious Rx section for other examples of pediatric-specific alternative medicine claims that don't survive scrutiny of their own cited sources. Our sister site ChiroWatch.com documents chiropractic-related deaths, including cases involving spinal manipulation of the kind discussed here.