Outcome Measures That Matter - Dr Jacey Pryjma

Learn the tips and tricks to working with kids

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Outcome Measures That Matter

What’s the point of doing an initial examination if you are not going to use the data collected to compare the scores at a later date? In this video I am going to go through 3 outcome measures that matter and need to be routinely tested during your progress examinations with kids.

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How many times have you heard – is my child improving? Is he getting better? He is still sore, crying, not sleeping, not pooing, I am not sure chiropractic is working?

Does your practice focus on symptom resolution or encourage long term health goals? What ever you choose to focus on in practice is up to you, as long as you have a way of measuring a child’s improvement along the way and your language and behaviour day in day out supports your overall goals.

My practice is focused on building long-term relationships with families to help them achieve a higher level of health through chiropractic care. So the outcome measures I will be sharing with you today are to measure their improvement of health and function, not decreased symptoms.

Let’s get into it. There are some things that a child needs to grow and thrive to their full potential.

  1. They need to move well
  2. They need to have good tone and posture
  3. They also need to hit their milestones – good neurological development

Let’s look at each in a little more detail.

Moving well is essential to growth. Poor movement or imbalance in the skeletal frame means that a child will experience a lack of neurological stimulation or a distortion in the overall balance and use of the neurological system.

So lets look into Range Of Motion.

Range of motion scores in rotation, lateral flexion, flexion, extension and are the four most important ranges to check. You can check Kemps but it’s not necessary as the lateral flexion or rotation should pick up any problems with kemps. As a minimum you need to be checking a child’s neck and lumbar range of motion.

Make sure you score these findings in a range that you consistently use. For example 1-4 with 5 being excessive motion.


Now onto tone and posture.

Muscular tone is essential to understand how well the neurological system is firing. Low tone can indicate subluxation and can therefore improve under chiropractic care.

Your assessment of tone should include tests for the upper extremities, lower extremities, and for the head, neck and body.

In older children, your assessment can be achieved through assessing the motor development of a child and by simply evaluating a child’s posture. If there is an issue with tone it will be easy to see in a photo.


Milestone development

We know that a child’s body moves through stages. The primitive reflexes (are in at birth – check). As the brain develops they integrate as the postural reflexes emerge. During this time we will start to see motor control begin, the identification and controlled co-ordination of limbs and finally balance and fine motor skills come in to facilitate further learning and growth.

This ordered pattern is predictable. Which means a child’s movement through them needs to be monitored and documented.

Your assessment needs to follow kids through this pattern.

At the end of the day, the data collected from a child’s examination needs to be used to monitor progress. It’s essential to document their success while under your care. It will clarify for you what your kids in care need and will serve as a valuable tool for you to share with parents. .

It can take hours to re-create your kid’s exam over and over.

And this is why I put together the Well Kids Program. In the program everything is done for you! We have a specific report for families that explains everything they need to know about their child’s progress.

How do you structure your exam?

What are your favourite outcome measures to use?

As always be sure you leave your tips, ideas and comments below.


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