Learning objectives: By the end of this symposium, participants will be able to
1. Recognize the complexities of the use of spinal mobilizations and manipulations in the paediatric population in regard to harm and effectiveness.
2. Be aware that infants (0-2 years old) are a separate population with different rules, regulations and law in regard to the use of spinal mobilizations and manipulations.
3. Understand recommendations and the position statement on spinal mobilisations and manipulations in the paediatric population based on current available research and clinical reasoning.

The session will start with an introduction from the Chair of this panel explaining that IFOMPT and IOPTP (International Organization for Physiotherapy in Paediatrics) formed an international task force to develop a position statement to guide safe and effective use or non-use of spinal mobilisations/manipulations in the paediatric population across diverse conditions. The panel of experts will then present outcomes of completed work from the task force on mobilisations and manipulations in a paediatric population including the results of:
a. One Scoping review (3) with the aim of identifying and mapping the available evidence regarding effectiveness and harms of spinal manipulations and mobilisations for infants, children and adolescents. It also aimed to identify and synthesise policies, regulations, position statements and practice guidelines informing their clinical use;
b. Two systematic reviews (4, 5) which investigated the clinometric properties of outcomes measures identified in the scoping review;
c. One Delphi study of international expert physiotherapists, which aimed to describe current practice, perceived effects, and perceptions of peers in the field of orthopaedic manipulative therapy and paediatric physiotherapy regarding spinal mobilisations and manipulations appropriateness and usage in infants, children, and adolescents.

The information of the above will be used to inform a position statement on spinal mobilisations and manipulations in a paediatric population. Finally, the session will end with a panel discussion and questions and answers session regarding evidence informed practice benefits and harms, the types of studies that need to be conducted on the topic of paediatric spinal manipulations and mobilisations, the political milieu related to infants (0-2 years of age) including consenting and legal issues in various countries about spinal manipulations and mobilisations, the reasons physiotherapists should or should not manipulate or mobilize paediatric population and for which conditions, and some trends for the future.