The Practice Gap
The Practice Gap
Bridging the Gap: Pediatric Chiropractic Beyond Infancy-With Dorte Bladt DC
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
In this episode, you will meet Dorte Bladt, a Danish chiropractor practicing in Australia who specializes in pediatric chiropractic care. Dorte shares her journey that led to focusing on helping children with learning and developmental challenges through chiropractic adjustments.
• There is a gap in chiropractic care between treating babies and teenagers with most practitioners missing the crucial developmental years
• Many chiropractors lack confidence in assessing school-age children despite having foundational skills
• Each developmental milestone builds on previous ones, making early intervention crucial for preventing issues
• Introducing pediatric care into practice involves modifying existing assessment skills and learning to communicate effectively with children
• Focusing on nervous system function rather than symptoms when explaining findings to parents
• Creating appropriate care plans based on thorough assessment, with frequency determined by the severity of nervous system interference
• Gentle adjustments calibrated to the child's nervous system capacity—"less is more" approach
• Kids Summit in Barcelona (September 13-14) featuring expert speakers on pediatric chiropractic techniques
Visit the Kids Summit in Barcelona to learn from pediatric chiropractic experts and support research into chiropractic care for children.
Thank you for listening! If you like what you hear, please share it with someone that you think might find value in this episode. If you enjoy this podcast, please take a moment to rate us on Apple Podcasts or where you listen to us. Your feedback helps us improve and reach more listeners. Thank you!
Kind regards,
Elisabeth Aas-Jakobsen, DC, MSc
follow on instagram
or visit homepage
Introduction to Dorte Bladt
Speaker 1Hi and welcome to the Practice Gap, the podcast for closing the gap between the practice you have and the one that you want. I'm Elisabeth, a chiropractor, a business owner, coach and entrepreneur, on a mission to help you move from frustration and overwhelm to clarity or remotely. Dotte Blatt, who's a Danish chiropractor who works in Australia. Could you please tell the audience a little bit about yourself?
Speaker 2Yes, well, yes, I'm a Danish chiropractor. I work in Newcastle in Australia. I graduated from Palmer College of Chiropractic a long, long time ago and started, but I was always interested in working with children and actually got into chiropractic because that was the way I was introduced to chiropractic. I thought it was all about kids. And then I had some issues with my daughter who didn't quite in her early baby years. She wasn't quite as I had expected a chiropractic baby should be.
The Gap in Children's Chiropractic Care
Speaker 2So when she started kindergarten or Bernehale class, whatever that's called over there in Norway, we realized that she had some significant learning challenges and I then used a chiropractic approach to get her to succeed in school and that just created the biggest passion for working with children who had learning issues, but also children who were just that little bit older than the traditional baby chiropractic patient, and I guess I have focused on that ever since. So I teach other chiropractors how to work with children in my Switched On Kids programs. I run a coaching program called Practice Pro, where I again teach chiropractors how to care for kids and, as you may have heard of, the Kids Summit is also a baby of mine where I have an event where the sole focus is raising funds for research into chiropractic care for kids. So I think that is a synopsis of me and my practice life, I guess.
Speaker 1And this year the Kids Summit is coming to Barcelona in September. Right the 13th? No, yeah, 13th.
Speaker 2Yeah, 13th and 14th. Yes, very excited to get back to Barcelona. We were there a couple of years ago and absolutely loved it and really loved connecting with the European chiropractors. We hadn't done very much. We had been to the States a couple of times and we've run this event in Australia many times. This year is our 10th event and we have, at this point, raised over $400,000 for research into chiropractic care for kids and we're super excited to get back to Barcelona and hopefully help fund more research.
Speaker 1Very cool and I must say I was there a few years ago and I absolutely love it. It was wonderful, super inspiring and motivating seminar weekend. It's good and for at least here in Norway we are pretty good at treating really young like babies.
Speaker 1We are pretty good at treating really young like babies, and then these babies, we don't really see them again until they're like 15, 16 years old and they come in with back pain or headaches or something. I think there's generally a huge gap between the babies and these young adults with pain. Do you, can you? What are your thoughts about that?
