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The Empowered Parent with Dana Baltutis
Welcome to The Empowered Parent Podcast.
This podcast is a space for parents to learn, reflect, and grow.
Each week, we explore topics that help parents understand themselves and their children more deeply - from communication and connection, to supporting neurodivergent development at home and in the community.
We’ve had wonderful conversations with experts, parents, and professionals - including speakers from the Neurodivergence Wellbeing Conference, and a special series following one mum’s journey in unschooling her child.
Every episode is here to inspire curiosity, compassion, and confidence in your parenting journey.
Don’t forget to follow along, share your reflections, and join the conversation.
You can connect with me at danabaltutis.com or mytherapyhouse.com.au.
Let’s celebrate neurodivergence.
Let’s celebrate belonging.
The Empowered Parent with Dana Baltutis
Episode 48: Dr. Genevieve Keating (Chiropractor) - Empowering Child Development Through Pediatric Chiropractic Care and Collaborative Approaches
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Discover the transformative power of chiropractic care for children in our latest episode featuring the esteemed Dr. Genevieve Keating. With an inspiring career spanning over 45 years, Dr. Genevieve shares her personal journey from a childhood concussion to becoming a leading figure in pediatric chiropractic care. This is more than just a story of professional success; it's a testament to the healing potential of gentle chiropractic techniques for children, particularly those facing neurodevelopmental challenges. Listen as Dr. Genevieve demystifies common misconceptions and highlights the role of chiropractors in nurturing the youngest members of our communities.
Our conversation doesn't stop at chiropractic care; it explores the broader landscape of childhood development. Dr. Genevieve discusses the significance of early intervention and the synergistic relationship between chiropractors and other healthcare professionals. From addressing breastfeeding difficulties to understanding sensory motor development, we delve into how a collaborative approach can significantly enhance a child's developmental journey. This episode is a treasure trove of insights for parents seeking comprehensive support for their children's health and well-being.
https://www.chiropractors.org.au/ https://dynamicneuro.com/our-team/ https://www.kidsneurochiro.com/
danabaltutis.com, mytherapyhouse.com.au, https://mytherapyhouse.com.au/your-childs-therapy-journey/ https://www.danabaltutis.com/services
Welcome, dr Genevieve Keating. I'm so happy to have you here. It's taken us a while to get here, but here we are. You're an internationally recognised chiropractor and educator who has spent the last 45 years wondering how we are, who we are. You are passionately interested in developing brains and how we, as a community, can have a guiding hand. Your study has earned you a Bachelor of Applied Science in Chiropractic, a Diploma of the American Chiropractic Neurology Board and a PhD in Early Childhood Development and Infant Mental Health. Wow, what an amazing combination.
Speaker 1You are a full-time family practitioner and an internationally recognised educator. You've designed and taught seminars for over 25 years. You teach chiropractic paediatric seminars and a two-year chiropractic paediatric diplomat program, and you are a keynote speaker at many interdisciplinary conferences. You are a fellow of the Australasian Institute of Chiropractic Education, a founding member of the College of Chiropractic Paediatrics and an assistant professor of the Carrick Institute for Graduate Studies, genevieve. You represented the chiropractic profession on a government review of spinal manipulation for children under 12 years of age. You were awarded the Australian Chiropractic of the Year in 2019 and have published papers regarding chiropractic care for infants, children and adolescents. You are committed to engaging health practitioners and the community in understanding, assessing and supporting neurodevelopment, ensuring that babies and children are given the best chance for healthy, happy lives, and you are incredibly inspired by babies, children and the families you work with. And before we go on and people go, where is this lady? I need her. You're based in Victoria. Welcome.
Speaker 1Yeah practicing in Victoria. Welcome, dr Genevieve, to the Empowered Parent Podcast. I can't wait to get into the nitty-gritty of chiropractics with you. How did you come to work in this space and what inspired you?
Speaker 2Wow, that was a long introduction. Thanks, Dana, if we've got time left for the podcast.
Speaker 1Oh, I couldn't. When I researched and read about you, I thought people need to know that chiropractic people in chiropractics aren't just people who are crunching bones in a little room somewhere, but they're out in the community doing things for the community, for kids, babies and families. So I had to put that in.
Speaker 2Thank you, dana. It's a pleasure to be here. I'm always interested in working with other and sharing with other health practitioners and learning from others who are working in this space of children and children's development and really keen to work to support the families in our community. So I respect what you do and I'm delighted to be here today. So we're going to come back to the crunching babies. Actually, let's handle that now. Chiropractors don't crunch babies. We don't do that at all. Chiropractic is a very diverse way that we work with children. There's not just one technique. We don't use spinal manipulation in young babies and young children. There's many gentler ways that we do gentle spinal mobilization and unwinding of postural things. So we'll come back to that part.
Speaker 2How I got interested in this is really quite an interesting story because when I was 12, I dived into a pool and hit my head on the bottom and I was very badly concussed and badly injured. But that's a long time ago now and people didn't diagnose. Well, I look back and I had a really severe concussion and I had postural orthostatic tachycardia syndrome after that for many, many years. What is that and what is that syndrome? Yeah, pots people. Some people will know about it. Pots is where you stand up. Your heart races but you don't get enough blood pressure to your brain. You feel quite lightheaded. It's really an imbalance in the sympathetic, parasympathetic nervous systems and it's quite debilitating. So, for example, I would do things like you know stand up at school assembly and faint and I just thought that was normal. I didn't realise we had moved towns at the time to a much hotter area and so I just thought it was the heat. I thought I couldn't cope with the heat, but it was really the head injury.
Speaker 2And I remember my beautiful auntie Wendy saying when I was staying with them on holiday. She said I don't like to see you like this. Jen, tell your mum to take you to the chiropractor. So I went home from that holiday and said mum Wendy said I need to go to the chiropractor and my mum and dad knew about chiropractic but they didn't know you could take children. So my mum you know wisdom goes oh, okay, no problem.
