Motor Competence in School-Aged Children at Risk of Vestibular Loss: An Overview.

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.