Speaker 2I think it's a little bit hard to know because I've actually never worked with. You know I never worked in Denmark. Well, I have, but it was such a short time that it probably doesn't really count. But in Australia we definitely see children through their early preschool years and into their school years, so potentially a bit more than you do in Northern Europe. But what I find is often a challenge for chiropractors is that they don't know they don't have, they don't feel confident in their skills and how to assess a slightly older child.
Speaker 2You know we get a fantastic education in working with adults with. You know sports injuries and with disc injuries and facet. You know issues and blah, blah, blah, blah. But you will not have a seven-year-old. It is very, very unlikely to have a seven-year-old that comes in with a positive straight leg raise or you know that has issues with. You know wear and tear type chronic issues that we would see in an adult and they obviously are very, very different. You can't do a pull to sit test and you know their tummy time is quite good.
Skills Needed for Treating Children
Speaker 2So I find that people don't really know what do we do about these kids? So the skills in actually finding the subluxation pattern and the effect that it has on the nervous system function is lacking and that was, as I said when I was talking about my early life, my early experience in children. That was very much what I found myself. You know, my children had been adjusted since birth on a fairly regular basis, but I didn't really own the skills to figure out what was I missing with my daughter.
Speaker 2So that took, you know, some research and there are some wonderful tests, I mean, and many of them, many of you will know how to test for a retained primitive reflex and you will know how to test for a C-abilitis function and you will know how to test for a sensory processing type of challenge. And those are the tests that we need to correlate with the subluxation pattern. And I think if we would take the time to take further education and learn confidently how to deal with these kids, we would prevent an awful lot of. Well, one thing is back pain, but also challenges at school, challenges with sleep, challenges with behavior, because we know that each developmental milestone is built on the one before and we end up with a certain behavior pattern, a certain movement pattern in young adults when we start seeing them with back pain or headaches or whatever. But that could have been picked up potentially in a 10-year-old, in a 5-year-old, in a 2-year-old, and I actually think we need to get better at catching these kids early and prevent challenges later in life.
Speaker 1So what I hear you say is even though you don't have, if I'm a chiropractor and I don't have huge experience in treating children and younger adults, I would have some of the basic skills. I just wouldn't know how to apply it on the child. Is that correct?
Speaker 2Exactly yeah, exactly yeah, exactly yeah. So many of these. They obviously have to be modified a little bit, but, yes, absolutely, we know a lot. We just need to target it to the correct age group and then, as I say, translate it into a care plan that is user-friendly for a younger person. Yeah, is user-friendly for a younger person. Yeah.
Speaker 1So if our ambition is to really impact the future generations, we need to work with the kids right.
Speaker 2Well, as far as I'm concerned, yes, the children are the key to our future, and I also think that it's a key to our future as a profession, because the back pain market is being challenged in all sorts of directions and we know that there's lots of preventative issues we can have through exercise, and the physiotherapists are doing a wonderful job of helping. And I'm not saying that chiropractic is not good Hang on, that's not at all what I'm saying. But I am saying that the marketplace is getting quite squeezed, so it might be good for us to have alternative skills to use as well as taking care of of the adults that still will need our care so it's kind of what you usually call like it's.
Speaker 1It's a blue ocean market. It's a market that hasn't really been tapped in. We have so much potential there to help all this. Yeah, absolutely a big uh. I mean if, if we say from from one to 15 or one to 20 years old, that's basically between 15 and 20 percent of the population, something like that. That hasn't really so, or we have big potentials. Yes, yeah, if. If you see that, okay. So I, if I'm a newly educated chiropractor I've been out of school for a couple years and I've really worked with kids and I'm a little bit afraid, afraid, how? What would you tell me to motivate me to get into this treating children?
Speaker 2So you're saying that I already have some skills?
Speaker 1Yeah, I have very like. Okay, say that I've been working for like maybe three years and I just had a normal. I've seen headache patients and back pain since, but like a completely ordinary chiropractic practices Very few children.