Speaker 2So off we went and really changed the course of my life. I was fascinated, not only what happened with me but what I saw happening with the other siblings in my family that went over time as well, but also what was happening in that practice. I really got an interest in that and so I did work experience there when I was in year nine and I'd always been interested in studying, you know, maybe child development from a psychology point of view or working with children in that developmental perspective. But chiropractic was really exciting to me when I worked and after that they offered me an after school job there and I leapt at the chance because I wanted to learn way more about this and so I went off to university when I finished high school to study and have never looked back.
Speaker 1Dr Genevieve. How did that visit to the chiropractic and the subsequent visits how did that change you Like? What did you feel in your body?
Chiropractic Care for Babies and Children
Speaker 2and the subsequent visits. How did that change you? Like, what did you feel in your body? I felt much clearer in my head. Um, I took time because I'd had the injury for quite a while and it was quite severe. Um, it did take time, but I just felt. I just remember, after the first time I had an adjustment, I was in Bendigo that was where I lived and where the practice was and I walked out and I was walking across the street to the park and I just remember the sky looked bluer and the birds sounded chirpier. It's just. It just was this lifting of some clouded thing that was over my head. For, you know, for that time since the injury. So it took time to really get my health fully back. But chiropractic was a really important part of that and I'm forever grateful to Aunty Wendy for saying tell your mum to take you to the chiropractor.
Speaker 1Would that have been like a weekly thing or did that just happen on a one-off? You know, regularly People think, oh, they go to the chiropractor and they go, oh yeah, work for about four hours and then it went away. You know, is that what you hear often? But it's about regular, isn't it regular?
Speaker 2attendance. It's about, first of all, getting out of the immediate issue, whatever that is, and then it's about stabilising that and balancing the nervous system and making those corrections. So people don't always have to go, you know, for a long term, but it depends what their health goals are and what it is that they're about. So sometimes you know we're correcting a specific issue and it takes time to rehabilitate that and rebuild that and make new pathways and really it's about what happens in the brain. It really that's what it's about. It's changing into those sensory motor integration in the brain pathways.
Speaker 1It's changing into those sensory motor integration in the brain pathways. Wow, so let's go to the next question what is a chiropractor?
Speaker 2and how are they different to physiotherapists yeah, look, we get that question a lot and osteopaths as well. You know we get asked that Chiropractic is a diverse health profession, five-year university trained, registered under ARPRA, like medical doctors and physiotherapists and osteopaths and psychologists and nurses and midwives and etc. So registered under ARPRA and obligations as far as that goes for continuing professional development etc. There's many different techniques that chiropractors use. The sort that we use is that more gentler technique. We see a lot of babies referred to us for breastfeeding difficulties. So we work across the age range in our practice. But for my part of the practice I see the babies and the children and adolescents, but not adults anymore. My associates see the adults but we see babies referred from maternal and child health, nurses and midwives and paediatricians for babies that have difficulty with settling, calming, sleeping, feeding. And the other thing we see a lot of is babies with torticollis or the flat head, the plagiocephaly. That can happen, where they develop a flat head because of that tension in the system and always lying with the head turned one way and that can come because they can't turn the other way like a restriction. Or it can happen because they've got a torque or a tension right through the whole body so that they've got a head tilt, a head turning preference, and that called plagiocephaly is um affects development and so we work with that to help with the postural alignments, the nervous system balancing and working with um.
Speaker 2You know those very young babies and, as I said to you before, there's no spinal manipulation involved in young babies at all. It's very gentle and we get better mobility and movement and range of motion. But that also has an impact on the nervous system. So, for example, we see a lot of babies that come to us for reflux or unsettledness. You know those babies that they're awake and their arms and legs are on the go and they're quite wound up. They don't have that calm, alert state. They're either asleep, their arms and legs are on the go and they're quite wound up. They don't have that calm, alert state. They're either asleep or awake and kind of moving and edgy. And so we see a lot of babies like that. So by doing our gentle corrections it helps calm their nervous system and it helps them rest and digest and really balances that parasympathetic nervous system.
Speaker 1So how does that work? Like do you guys you know what part of the body are you touching when you're looking at babies and how old are the babies?
Speaker 2Well, some babies are very young babies, the babies that are having difficulty sucking or feeding.
Speaker 2We see those babies very young because of course, that's important if people do want to breastfeed and, let's face it, let's hope they do and but they often need support to do that and sometimes the way babies are born, whether it be from a forceps or, you know, a caesar it can put a lot of pressure on the baby's head and neck. So we're working with holding the sacrum and the pelvis and the head and we're gently unwinding that tension so that they can lie straighter, turn their head both ways and suck and feed better. And of course, there would be some babies that the issue of their breastfeeding issues isn't related to their posture, alignment and nervous system. So they're not the children we work with. You know it could be a cow's milk, protein allergy or some other reason that the baby's very unsettled, and so we look at that as well and make recommendations as far as that goes. So we're primary health practitioners and we work in a lot with other health practitioners to get the support that families need.
Speaker 1Do you often see when you're working with the baby? Do you often see that the mum needs an alignment as well, you know, especially with holding the baby, or do you? I know you said you don't work with adults, but when the baby's there, are you doing something with mum too?
Speaker 2Yes, oftentimes the mums would be patients in the practice or see another chiropractor that might be, you know, closer to them, because what we do is a bit different than not. All chiropractors see those very young babies. So sometimes, you know, we might make a recommendation for a mum to see a chiropractor close at home or in our practice one of my associates. Yes, of course, because of the hormones of relaxin for the birth and then sitting and a lot of sitting and trying to feed and holding babies and rocking babies, it's a lot of strain on the mum's head and neck. You know, what I think is upsetting, dana, is oftentimes when babies are very unsettled.
Speaker 2As health practitioners across the board, families are often told oh, babies cry, it's normal for babies to cry, you know. Oh, they'll grow out of it, oh, they'll settle down. And yes, crying is normal for babies, but not that excessive crying. You know more than three hours a day or more than three days a week, you know over three weeks, that's kind of a definition of that excessive crying. But parents know generally when there's something not right with their baby. You know, if the baby's fed and rocked and nurtured, um, and the baby's still unsettled. It's really disrespectful to me that people say, oh, but baby's crying, oh, I just get used to it, I'll just put them in the room and, you know, walk away from that.
