Vestibular issues & kids: what to look for with a vestibular disorder
Have you noticed your child is having a hard time keeping up with their friends? Maybe you’ve seen your child trip, stumble, or even fall when there wasn’t a tripping hazard. It’s common for parents and guardians to tell me their child seems more clumsy or off balance than their siblings, or even their friends or classmates. If your child has been having frequent falls, they may have an issue with their vestibular system.
We know children can struggle with telling their parents how they’re feeling or what’s happening, and this can be even harder for them when they are having difficulties with their vestibular system. Sometimes we have to rely more on what they do vs what they say as clues to what is going on. This makes watching your child and what’s giving them trouble that much more important.
As a parent, it can be hard to know when to seek out care for your child. To help you identify what a vestibular issue may look like here are common things to watch for:
Vertigo:
Vertigo is the term used to describe when a person feels they or their environment is moving or spinning. Depending on your child’s age, this could be something they tell you or if they’re younger they may cling to you, refuse to stand up, or even fall asleep (1,2). Not every child with a vestibular issue will experience vertigo and identifying it’s presence helps your healthcare team to identify what is going on.
Key things to pass along to your healthcare team are: how long these episodes last, how often they happen, when they happen, & other things that happen with these episodes (i.e. loss of appetite, vomiting, saying their stomach hurts, headaches) (1,2). Often children aren’t able to recall this information on their own and a good history helps your healthcare provider with their evaluation.
Dizziness:
Dizziness is a common complaint with vestibular system issues, but isn’t present in all children. Older children may tell you they feel woozy, lightheaded, or that the ground is moving under them when they are still or moving.
Just like with vertigo, it’s important to pay attention to how long your child’s dizziness lasts, when it happens, how often they feel it, and if your child has other symptoms at the same time as their dizziness so you can relay this to your healthcare providers (1,2).
Motor development, walking, and balance problems:
Children with vestibular deficits have been shown to have problems with balance, motor development, and walking with loss of vestibular function at or shortly after birth (2-7). In smaller children, this could show up as completely refusing to walk or stand unsupported.
Often children with vestibular issues will go through their developmental stages more slowly than other children their age do (2-4). You may notice your child using other supports, such as a wall or furniture, to help steady themselves (4). In older children, this could show up as poorer balance depending on how severe the vestibular involvement is (7) or clumsiness with activities when compared to their peers.
Gaze stability difficulties:
Children with vestibular issues often have trouble with keeping objects still in their vision or keeping their eyes on a target, especially when they are moving. In smaller children, this can show up as having difficulty tracking a moving target. As a parent you may notice that your child isn’t able to easily follow you as move around the room or you may see them searching for something that they’ve not been able to keep their eyes on.
In school-age children, this can show up as underperforming in school (8), due to difficulties with reading or visual acuity when the head is moving. They may also have difficulty keeping up with friends or following a ball while playing or participating in sporting activities (4).
Does any of this apply to your child? A thorough assessment with a healthcare provider trained in vestibular rehabilitation can help to identify what is going on and what the next steps should be to help your child feel better.
Are you unsure of how to find a healthcare provider with training in vestibular rehabilitation? Check out the Vestibular Disorders Association provider listing
Read more about vestibular physiotherapy for your child. If you live in Ontario and would like to speak further about vestibular physiotherapy for your child, you can contact me or book a free 10-min consult call using the button below.
Updated: August 31, 2024
References:
Rine RM & Christy JB. Part 1: Pediatric Vestibular Disorders. Vestibular Disorders Association. 2016. https://vestibular.org/sites/default/files/page_files/Documents/Pediatric%20Vestibular%20Disorders_Part%201_46a.pdf
Rine RM & Wiener-Vacher S. Evaluation and treatment of vestibular dysfunction in children. NeuroRehabilitation. 2013. 32:507–518. DOI: 10.3233/NRE-130873
Rine RM, Cornwall G, Gan K, LoCascio C, O’Hare T, Robinson E, & Rice M. Evidence of progressive delay of motor development in children with sensorineural hearing loss and concurrent vestibular dysfunction. Perceptual and Motor Skills. 2000. 90:1101-1112. DOI: 10.2466/pms.2000.90.3c.1101
Wiener-Vacher S & Lecervoisier S. Balance problems in children: for day-to-day comprehension and advice. English version. Action Connaissance Formation pour la Surdité; 2014. ACFOs.org English Version
Christy JB, Payne J, Azuero A, & Formby C. Reliability and diagnostic accuracy of clinical tests of vestibular function for children. Pediatric Physical Therapy. 2014. 26:180-190. DOI: 10.1097/PEP.0000000000000039
Janky KL & Givens D. Vestibular, visual acuity, and balance outcomes in children with cochlear implants: A preliminary report. Ear and Hearing. 2015. 36;6:364-372. DOI: 10.1097/AUD.0000000000000194
Sokolov M, Gordon KA, Polonenko M, Blaser SI, Papsin BC, & Cushing SL. Vestibular and balance function is often impaired in children with profound unilateral sensorineural hearing loss. Hearing Research. 2019. 372:52-61. DOI: 10.1016/j.heares.2018.03.032
Franco ES & Panhoca I. Vestibular function in children underperforming at school. Brazilian Journal of Otorhinolaryngology. 2008. 74;6:815-825. DOI: 10.1016/S1808-8694(15)30141-5