Building Confidence with Young Patients
Speaker 2What I would do is, I guess, I mean, obviously, immerse yourself in learning, learning the skills from a theoretical perspective, and, you know, go to your weekend courses and, you know, do enough. To that. You think, okay, well, I've got a handle on this. And then I think it's actually quite simple, it goes hand in hand. I would connect with friends and siblings and neighbors and volunteer my services, both from a professional, getting hands-on children, but also in a how do I communicate with a seven-year-old? What can I say? What can I do? What sort of silly jokes do I need to have Because at the end of the day, the seven-year-old is not going to come in and just lie down.
Speaker 2And well, some will, but most will not just come in and lie down on the bed and you know, okay, turn over and do this and do that. They require, you know, an interaction that's a bit more fun and a bit more lively. And you know you might have to encourage the rest of the family maybe to get adjusted first, because they might be a little bit scared. But when you actually are around children, you know how to target your behavior to make a seven-year-old or five-year-old or 15-year-old feel a bit more comfortable. And it's quite different for those different age groups.
Speaker 2And then for actually the professional side of things, it's quite easy to ask the current practice members you know so, when did your child last get checked?
Speaker 2When did they last have an adjustment?
Speaker 2And then they will likely say, oh well, you know they don't have any back pain, they've never been checked.
Speaker 2And then you turn around if you're trying to build your practice, and say, you know, oh, really, oh, but I would, you know, I think that that is, you know, crazy or that's silly, or let's do something about that, and then maybe offer not necessarily a complimentary check or anything, but to say you know what, next time bring me in, let me just have a quick look, and to see how their nervous system is working, how their bodies are working.
Speaker 2Don't get stuck in symptoms, because you're going to talk yourself into a corner when you're talking symptoms, I mean from an evidence point of view. We don't have a lot of research yet that links the care that we provide with learning issues or anything. But if you just want to check their spines and then you can have the conversation about how does the nervous system work, how is the spine involved in making sure the nervous system is working well and then potentially take the conversation to the next step of well, I would recommend that we do a proper check and then you book them and then do a full check and then you book them into a full assessment and potentially some work.
Speaker 1Say that I'm a patient of yours. I have a seven-year-old daughter who I'm taking her to see you. Based on what you said, what would you tell me, as a parent, that you actually do?
Speaker 2How I?
Speaker 1would give them an adjustment. No, I'm thinking like how, like see, if I'm the mother and I'm taking, like you've done something, so I actually take your, I want to take the child to you, I bring them in, like if I'm a patient. What do you actually?
Speaker 2tell me. So my conversation would have developed over a period of time. I know we all have different sort of philosophies with regards to what we do, but my take on chiropractic is that I look at how the nervous system is functioning and if there's something subluxated, if there's something not working in the spine, it may interfere with the way the nervous system is working, and I would explain. That means that, you know, the brain doesn't receive the best information from the body and it doesn't send the best information back. So I would have had that conversation over, you know, a period of time, explaining to the mom okay, and that's why blah blah, blah, blah blah happens with you. So let's just say that mom says well, you know my daughter, I'm wondering whether I should bring her in. What I would explain is. So what we would do is, you know, check your daughter's spine Again.
Nervous System Assessment and Communication
Speaker 2What I'm looking for is potential interference to the nervous system. Now, the nervous system, you know, sends messages between the brain and the body. So we would look at, for example, how does your child balance? If the child has an issue with balance, it could mean that the information from one foot doesn't travel as fast to the brain as it does on the other side. So therefore they get a little bit more wobbly on the left rather than the right. Now what that means is that there's different stimulation to the brain. If there's different stimulation to the brain, that can have detrimental effect over time, because it means that the brain on one side potentially doesn't develop as well as it could on one side compared to the other. So what I would check for is whether this is happening in your daughter. Does that make sense?
Speaker 1That makes perfect sense and also good knowledge is with the message of traveling from the foot. I like that one. I also think like, say, that I bring my seven-year-old child. You find some problems there, and what would an ordinary treatment plan look like? I know that every patient is different, but just in general.