Speaker 2The research doesn't support that whole idea of babies just crying. Matter of fact, there's been some interesting. I won't name too many names and go too much into research in this format, but there's been some interesting. I won't name too many names and go too much into research in this format, but there's been some interesting studies done where children who have excessive crying don't grow out of it. It goes on to manifest, sometimes as ADHD or other self-regulatory issues. That's in the research, internalising and externalising behaviours. It's interesting.
Speaker 1Yeah, it's fascinating, fascinating. That's very interesting. And what about when babies, you know, don't sleep, don't sleep through the night, or you know, um, I've heard, uh, people put their babies down and they've fallen asleep. But as soon as they're down and they're um, they just wake up again is that the nervous?
Speaker 2system that you guys work with to settle the nervous system that's right, because those areas, the sleep-wake cycles, um, the rest and digest, the calming, they're all um driven from the brainstem. And when babies are unsettled doesn't mean say there's something wrong with the brainstem. And when babies are unsettled it doesn't mean to say there's something wrong with the brainstem. But it can be too close to threshold. You know, a baby's calm, fed, changed, settled, put down, and 10, 15 minutes later, 20 minutes later, the baby's awake and really unsettled again. That sometimes can be because that nervous system is just set onto that fight flight and so they can't just that calm, rest and digest and so so, yeah, a lot of what chiropractors do is that very gentle work to help with spinal cranial system, to help nervous system integration and regulation. So the idea that babies, just, you know, grow out of it is is not, you know, a good idea to sort of just rest on that, because it's important to find out is there something going on with this baby that's causing the baby to be unsettled?
Speaker 1that can be gently and easily helped, which changes the course of a little life you know you mentioned adhd, um, and I can really really see how, um, if a baby's very unsettled, the nervous system doesn't learn to settle right, and so then that grows bigger and bigger and bigger, and then it becomes like you can never self-regulate, you can never settle. Do you guys end up working with very active toddlers and then young children and then school-aged children, and does that help?
Speaker 2Yes, absolutely, and of course it's a multi-pronged approach. You know, it's really important. We work a lot with speech pathologists and occupational therapists and psychologists, child psychologists, educational psychologists and with families. You know one of the simplest things, dana, that I think. I mean my background. I don't know if you know, but my PhD was through ICTL originally. I don't know if you know that.
Speaker 1Oh really no, which is for those people that don't know ICTL is the home of DIR. Floor time yes.
Speaker 2Yeah. So it was Stanley Greenspan that his work that really inspired me to do that PhD. I wasn't interested in a PhD. I'm a clinician. My best part of all the work I do and I do a lot of work my best part is in the rooms with the families. That's the part I love the most. But I was very inspired by Stanley's work. I saw a lot of his videos and interviews and read a lot of his books, and so then I applied to do the PhD through ICTL.
Speaker 1And I know you've had Jeff Gerns on recently. Yes, yes.
Speaker 2Yeah so, and then ICTL moved, then the PhD program then moved under Fielding University. But that's really where we started and that was what it was about and that was really an interdisciplinary approach to child development. I wanted to understand from the bottom up what is it? You know, that was my question as a teenager. How are we who we are? You know, what is it that happens in our lives that forms? You know, because I just don't believe it's personality or temperament that we're born with. You know, yes, there's a maybe a part of that, but a lot of it is our experiences. And so, you know, stanley Greenspan and all of that group were really inspirational to me and that's why I did the PhD that way and then ended up doing my dissertation in another field we might talk about in a minute, but DIR floor time is really close to my heart and that's a lot of when I'm working with babies.
Parenting and Child Brain Development
Speaker 2You know, said you asked do the mums need an alignment? Yes, physically yes, and that can be helpful. But I think we need that co-regulatory alignment. You know, when parents have had really unsettled babies, it's very hard to bond. I mean, the research tells us that, but we know this clinically, it's very hard to bond, attach, to feel I'm enough for my child. If I can't settle my child, I can't calm my child and people sometimes you know I've seen it a lot where people think a child that's dysregulated, say it's a toddler or a preschool or an early primary school that's dysregulated. A lot of people in a judgmental way in the community say, oh, that's because the parents don't know how to discipline.
Speaker 2But I'm going to tell you, I've been in practice just starting my 38th year and I'm going to tell you that I think dysregulated and unsettled children cause parenting challenges because we get really rigid and we're going to get it organized, we're going to have everything done, we're going to get this ready and we're going to get it organised, we're going to have everything done, we're going to get this ready and we're going to get that ready and then that doesn't work. So, oh well, you do it all yourself, kind of idea. And you know, as Dan Siegel would say, going down that river, instead of flowing smoothly, we're bouncing between the banks of, you know, over-controlling and rigidity and disorganization, or you know more, that chaotic approach and that bouncing. And one of the things that I find the most helpful to say to families and it's particularly dads that I say this to, but mums as well when you're trying to decide whether your child can't do something or won't do something, I really want you to understand they can't in that moment.
Speaker 2I'm not talking babies, I'm talking toddlers and school. You know, yeah, they can't in that moment. I'm not talking babies, I'm talking toddlers and school you know, yeah, between can't and won't.
Speaker 2They might have been able to do it on another day in a certain circumstance, but right now, if you can understand, they can't do that and they need some co-regulation, some support, some scaffolding to be able to do whatever it is maybe it's get ready for school, maybe it's, you know, finish up, be able to do whatever it is. Maybe it's get ready for school, maybe it's, you know, finish up at the swimming. But whatever it is, if we understand we need support to do that, to move through that, rather than sort of going well, he just won't do it. It's a behavioural problem. I'm just going to get rigid about it. I'm going to set the rules further. I'm going to show him who's boss, whatever it is.
