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Motor Competence in School-Aged Children at Risk of Vestibular Loss: An Overview
Ruth Van Hecke1, Ingeborg Dhooge2,3, Cleo Dhondt3
1Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Insights
A comprehensive assessment protocol for children at risk of vestibular disorders is crucial. Combined vestibular and auditory deficits significantly impact motor skills, necessitating early intervention and monitoring.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Developmental Pediatrics
Background:
- Vestibular disorders in children can arise from various factors including genetic mutations, infections, head trauma, and sensorineural hearing loss.
- Early identification and management of pediatric vestibular dysfunction are critical for optimal development.
- A comprehensive assessment protocol is needed to address the multifaceted nature of these disorders.
Purpose of the Study:
- To present the outcomes of an extensive auditory, vestibular, and motor assessment protocol in school-aged children at risk of vestibular disorders.
- To characterize the clinical features and motor competence of children with potential vestibular dysfunctions.
- To evaluate the effectiveness of a multidisciplinary approach in managing pediatric vestibular concerns.
Main Methods:
- A cohort of 117 school-aged children (4.0 to 16.9 years) at risk of vestibular deficits were assessed between 2017 and 2021.
- Risk factors included vestibular complaints, hearing loss, ototoxic drug history, inner ear malformations, head trauma, genetic mutations, and specific infections.
- Assessments encompassed auditory, vestibular, and motor function evaluations, including the Movement Assessment Battery for Children-2 (MABC-2).
Main Results:
- Four groups were identified: combined vestibular and hearing loss (n=47), isolated vestibular loss (n=5), isolated hearing loss (n=33), and no audiovestibular deficits (n=32).
- Children with combined vestibular and auditory dysfunctions exhibited significantly diminished fine motor skills, balance, and MABC-2 scores (p < 0.001).
- Severe bilateral vestibular deficits were associated with the most pronounced motor impairments, leading to 80.9% of affected children being referred for further monitoring or physical therapy.
Conclusions:
- This study highlights the diverse clinical presentations in school-aged children at risk for vestibular disorders.
- A comprehensive assessment integrating auditory, vestibular, and motor evaluations is essential for accurate diagnosis and management.
- Particular attention should be given to children with combined vestibular and auditory deficits due to their significant impact on motor development.
Objectives:
On the basis of research and clinical experience, our otorhinolaryngology department developed an extensive protocol including auditory, vestibular, and motor assessments for all children at risk of vestibular disorders. The purpose of this study was to present the outcomes of this clinical protocol in a school-aged population and to provide an overview of the main clinical features and the motor competence of the children at risk of vestibular dysfunctions.
Design:
Data collection for this study took place between October 2017 and October 2021. During this timeframe, all school-aged children (4.0 to 16.9 years old), who were either in follow-up or referred to our otorhinolaryngology department at the Ghent University Hospital because of a risk of vestibular deficits, and who expressed a willingness to participate in the study, were included. Children were deemed at risk if they had (1) vestibular complaints (i.e., vertigo, instability, dizziness), (2) sensorineural hearing loss (with or without cochlear implant[s]), (3) a medical history with ototoxic drugs, (4) inner ear malformations defined by imaging, (5) a head trauma, (6) genetic mutations linked to vestibular loss, or (7) evidence of prior infections that are related to vestibular loss in the literature (e.g., meningitis, congenital cytomegalovirus infection).
Results:
Among the 117 participants (59 boys; 7.3 ± 3.1 years), four groups could be identified: those with combined vestibular and hearing loss (n = 47), with isolated vestibular loss (n = 5) or hearing loss (n = 33), and those without audiovestibular deficits (n = 32). Group differences revealed diminished fine motor skills, as well as lower balance and total MABC-2 scores in the group with combined vestibular and auditory dysfunctions ( p < 0.001), particularly in children with severe bilateral vestibular deficits. Moreover, the majority (38/47; 80.9%) were referred for additional monitoring of their motor functioning and/or for physical therapy.
Conclusions:
This first large-scale study encompassing school-aged children at risk of vestibular disorders revealed a diverse clinical presentation among them. Considering crucial trends and influential factors, the study emphasized the importance of adopting a comprehensive approach, including auditory, vestibular, and motor tests, for assessing and managing pediatric vestibular concerns, particularly in children with combined vestibular and auditory deficits.
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