Document Type

Presentation

Publication Date

4-8-2026

Faculty Mentor

Roxanna Bendixen

Abstract

Introduction: The vestibular system is comprised of five organs located in the inner ear that support balance, coordination, and spatial awareness (Cleveland Clinic, 2024). Due to the proximity of the hearing and vestibular organs, children with hearing loss are at an increased risk for vestibular dysfunction (Cushing & Papsin, 2018; Kelly et al., 2021). Early recognition and treatment of vestibular disorders via vestibular rehabilitation therapy can support healthy development throughout childhood (Monshizadeh et al., 2022; Wrobel et al., 2020). While vestibular assessment falls within the audiological scope of practice, barriers preclude routine screening of vestibular deficits in pediatric patients with hearing loss.

Methods: In collaboration with a hospital-based audiology department, this occupational therapy doctoral capstone project implemented a functional pediatric vestibular screening protocol complemented by caregiver and interdisciplinary education. The screening protocol enveloped both subjective and objective data. First, caregivers completed the student-developed Pediatric Vestibular System Profile (PSVP) that assessed caregiver observation of vestibular modulation and discrimination. Second, children with identified hearing loss aged four and older were evaluated using the Bruininks-Oseretsky Test of Motor Proficiency, 3rd Edition (BOT-3) balance subtest. Additionally, an educational handout was created to inform caregivers on vestibular dysfunction and potential interventions.

Results: 128 children (aged 23 months to 19 years, all with hearing loss) participated in the vestibular screening protocol, with 87 caregivers completing the PVSP and 112 children completing the BOT-3 evaluation. With the PSVP, 35% of participants scored as under-responsive and 10% demonstrated deficits. On the BOT-3, 88% of participants scored average or below, with 22% scoring well below average. A significant correlation was found between hearing device type and BOT-3 descriptive categories; however, no significant correlation was found between BOT-3 descriptive categories and PSVP results.

Conclusion: Occupational therapists are uniquely equipped to identify and treat vestibular dysfunction in children with hearing loss. Increasing the prevalence of screening within audiology clinics facilitates early identification and interdisciplinary care, ultimately aiding long-term patient outcomes. Enhanced awareness, caregiver education, and improved treatment practices for vestibular disorders will improve developmental outcomes and the overall quality of life for children with hearing loss and vestibular dysfunction.

References

Cleveland Clinic. (2026, January 16). What is the vestibular system? https://my.clevelandclinic.org/health/body/vestibular-system

Cushing, S. L., & Papsin, B. C. (2018, July 20). Cochlear implants and children with vestibular impairments. Seminars in Hearing, 39(3), 305-320. https://doi.org/10.1055/s-0038-1666820

Kelly, E. A., Janky, K. L., & Patterson, J. N. (2021, September 17). The dizzy child. Otolaryngologic Clinics of North America, 54(5), 973-987. https://doi.org/10.1016/j.otc.2021.06.002

Monshizadeh, L., Hashemi, S. B., Rahimi, M., & Mohammadi, M. (2022, August 18). Cochlear implantation outcomes in children with global developmental delay. International Journal of Pediatric Otorhinolaryngology, 162, Article 111213. https://doi.org/10.1016/j.ijporl.2022.111213

Wrobel, C., Zafeiriou, M., & Moser, T. (2021, January 8). Understanding and treating paediatric hearing impairment. EBioMedicine, 63, Article 103171. https://doi.org/10.1016/j.ebiom.2020.103171

Download

Share

COinS