Speaker 2That whole thing really helps parents understand. It's one of the simplest things I say, but I see it has a profound impact on people realizing. Because when parents are struggling with dysregulated children, with children with self-regulatory you know challenges, often they think, well, I'm just going to control it more, I'm just going to be a better parent, I'm just going to show him who's boss, I'm just going to step in. It's not about that. It's about that joining and I don't mean to say this to you, darling, because you know that more than anybody else, but for the parents out there, it's that joining and how do we co-regulate each other and how do we help move through this to another developmental stage. So you know, that's that some of the work I do, just by conversation in the rooms when we're working with families.
Speaker 1Oh, I love that. I absolutely love that. I've just published an online course about supporting children's communication development and 75% of that is parents working on themselves and understanding that the children are doing the best they can with what they've got in this moment. And, like you say, you know, um, yes, the child might have been able to put their shoes on one day, but today they just can't because they're really tired, because they're hungry, maybe they're constipated or maybe they're just thinking oh, oh, and I have those days, I have those days where I'm thinking I can't do that.
Speaker 1So it's, I think you know, I love what you're saying and I really I'm going to be putting this podcast as a reference in, you know, for parents to listen to, because I think you know it does get a very I get sometimes a little bit despondent because you know, sometimes, especially when we're talking with behaviouralists, professionals that are behaviouralists and you know this is very much a relationship-based approach and it's really important. You know, it's that oxygen mask. Isn't it where we put on our oxygen mask first as adults and then we put it on our children? So we've got to make sure that we're okay, and even as practitioners, that we're okay, because sometimes you, you know you are a great practitioner and you are able to support these parents that come into the room that may not be co-regulated with their um with their children that's absolutely true.
Brain Development and Collaborative Support
Speaker 2I couldn't agree with you more on that. Um, what's interesting to me about all of what we're talking about is that whole idea. I read a paper it has to be 25 years ago now. It was actually published in 1963 diamond and belvin and it was called mother as auxiliary, extra auxiliary cortex. And the whole idea in the paper wasn't because it was the 60s, it was mother, not parent or caregiver, but the whole idea of because a baby is born developmentally underdeveloped or born underdeveloped. Um then, the better that a mother in this case in this paper did the caregiving role and supported the child, the better that a mother in this case in this paper did the caregiving role and supported the child, the better. That allowed the child's own cortex to develop. So the mother's the extra cortex, because the baby doesn't have that higher cortex developed yet. And so that is that development is happening over time.
Speaker 2And that paper was incredibly inspirational to me because of that whole idea of that caregiving, not to put over responsibility I don't judge parents, we're all doing the best we can but that whole idea of that co-regulatory capacity and helping children learn how to calm and regulate. I mean it's all about frontal lobe development and we see a lot of children that are sensorily so kind of wound up and in that fight-flight response that they get dysregulated very easily and that gets in the way of those normal pathways of frontal lobe development. And it's the frontal lobe and the prefrontal cortex particularly that grows very slowly and steadily in children and then has a good trim away in adolescence before it rebuilds those more permanent pathways. And I think that's you know. It's critically important to remember that we're building brains and humans here as parents, not just trying to control behaviour or work at it from, as you said before, that behaviouralist perspective. It's a developmental focus that we need to come from.
Speaker 1I love that we're building brains and humans. Can you just, for people who are not sure about the function of the frontal lobe, what does the frontal lobe do and why is it important?
Speaker 2Well, the frontal lobe first of all drives out all of our motor skills. So when we're born that's not well developed yet, we know children don't have those motor skills well yet and so it's feedback from the body that comes in through all the receptors, through the spinal cord up into the parietal lobe, which is sort of above the ear part of the brain, and then from there information feeds forward into the frontal lobe. So the frontal lobe's a lot about movement and planning. Movement we've got our area of motor planning. That's in the frontal lobe as well drive some of our eye movements. But the prefrontal cortex are really about that sort of decision making focusing, fixing and focusing attention, staying on task, deciding what's important to focus on, being able to calm us and regulate us, inhibit unwanted thoughts and movements and be able to just provide that sense of self and calmness. And that takes time to grow and develop. And you know, as parents, as teachers, as you know healthcare providers, as a community, it's our job to support that development.
Speaker 1So children that are very hyperactive and have difficulty in attending to specific tasks, their frontal lobe would be affected, wouldn't it?
Speaker 2according yeah, probably not. Yeah, not developed well yet, not not fit for duty yet you know, and that's where we need that. Yeah, still growing, that's, it's still under development, you know, and the better we can help support that. And you know we think as adults a bit about top down. You know about ideas or meditation or you know, and that works well for adults. You know other things, cognitive processes, that's what we do a lot as adults.
Speaker 2But really bottom up's really important. I mean bottom body up is really important that we've got the right amount of sort of firing of receptors and movement. That's why outdoor play and movement so critically important, because as we're moving in gravity we're firing muscle spindle cells and all of our receptors, our pressure receptors, our skin receptors, all of the juice of those proprioceptors and that comes up into the brain and that helps fire and wire the brain and connect the brain. Which is why I think that whole idea of when we're looking at helping a child learn those regulatory capacities, firstly it's in a co-regulatory, so with somebody else supporting. We all know that even as adults, if you're really overtired or really unsettled and you have somebody that kind of joins you and supports you in that, it's a whole different ballgame than if you have somebody who judges you for that or leaves you alone or says, well, you're, mo'm just going to leave you. Some of us do need peace to be able to kind of calm ourselves. But kind words, kind touch, that can be really helpful as well. So those self-regulatory capacities are, you know, are developing. So co-regulation is important for children.
Speaker 2But also to help their frontal lobe develop is the right amount of movement and the outdoor stuff and of course, off screens. That's a big issue, isn't it? It's a huge issue that we're seeing um. And then there's the things of how well is their posture and their system working. You know, some kids might have a little bit lower tone or they don't have body confidence or they don't have central postural control, which makes it very hard to get out other skills like monkey bars and bike riding and all of those other things.
Speaker 2You know the child that might want to play with a group of, say, preschool kids and they come up but instead of being appropriate with the child they misjudge it physically. You know they might bump into them, they knock the bottle over they. You know they take the ball. That whole capacity of being able to understand others and knowing having a map of our own body and a map of the world. You know babies and children are building maps and I think that's you know. They're building maps in all different areas of their brain.
