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Vestibular Function in Infants and Children


Vestibular Function in Infants and Children
Kristen Janky, Au.D., Ph.D., CCC-A, Vestibular Audiologist

The vestibular system is attached to the hearing part of the ear, so when there is hearing loss there is always a chance that we can have vestibular loss with that. The number one thing that parents will complain of if a child has a vestibular disorder will be a delay in gross motor development. So kids will be late to develop head control, late to sit independently, walk independently. Those kids may also have some guarded actions when they are playing on the playground, may be a little apprehensive about jumping off of playground equipment, maybe late to learn how to swim, late to learn how to ride a bike and maybe not the best roller-skater.

How is vestibular function assessed in children?

Typically for young children below the age of three we are putting them in the rotary chair so in the rotary chair the parent will first sit down and we’ll set the child in the parents lap. We put sticker electrodes on their forehead, under the eyes, close the door to this light tight booth and then both the child and the adult rotate back and forth in this rotary chair. And that tells us overall about vestibular responsiveness.

Once the children are over the age of five all the assessments that we do on adults we can typically get in children, so we can get the video head impulse test, where they wear some tight fitting goggles. We move the head rapidly back and forth. We can do the vestibular evoked myogenic potential test where we put sticker electrodes on the neck, forehead, under the eyes and they listen to some clicking sounds and then we’ll do what’s called video nystragmography which is a typical assessment for anybody who has been diagnosed with dizziness, where they wear some goggles and watch a light do some different things on a light bar and then we do what is the caloric test where we put water in the ears. And measure eye movements in response to that water stimulation.

Why should vestibular loss be assessed in children?

That’s part of our research that we are determining whether or not more focus needs to be put on it whether vestibular loss has other consequences or implications beyond just learning how to sit, stand, walk, and crawl.

We know that children who are delayed in their gross motor function will eventually catch up with typically developing peers but we don’t know what the long lasting consequences of not looking at the vestibular loss are therefore we are continuing to do research to hope to answer that question.

Children with hearing loss could also experience vestibular loss as well. Kristen Janky, Au.D, Ph.D., CCC-A​, vestibular audiologist with Boys Town National Research Hospital, explains the signs of vestibular loss in children and how vestibular loss is assessed in children.