the nervous system and making those medical conditions, making those secondary signs or symptoms to their care. Dr. Hoffman: Do you have a different history form that you utilize for a pediatric patient versus an adult patient? Dr. Apfelblat: Actually, I have many. The Michigan Chiropractic Pediatric Association created forms. We spent about two years doing this and compiling information because the form that's out there for an adult, it's just nothing like the questions that you need to ask parents to gather the information to substantiate care for children. We have an intake form. We have evaluation and exam forms. The evaluation, the health intake forms are geared towards children. We have one for infants, 0 to 12 months. Then there's one for toddlers, 13 to 16 months, and then a 4 to 12-year-old intake form. In these are different subluxation related complaint so that we can gather the information and that parents can look at that and understand that chiropractic has a relationship to these signs and symptoms. I'd like to compare the infant, and toddler, and child subluxation related complaints so that you could get an idea of the different questions that are asked. Would that be okay? Dr. Hoffman: Of course. Dr. Apfelblat: Great. For an infant ... We're looking for neurological stress or abnormal neurostructural patterns which are subluxations in children. Subluxation related complaints for an infant could be asymmetrical face structure or head tilting, earaches. Did they have colic? Do they spit up? Are there constipation or issues with diarrhea? Do they have difficulty nursing or latching? Have they ever experienced seizure? Do they have neurological ticks? Do they have any skin issues like eczema, or do they get rashes? Also, if they are on formula, do they have an intolerance to formula or if they're nursing, do they have any intolerance to any food in the mother's diet? Then as we move on to a toddler, we can ask questions about their digestive issues or perhaps they have difficulty eating. Have they been diagnosed with autism, or do they have neurosensory dysfunction? Also, do they appear clumsy, or do they have ... Do you see any poor coordination skills? Then moving into a child's form, we can also ask many more complaints now. Do they have any focus concerns or ADHD? Do the parents suspect that? Do they have any learning disabilities in school, or enuresis, poor coordination? Now, we can ask about headaches and
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