Speaker 2But to get the frontal lobe to fire we need that body ability to do that. And chiropractors we work, particularly chiropractors that work in the neurodevelopmental space. We work by stimulating pathways. You know we might be doing some mobilization of feet and some muscle stretch and some stimulation to fire those pathways to the brain and then we'll be giving home care, might be rocking on a ball or some extension exercises, you know, to help, to help build that I that, and as a speech pathologist I found most of the children that I was referred I had to do everything through movement.
Child Development and Reflex Integration
Speaker 1So I remember way back must have been 20 years ago I set up my room as a sensory motor room and I remember one mum coming in and I at time I don't, we don't have that anymore, but we had a ball pit in there and I just remember one mum came up and said why have you got all the balls when we're I'm here for speech and language? And I said because it's sensory motor, we're going sensory motor first before we go to speech and language. You know, and it's all about I really believe it's all about the body comprehension, who I am in space, where you are in space, where that object is in space. Because if you don't know the relationship between yourself and your space and the relationship between you and another person and an object, how are you going to get language? Because language is all about words relating to each other. So when you speak like that, dr Genevieve, it's like I'm smiling from ear to ear. I'm smiling from ear to ear. So tell me Me too, dana.
Speaker 2Me too, because you know this is where this collaborative work is so critical. It's so critical because we all have skills to help children, but it's what's the right timing and order and how much, and you know how does that help. You know, I first started working a lot with speech pathologists when I had a speech pathologist who I didn't know. She called, she worked here in Melbourne and she's moved into state now. But she called me up and she said can I talk to you? I don't know much about chiropractic, but but I have.
Speaker 2I'm a speech pathologist for a long time and there's five children that are going through my program much more quickly that I've been astounded from my original assessments as to what I'm finding with them and I'm really curious about that. So I've dug in and the link that's the thing is, they're all patients of yours. Now I hadn't referred them to her. I might have just referred generally to a speech pathologist, but I hadn't referred specifically to her because I hadn't met her. And so she said I'm just so fascinated about this and her and I have done a lot of work together, sharing with each other and bringing other speech pathologists and OTs in on that, and I think it is important that we work together to help. How do we understand how to get everything firing and wiring in that brain to change the outcome of a little life and therefore a family?
Speaker 1yeah, um, what about children? What we've spoken a little bit about, the neurodivergent children in terms of adhd. What about children on the autism spectrum? What is your framework for that? What is your thinking around that?
Speaker 2it's interesting because you know, I think it's a spectrum for a reason that there's many different types of children that fall or might be diagnosed onto the autistic spectrum. And the way that I think about that is how can I with that individual child because they're individuals, what do they need to help integrate their nervous system, to help that sensory motor integration? And we see a lot of times with retained primitive reflexes and I'd love to talk about that in a second because I think people are starting to understand a lot more of it, but I'm not convinced we're helping people understand the story correctly about it. So my thought with children on the spectrum I'm never treating autistic spectrum disorder or ADHD we're helping that sensory motor integration, the self-regulatory capacities, the postural control, and that's really where we start from With any child diagnosis label or not. That's really what we work with.
Speaker 1And what about children that are? I know I've got, you know, some children on our caseload that are always repeating the same words over and over and, over and over and over again and parents are really getting like frustrated and telling them to be quiet and, you know, thinking about why are they doing that. Can chiropractic help those children?
Speaker 2Well, I think, I think you know if we can draw them in, you know, to a bigger world. You know, because we have those children that are very verbal but they're scripting or echolalia verbal exactly that's what you're talking about, um, and they're not using, or they might be using, language to get their needs met, like get supplies, I want food, I want out, I want shoes, I want, you know, whatever. They're not using language in that interpersonal way and I think the better their body connects up and they become aware of themselves and their world, then the better that they can understand. There's somebody else here. You know, one of the saddest things many, many years ago in practice I was doing it was a new patient consultant was a little boy who was nearly three and there was a bucket of Duplo there and his mum and I were talking. He'd been rolling a little ball around and then he got his mum and dragged her over to open the Duplo bucket because he couldn't get it open. But he used her hand like a tool. You know that hand over hand. It was almost like it was the clearest I've ever seen of that, that he didn't even really realise his mum was at the end of that hand he had seen what had happened and the detail of that without the human connection. And so you know that's about how do we help in a collaborative, interdisciplinary way, in a developmental way, draw those children into a bigger world so that you know they can appreciate the other human there and the warmth of human interaction. You know, and there was that research that they tried to do exogenous oxytocin. You know, because oxytocin being those, in a simple way, the hormone of affiliation and love and bonding, and they tried to use exogenous oxytocin to see if we increase oxytocin does that help. I haven't seen any research that says that that really helps.
Speaker 2It was a nice idea, it made sense for the idea, but it's really about building it from that internal drive. You know we talk about sensory motor integration, dana, but before all that is that desire to emotionally connect. You know we talk about sensory motor integration, dana, but before all that is that desire to emotionally connect. You know that's as humans. That's really where it all comes from.
Sleep, Reflexes, and Brain Development
Speaker 2And so the framework when we're working with children, it always is done. We work with children rather than do it to children, and that applies to our chiropractic work we do, but it also applies to when we're giving, you know, homework or home care exercises. We don't give a whole list, just simple, bit by bit, step by step, to build from that ground up. But it always has to be with them, you know, and some of those really driven parents are like but isn't he supposed to have his head down or his arms straighter eventually? But we're starting where we're starting, you know, and then outside of that, you know, I think of vygotsky's work and vygotsky, lev vygotsky he didn't actually use the term scaffolding, but he used the whole concept of that.
Speaker 2If we have that zone of things we can do, and outside of that is the zone of proximal development, with support we can do this, and then outside of this is we're not there yet. So my thing is start wherever we're at, make it fun, make it successful, you know, give some genuine kind of excitement and emotional connection with doing it and then build those skills over time.
