Pediatric Balance and Vestibular Disorders Clinic

What to expect at the Pediatric Balance and Vestibular Disorders Clinic (PBVDC)

Prior to attending the Pediatric Balance and Vestibular Disorders Clinic (PBVDC), your child must undergo a vestibular evaluation. Depending on the results of these tests, they may or may not be recommend to attend the PBVDC. On the day of your child's PBVDC appointment, you and your child meet a team of providers that have been chosen based on your child’s history and symptoms. Our experts perform a thorough medical examination and review your child’s medical history. They may also perform a balance assessment and hearing test.

We schedule the evaluation so your child sees all the necessary providers in one day for a quick, accurate diagnosis. You should expect to spend about three hours at the clinic on the day of your appointment. We may recommend inner ear testing before you see us to help us make a diagnosis.

Vestibular tests and equipment:

The exact tests we recommend will depend on your child’s symptoms and any existing diagnosis.

Throughout testing, our child life specialists are here to support your whole family. They can meet you in a telehealth appointment before your PBVDC appointment to help you understand what will happen during your child’s assessment and answer any questions you or your child have.

A child life specialist can also be present for the clinic appointment to provide age-appropriate support for your child throughout testing. If you are interested in including this free service, please let us know when you make your vestibular evaluation and PBVDC appointments.

Tests we use to diagnose vestibular disorders include:

• Videonystagmography (VNG): This tests your child’s eye movement as they react to different stimuli. For one test, your child lies down in different positions and looks at moving objects on a screen. They wear goggles with small cameras that record eye movements. For another, the audiologist places warm and cool water or air in your child’s ears, and the video goggles will record how their eyes move in response. During these tests your child may feel like they are moving, but the table remains stationary.
• Vestibular evoked myogenic potential (VEMP): The audiologist places small sticker sensors on your child’s neck and face. Your child listens to a loud sound for a few moments while they lift and turn their head or look at an object above them.
• Video head impulse test (vHIT): Your child wears lightweight goggles that measure eye movements. They will be asked to hold their eye gaze on a target. At the same time, the audiologist moves your child’s head in quick, small movements to the left/right and up/down.
• Rotational chair testing: Your child is seated on a rotating chair controlled by a computer. They will be safely secured with a safety belt, booster seat or car seat. The chair is inside a small, dark room and is monitored by the audiologist through a camera. Your child wears goggles containing small cameras to record how their eyes move as the chair gently rotates left and right.

Physical therapy (vestibular rehabilitation):

The vestibular testing team includes physical therapists with specialized training in vestibular rehabilitation. Our vestibular physical therapist reviews your child’s medical history and evaluates their posture and the way they walk and move. We also check for possible neurological concerns. Your child will be asked to do things like balance on one leg with their eyes open and closed, hold the therapists’ gaze and other stimulus and reaction tests.

The physical therapist creates an individualized exercise plan to improve balance, decrease dizziness and promote achievement of developmental milestones based on your child’s evaluations.

Prepare for your appointment at the Pediatric Balance and Vestibular Disorders Clinic

Preparing for your appointment

Before your visit, please complete the vestibular questionnaire below and bring a copy to the appointment.

Dizziness Handicap Inventory for Patient Caregivers (children 5-12 years) (PDF)

Dizziness Handicap Inventory (children 13 years and older) (PDF)

Medications

Certain medications sometimes affect balance, so we ask that you discontinue any medication your child is taking 24 hours prior to your child’s vestibular testing appointment. If you have concerns regarding this, please discuss them with your child’s primary care provider or prescribing provider before discontinuing prescription medications.

• Antihistamines
• Antinausea medications
• Antidizziness medications
• Aspirin
• Sedatives
• Tranquilizers