Speaker 2Yeah, so I make a care plan based on the assessment results I might do. In a normal assessment I might have 25 tests that I do, and that sounds like a lot and it isn't really, because most of them are quite quick. But let's just say that I have done 25 tests and there is I don't know 20 of them that are not working well. So I know that that's a nervous system that is under a significant stress. I would, in that case, come up with a plan that would be, you know, twice a week for a period of time, and then it'll be followed by a reassessment, and then once a week for a period of time, and then, you know, going down in sequence, but each change in care would be preceded by a like a reassessment. So I basically have an idea of how well the nervous system is improving. Now, when I'm talking about this particular case, I just have to say it's a little bit hard when we're talking theory here. Someone that comes in to me that has 20 tests out of the 25 that are not functioning well would be a child that is on the autistic spectrum. It would be a child that has significant learning delay a child that is on the autistic spectrum. It would be a child that has significant learning delay. It would be a child that has quite significant sensory processing issues. So it's not the average little Joe Blow that has just fallen while she was playing soccer in the backfield, because that child is obviously very different. That child may have you know, they might have landed on their sacrum and it might be a question of you know more acute care.
Speaker 2But yes, I base it on my test results because I'm looking at as well as I can on nervous system function rather than symptoms, and I want to include enough time for the nervous system to heal. And I have this conversation. I run my SwissDone Kids and SwissDone Baby seminars in Denmark quite frequently and I don't know how it is in Norway, but I imagine it's probably fairly similar, where you have quite a limited timeframe to fix things in, and I feel that that limits the effect you have on the nervous system function. It tends to be more of a physical function. Yes, you might release if there's a facet. I can never remember what the heck you call them, but I'd call them a subluxation. You know you can loosen something in the spine and that loosens quite quickly. But if you're actually trying to make a change in the way the nervous system functions. You have to follow up and make sure that the nervous system actually improves over time.
Speaker 1And I think that's a lot of where the hair among a lot of colleagues are to like to take on patients that are actually need to follow up. There is a feel there is with it, even within the profession and also within the people using us. It's like, oh, it's quick fixes and then, yes, and we are just so scared of taking on chronic cases and also, yeah, these people like children and also things that need to continuously monitor and follow up, and that we are doing something. We're not doing a job. If we need to follow them up, we're not.
Treatment Plans for Children
Speaker 2Yeah, yeah, we're not having the impact that anyway that I'm saying that we are having. If we, you know, give a couple of adjustments and then let them go. If we're looking to change a developmental trajectory, them go. If we're looking to change a developmental trajectory, we need to stay fairly involved in adjusting and assessing and, I think, also recognize that the adjustments themselves they have to be within the limitation of the child's nervous system. It is very easy to overpower a young person's nervous system, in which case they don't. Yes, they will have the spinal release, but they will not actually get the improvement in the nervous system. The system shuts down. And I think we sometimes forget that it is too easy to do a lot. We don't want to do too much, we want to do just enough to that they get the optimum healing, and then stop and let the body do the work by itself.
Speaker 1So less is more, less is more, absolutely Okay. Say that my seven-year-old. She has six out of 25 issues. Would you share those issues like patient communication-wise? Would you say, like, okay, she can only stay in one? Would you share the checklist in a way?
Speaker 2No only if mom asks and I think that that's a very important piece of information that I feel is essential to think through when you're setting up your practice and your procedures what is it that you want the person to remember when they leave? For me, what is important for them is that there is nervous system interference, that chiropractic, via gentle adjustments, can help and that there are some things that we need to do at home. That's sort of the main things I want them to know. So if they come in and say, oh okay, well, I noticed this, this, this, this, yes, I'm very happy to explain. Okay, well, it was the ATNR on the right and it was a whatever dysdiagoconesia on the left, blah, blah, blah, if that's what they're interested in.