Speaker 1And this is what I say, and it will take, however long it takes, because it's not my timeline, it's the child's timeline and we can support that. But it's the child's timeline let's talk. Support that, but it's the child's timeline let's talk about. I'd love to talk about these postural and primitive reflexes that you are so excited about, Dr Genevieve Tell me about them and why should we talk about them? Why are they important?
Speaker 2Yeah, well, I think you know on TikTok and Instagram world there's a lot. Not that I belong in that world really at all, but I do keep a little eye through my families that I work with. You know there's a lot about oh, the child has learning issues, or the child has motor coordination issues, or the child can't catch a ball because they have a retained primitive reflex, and so people go about all of these sort of exercises to integrate primitive reflexes, and so people go about all of these sort of exercises to integrate primitive reflexes. I'd like to sort of help people understand what primitive and postural reflexes are very simply.
Speaker 2So when we're born, we're born developmentally earlier than our. You know nearest, you know evolutionary relatives and you know they say that if children were born at the same developmental stage say, as you know, monkeys then we wouldn't be born until two years old, but then the head would be too big to get out of the pelvis. And so we're born earlier, which brings a double-edged sword. There's a real benefit to that because with an enriched environment that helps you know of caring and nurturing that helps children develop, there's a great possibility for encouraging brain development and growth. But in any situation of, you know family violence, or you know toxic stress or really poor nutrition, or you know all of those adversities that brings a real risk to brain development.
Speaker 2So we're developmentally earlier and we have primitive reflexes. So those reflexes we're born with, like the rooting, sucking reflexes, the palmar grasp, the plantar grasp, the morrow, which is that startle reflex. You know you lay a baby down and that movement startles them and their arms come up. All of those reflexes are primitive reflexes within the nervous system that come from the brainstem and the lower cortex and it's as higher cortical development occurs over that first year in life that those primitive reflexes are integrated. So they they stay there in the system so that if somebody as an adult has a stroke or a brain injury or a dementia, sometimes we get back those sucking and reaching or grasping reflexes yeah, they can come back.
Speaker 2So they're primitive reflexes in the system and they're about survival. They're about feeding and you know the primitive crawl reflex to get to the breast, and all of those reflexes are about helping us survive. But then, as we're maturing over that first year, at different stages, for different reflexes, the higher cortex is what integrates or inhibits those reflexes. And while that's happening, we've got another set of reflexes called the postural reflexes. The postural reflexes that are developing and they're about that bouncing on the legs at four months when babies want to, you know, you hold them and they want to stand on their legs, yeah, and when they're sitting and you give them a little tip and they'll put their hand out to protect. That's a vestibular reflex that catches them and that comes in around six months. And then there's the other, you know ones that come in over time.
Speaker 2So these reflexes, the integration of the primitive and the bringing of the postural reflexes that help us cope in a gravity-based environment, um, what happens with that is the brain, that's the higher cortex that drives that. It's a higher cortex that integrates the primitive and brings the postural to help us cope in gravity, and that higher cortex is what we're talking about earlier the frontal lobe and the parietal lobe, and that's where we're building our maps and forming our movements and making our decisions, and all of that. So the whole idea of repeating an exercise to integrate a reflex doesn't really make sense to me. What we work with is how do we stimulate that cortex to come online more, which might be through our hands-on adjusting work, our body work, it might be through movement, it might be through, you know, emotional, social integration. All of that is what brings the higher cortex that allows us to develop I hope I've explained that, dana.
Speaker 1yes, you have, and I know that I've done some reflex work. So when you were saying that, I'm like, yeah, that's right, yes, that's right. And are there children who have them still going on, these primitive reflexes, when they're older?
Speaker 2Yes, absolutely. We see five-, six seven-year-olds who might still have their startle reflex or their asymmetric tonic neck reflex and what happens with that is that does. It shows that that higher cortex is not integrating those properly and so these kids will often have not only those reflexes but they might have balance issues or hand-eye coordination issues and they can also have writing. Issues like fine motor can be impacted because we're at an earlier developmental stage of our nervous system. Very interesting work with those. We work with those reflexes, not by directly those reflexes but by getting sensory motor integration and the brain and body connection happening integrating them.
Speaker 1Okay, can we talk a little bit about sleep? Why is sleep important and how does it impact on the developing brain?
Speaker 2This is one of my favourite topics. Yes, it is. Yes, it is Because I think we're in an epidemic of poor sleep, and I think it is. I mean, research shows that we consolidate our learning and our memories when we sleep, and there was some great work done. I don't know if anybody remembers. There was a, some papers published and it made the mainstream media. It's quite a few years ago now.
Speaker 2Sleep is the dishwasher of the brain. There was a group Niedergaard and Iliff that worked to look at the cerebrospinal fluid that goes around the brain and down through the spinal cord. It's the fluid that cushions the brain, that brings nutrition to the brain and the spinal cord and that takes away the wastes from the processing of the brain and the spinal cord. And it comes from blood, from our arteries, filtered into cerebrospinal fluid and it's absorbed back through the veins through the skull. So what they found in their research was that the brain tissue called the parenchyma opens up further when we sleep so that the penetrating vessels can get deeper into the brain tissue to clear out the brain. So that's the first thing we know about sleep is that the brain clears itself of the toxins when we're asleep or also under general anaesthetic. It's showed as well. But there's other issues with that, obviously, but sleep is the easier of those ones. The other things we know about sleep is that babies that don't sleep well, as I mentioned earlier, can go on to have self-regulatory issues of ADHD or depressions and anxieties, et cetera. There's some very interesting work published on that and the other things that we know about sleep are it's about that.
Speaker 2It's a sign of how well the parasympathetic system is working, that rest, digest, rebuild. So when we think about the nervous system, there's the sympathetic nervous system, which is the get me up, get me active, get you know. Running from a threat, fight, flight or freeze. People might know that as and that's really a survival reflex, but unfortunately a lot of families are in that fight-flight response a lot of the time just to get daily life done and that then restricts or is counterproductive to the rest, digest, rebuild and heal, which is the parasympathetic part of the nervous system system. So they're both tonically active, but if the sympathetic rises and drives too high, then the parasympathetic of that sleep and digest, which is why I think we see an epidemic of digestive issues and children with gut pain and constipation and all of that. I think it's because that system's not well regulated into that sympathetic, parasympathetic, and a lot of people will have heard of vagal tone. Vagus is a very big parasympathetic and a lot of people will have heard of vagal tone.
