Vestibular Screening For Children With Hearing Loss

The vestibular system is a link between the inner ear and the brain. The function of the vestibular system is to help a person keep their balance. If a disease or an injury affects the vestibular system, the result is called a vestibular disorder. Although poor balance is the primary symptom, vision and hearing are often affected by vestibular disorders. Vestibular dysfunction in children causes chronic dizziness and balance problems. The long-term effects impact a child socially, educationally, and economically. Children with hearing loss are particularly vulnerable to vestibular dysfunction. Unfortunately, screening for the vestibular disorder is often not part of a routine exam.

The Vestibular System

Walking, getting out of bed, and even sitting upright in a chair are acts that generally cause no problems for people. However, impaired balance can be a frightening experience. The vestibular system interprets information regarding movement, motor coordination, head, and body position in space. The system plays a significant part in bringing together sensory information from visual, auditory, tactile, and proprioceptive systems. Information coordination allows each system to work together to perform everyday activities.

A dysfunction in the vestibular system occurs due to many different reasons. It causes problems in early development, crawling, and walking. The symptoms of vestibular function vary from child to child but can include:

  • Vertigo
  • Dizziness
  • Loss of balance
  • Lightheadedness
  • Vision problems
  • Hearing loss
  • Depression
  • Anxiety

Children who present with these symptoms should receive a screening of their vestibular system function by a clinician with training in vestibular rehabilitation and diagnostic evaluation.

Screening And Red Flags For Vestibular Dysfunction

A big reason that children with hearing loss are at an elevated risk for vestibular dysfunction is that they lack the language skills needed to describe the symptoms of poor balance and dizziness accurately. Researchers now believe that new technology and better treatment options will give families insight into the beginnings of a child’s vestibular dysfunction. Professionals who work with hearing loss and vestibular dysfunction are advised to consider the following factors:

  • Children with hearing loss and vestibular loss do learn to walk but at a slightly later time.
  • Some of these children experience challenges when learning to ride a bike or in balance-related activities such as skating and gymnastics.
  • It is possible that these children will experience impaired reading ability due to abnormal vestibular ocular reflex function.
  • Cochlear implant failure may be associated with vestibular dysfunction.

Healthcare professionals must consider these risks and be aware of which children need balance testing. There are many vestibular screenings available to help hearing healthcare professionals identify children at risk. It is essential that parents and clinicians be cognizant of the signs and symptoms that accompany vestibular dysfunction to seek appropriate specialists for an accurate diagnosis and proper care. Healthcare practitioners can use simple and inexpensive screening tests to decide if a child needs a referral to other healthcare professionals. Estimates suggest that 1 in 20 children in the United States has dizziness and balance problems, so it is vital that vestibular screening be a part of a pediatric exam.


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