Speaker 2But I will only say that if they ask me, because I mean, even with you it's like I'm not saying you don't know what I mean, but you know. It's like now you're starting to focus on the dysdiagoconesia. What does that mean and what effect does that have? Then you spend the next half hour trying to explain. You know how the cerebellum functions and you know, and you've lost them. They will not remember anything about what chiropractic is and they will not be able to take the important input of yes, we can help, because they get so lost in the details. So, generally, no, I will not tell them the six tests Perfect.
Speaker 1Thank you. So keep it simple.
Speaker 2in other words, yeah, I mean, what I will usually do and that's one of the reasons, I suppose is that I love the primitive reflexes. I will usually explain just very, very briefly what a retained primitive I won't say it's retained primitive reflex. I will just say there are signs that the bottom part of the brain has taken over and the top part of the brain is not firing as well as it should Now and what we need to do is to make sure that we actually get the top part of the brain to fire as well as it can so we can have proper again. It's that whole thing. We want the information between the brain and the body to connect. We want them traveling well, evenly, on side to side and that whole knee-jerk response that a primitive reflex is. We need that to settle down and they need to actually have much more adult brain working.
Speaker 2I wouldn't use these words, but I'm just explaining that. That is probably something I will touch on, just so they know that I'm not a bone doctor and I'm not a brain doctor either. I'm a nervous system connection. Well, doctor, I suppose.
The Kids Summit in Barcelona
Speaker 1Connector, that sounds good, I like that. Yeah, well, doctor, I suppose. Yeah, connector, that sounds good, I like that, yeah, okay, so I'm back to being now a chiropractor who has been working for a couple of years. Why should I attend the Kids Summit? What can I expect to learn there this year?
Speaker 2we have some absolutely incredible speakers coming from all over the world, some experts that are actually paying their own way to come and present to you and to me. I suppose We've got Martin Rosen, coming from the States. He is an expert in pediatric chiropractic cranial work and he will be sharing his three top cranial adjustments with the group. And one thing to remember is that we have a workshop session on Saturday afternoon so we actually get to practice some of the things, some of the issues that the chiropractors will be sharing from the stage. So that'll be fantastic, that'll be really good.
Speaker 2Linda Slack is another American presenter who has been teaching with the ICPA for the last 10 years or so. She will be sharing about the assessment of young children and how to communicate the findings with parents. We've got Heidi Hovik, who is the main recipient of the funds that we raise in the Kids Summit. She will be talking about science and some of the studies that they have funded with the money we have supplied so far. Janine Kinahan is talking about. She's from Australia. She's going to talk about the pelvic floor dysfunction in both children, as in bedwetting basically, and in postpartum, and will do do that from the sot angle. So again. There will be some adjustments um that she will teach.
Speaker 2Julie ren, from australia, is teaching about, I think, v-back, so vaginal birth after a cesarean. We've got jenny not jenny jennifer and simon floriani. They're locals, they live in barcelona and they're going to be talking about methylation and I'm trying to remember there's a particular supplement that they use that they're going to talk about, but they will basically look at vagal function and colic and the methylation cycle. Who else have we got? Kelly McLaughlin is coming from the UK and she will be talking about baby assessment from memory. Who else have we got? That'slaughlin is coming from the UK and she will be talking about baby assessment from memory. Who else have we got? That's a good question. There's heaps of amazing speakers.
Speaker 1It sounds great. Yeah, it sounds wonderful. I'm already super excited.
Speaker 2Yeah, you should be, it'll be great yeah.
Speaker 1And last question here If I'm a chiropractor and I don't know anything about treating children, can I still come? Should I still come?
Speaker 2You definitely should. Absolutely. It's a really good place to learn. There will be information for people who are just starting out, for people who are quite comfortable and people who have been doing this for 35 years. So there are different angles and different levels of information and there will definitely be skills to take home for Monday morning. So, absolutely, yeah, brand new or an old hat, come along.
Speaker 1Perfect. Thank you so much, Dorte, for taking the time to talk with us about the treatment of the little older children.
Speaker 2It's my pleasure. I was lovely to chat to you.
Speaker 1Thank you, and then to the audience out there. We'll see you all in Barcelona.