Speaker 2Yeah, vagus is a very big parasympathetic nerve that drives the digestive system. We get a lot of feedback from the gut, they say it's where our sense of interoception or internal knowing comes from, by the vagal nerve and it's what is um, responsible for all of the valves of the digestive system and the heart and the and the lungs as well. So that system is a very big system. The nuclei for that sit in the brain stem and that vagal system is really important for health and well-being.
Speaker 2So when we're not sleeping well, then we don't have that rest, digest, rebuild and. But also we're often not sleeping well because the nervous system is out of balance already. That's why we can't settle into a deep sleep and go through our sleep cycles and you know there's a lot of babies that can't get down into that. You know lowest sleep, the deepest sleep and any little noise and they're awake or any little gut movement in themselves and they're awake and that whole you sitting closer to the threshold, waking easily. And you know there's a lot of other research to do with sleep that I think you know is really important to think about in terms of high risk of family violence when babies don't sleep well higher. You know, learning issues, speech and language issues, all of those things. Um, when we don't have good sleep, they're not the only cause of it.
Speaker 1Of course they're not, but they're part of the picture I love um, because we all know fight flight freeze, but this rest, digest, rebuild and grow I wish that was um, that was a phrase that just came off our minds quicker, you know, like, instead of just focusing on fight flight freeze, okay, let's focus on rest, digest, rebuild and grow. And I've even had to write it down because it doesn't come naturally to me. Obviously, fight flight freeze comes naturally, but as a person that I'm always going and going and going and doing, I think I'm going to put those four words in big writing on my office you know office board, just to to remind myself, because I think that's really important yes, I think, donna, just on that also, a lot of people work out how do we get out of that fight, flight, freeze, and they try and sort of reduce that.
Speaker 2And yeah, that's a good idea, whatever the stressors are, et cetera. But a really helpful way to think about it is what do I do that builds that other side? And you know, sleep is one, meditation is another. Deep breathing we teach a lot of our kids, even from three years old, with the parent, to do the rib cage breathing. A lot of people think deep breathing is belly breathing, and yes, to some degree it is. But the ribs are designed to move and when we get that real excursion, that upright posture, that's why that midline postural tone is so important, because those ribs move off that posture. And so as the ribs are moving, then the lungs can move, which then is the oxygenation that our brain needs and every single tissue in our body. And research shows that when we have that head forward posture and shoulders in, we reduce our lung capacity by up to 30%. Now I don't know about you, but I don't want 30% less oxygenation for my brain.
Speaker 1No, I've just set it up because nobody can see us. But I've just set it up and I've started doing lung like rib breathing.
Early Signs of Pediatric Chiropractic Care
Speaker 2Yes. So we teach the parents to support the kids while they're lying down, even at night, going to bed hands over those lower ribs at the front and just nice, slow, deep breathing, and we put a little bit of pressure on the ribs for the kids to push out against that and get them to get that feeling of the ribs moving and that helps calm. So it's not only reducing fight, flight, freeze or the sympathetic side, but it's how do we build the capacity in that other side which is calming? Deep pressure massage is something else we teach parents to do. It's very slow joint compressions across joints and across muscles. It can even be just lying under the blankets in bed and gently putting that pressure between your hands and the mattress, which is calming but comforting to children.
Speaker 1and so these are some of the things we teach families about to help build the capacity for that rest digest rebuild, and I imagine that these skills that the children are learning are also going to have an impact on their digestion, right? Because, like you said, like if they're always in fight, flight, freeze, if they're posturally like leaning over or whatever, then they can't digest their food and they get constipation. So many kids have got constipation. So many kids have got reflux.
Speaker 2Absolutely, absolutely, and it's a really big issue, and so I think if we can help balance that nervous system through the work that we do, then that has a really big, you know, impact on that as well. I just wanted to pick up um on something we were just talking about. There are kids with um when we're talking about constipation. Yes, it can be because they're in that nervous system imbalance. It also can be when they have low muscle tone. So I'm not talking about necessarily muscle tone secondary to a neurologically progressive disorder like a muscular dystrophy. I'm talking about the children that have that lower muscle tone, but it's not secondary to a progressive neurological disorder, and we see a lot of those children, and people just say, oh, babies crawl when they crawl and oh, all babies walk when they crawl and oh, all babies walk at a different age.
Speaker 2And my thing, though, is, if there's something that can be done to support that development, why are we waiting? Because children with lower muscle tone, if they don't get the right input and support, they need to help that then they don't partake in games and join in with others. But the other part of that that I wanted to mention is that sluggish digestive system can be also part of that low tone and that can be part of the language low tone as well, where we don't have that good sensory motor integration because we've got low line tongue or poor, you know, control of the breathing, the airway that breathe, suck, swallow, cycle, um, that's, you know. That's part of that sort of low tone where we need to stimulate, um, via, you know, home care, but also as chiropractors, the hands-on work we do to stimulate the firing and wiring of that muscle tone control, because that comes from the higher brain as well and the cerebellum is involved in that I'm imagining there are parents listening and thinking oh, I'm going to take my child to a chiropractor.
Speaker 1Now are there chiropractors that specialize in pediatrics? Like what would some of the questions be to the chiropractor? If someone just calls a chiropractor down the street, what would parents be asking them?
Chiropractic Care for Children
Speaker 2Well, I think it's important to sort of get some recommendations and referrals in different areas. I know that people in different areas listen to this podcast, so it's really a person that has a focus on the neurodevelopment of a child. So it's a chiropractor that has done often some extra training in that area or you know some interest in that area that they've learned further about that. But chiropractors generally are good for helping children. It's just the highly specialised children, maybe with diagnosis, maybe they need, you know, a different sort of approach as well as or on top of. But chiropractors are trained in their undergraduate five-year training to work with babies and children and people across the lifespan. So that's, you know something. And the other thing is the Australian Chiropractic Association has some advice and recommendations about that. Find a practitioner section at the Australian Chiropractors Association.
