LM314 - Vestibular Monitoring Protocols for Complex Pediatric Populations

Abstract:
Pediatric vestibular evaluation and rehabilitation is an emerging area of practice and expertise within the field of audiology and cochlear implants. Research indicates the increased risk of vestibular dysfunction for children with significant hearing loss, such as the cochlear implant population.
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This presentation will review the risk factors for vestibular dysfunction for children with significant hearing loss and the current protocols for vestibular evaluation. Additionally, case studies will be included to outline the impact of this testing and resulting rehabilitation.

Summary:
Pediatric vestibular evaluation and rehabilitation is an emerging area of practice and expertise within the field of audiology and cochlear implants. Research indicates the increased risk of vestibular dysfunction for children with significant hearing loss, such as the cochlear implant population. Up to 50% of children with sensorineural hearing loss have abnormalities of the vestibular portion of the inner ear, with greater degrees of hearing loss correlating with greater likelihood of vestibular dysfunction (Cushing et al., 2013; Wiener-Vacher et al., 2018). These children are at risk for gross motor delays/plateau and problems with reading/academics, social skills, and memory without targeted early intervention (Hazen & Cushing, 2021). The presence of bilateral vestibular loss in a cochlear implant recipient makes that person nearly 8 times more likely to experience an internal device failure due to increased falls (Wolter et al., 2015). In order to provide comprehensive care to these children, a pre-cochlear implant screening protocol was developed, offered to all cochlear implant candidates. Pending the results of the screening and age of implantation, recommendations for follow up vestibular testing and a vestibular physical therapy evaluation are made. This presentation will review the risk factors for vestibular dysfunction for children with significant hearing loss and the current protocols for vestibular evaluation. Additionally, case studies will be included to outline the impact of this testing and resulting rehabilitation.

Brief Summary of Clinical Takeaways:
The clinical take-aways from this session are to identify risk factors for children who are cochlear implant candidates, to describe a protocol for evaluation pre- and post- cochlear implantation, and to discuss the impact of a vestibular disorder on a child's development.