Speaker 1And I'll include that on the show notes. So when would a parent be thinking, oh, do I take my child to a chiropractor or not? What would be some of the, I guess, characteristics that they'd be looking for? Like you said, low time Is that when they're W sitting on the mat, or you know?
Speaker 2It could be a child that's 10, 11, 12 months old that's not crawling yet. It might be a child that's 15 months that's not walking yet. It might be a child that's particularly 11, 12 months old that's not crawling yet. Might be a child that's 15 months that's not walking yet. It might be a child that's particularly unsettled, but even earlier than that, it might be a child that's developing a flat head. Or when you lie them straight, they tilt their head one way and turn the other way and you straighten them up and they go into that tilted position. That's one of the earliest signs that things are out of balance. And then, of course, it's children that have any of those sort of you know big falls off play equipment or things like that. Oftentimes they get the sort of medical clearance that there's nothing, you know, an emergency sense. But those issues can stay there and if we don't find those and work with those, so a lot of people choose that. I was a chiropractor on the government inquiry into chiropractic care for children. Back in 2019, the government did a big inquiry into chiropractic care. Is it safe? And and you know what do parents feel and what's their experience of it there was no safety concerns found across the board at all. With a child under chiropractic care in Australia, there was not one issue of safety found in that big inquiry. That inquiry ran for nine months, so that's important for people to know. And then another part of that inquiry was looking at what's the parents experiences of chiropractic care. So there's a government survey on a government website where parents could answer questions, both tick box questions and their own experiences written out. 22,043 parents responded to that survey. So over 22,000 parents in four weeks responded to that survey. 99.7 said their child improved under chiropractic care. They're very high, huge, yes, yes. 573 parents mentioned their child's sleep improved and that's significant, or more significant, because there was no questions asked about sleep. This is parents answering questions and then volunteering something from themselves. 5073 said their child's sleep improved with chiropractic care.
Speaker 2Um, so these are parents' experiences, you know, but if you looked at the media and you didn't have an experience of chiropractic care, you might think, oh, it's weird or it's dangerous, or it's fringe or it's whatever.
Speaker 2That's not the case. But there is this ultra conservative medical lobby group which you know feed the media and would like people to think that anything that falls under complementary or alternative is not, you know, suitable for children and it's absolutely not the case. And I have a lot of parents that say I wish I would have known to come to you sooner. You know you've made such a difference to our child or our family. I wish I would have known sooner. And a lot of families find out by word of mouth from mother's group and kindergarten friends and you know all of that as well as the speech pathologists and OTs and physios that refer to us, and paediatricians as well. But those who know about it know there's something really exciting happening here, and those who don't have an experience of it tend to follow the media and think, oh, it could be risky or it could be dangerous, and it's not amazing.
Speaker 1Um, just quickly tell us a little bit about your phd program into early childhood development. Are you researching anything at the moment?
Speaker 2um, at the moment I'm having a tiny little hiatus, however, um, I was going to do my dissertation, so my PhD originally, as I said, started through ICTL and then went to fielding, so that's my coursework, which is what I wanted. And there's a dissertation, and my dissertation was going to be and I did a pilot study on it the parental rationale for screen time in particularly young children. I wanted to dig into what's that about. I'm still really interested in that.
Family-Centered Pediatric Chiropractic Support
Speaker 2But when I had to take time off in 2019 to sit on that government inquiry, I realised there's a richness of parent information here that really only had a cursory look at in the inquiry Is there any safety issues, no, you know, etc. But they didn't delve deeply into that. So it took me a lot of months to get permission to get the data from that survey and that's what I did the secondary analysis on both quantitative and qualitative and wrote that up for my dissertation about parents' experience of chiropractic care for their children in Australia. Since then, I've gone on to run a worldwide Sorry, Dr Genevieve, has that been published?
Speaker 1can people get hold of that?
Speaker 2yeah, it has. It's in ProQuest. It's a like a PhD dissertation. It's not um, it's published in ProQuest, which is where dissertations are published. There's a couple of shorter versions of that as well, or detail from that, but that's. My next step is to write that into some smaller papers one on sleep, one on digestion and reflux things like.
Speaker 1That would be great, because then you could send it through and we could always add it to your um to this podcast yeah, absolutely, and I then looked at a.
Speaker 2We did a delphi study, um with cheryl hawk in the states um. We had 20 people on the steering committee and 60 on the Delphi panel looking at best practice management of infants, children, adolescents, and that was published last year as well. So I've got some further research things in the pipeline. However, as I said to you, in practice hands-on with families is really where my first love is.
Speaker 1Oh, my goodness, dr Genevieve Keating. Keating, you are amazing. I'm so glad that my colleague put me on to you. I know that when she met you she came back and she goes. You've got to have Dr Genevieve Keating on the podcast and absolutely, and now I'm thinking I used to see a chiropractor. I'm thinking I'm going to go back to a chiropractor because I think it's so important and you know it. Just you know, reaffirms everything that I believe and you know also about the relationship-based approach and that you know children need support with their musculoskeletal neurology, neuro system from way back. So you know from way early. So that's important. Thank you so much for coming on the podcast and giving your precious time, because I know you are so busy. Um, on all different meetings boards, you name it, plus your you know practice um, and I cannot wait for this to air and I'm going to be like referring to this podcast, to this episode, for a long time to come, you know, and and sharing it with many families.
Speaker 2Dana, thank you so much and I really would like to acknowledge the work you're doing to connect with families. I mean, that's really Maria told me part of that. It's really important to you know, to reach out to families and that's why I respect what you do and all of the people that work with families and indeed all of the families you know. I'm incredibly inspired by those families and the parents and the community that work with you know, with children and support you know child development. So it's an absolute pleasure to be part of it and I look to when our pathways cross again next time oh, I do too.
Speaker 1I can't wait, and I can't wait till you publish the short papers, and then maybe we can go into them more and do another episode on that okay, okay take care. Thank you very much bye Dana.
