Skip to main content
Download PDF

Clinical balance assessment tools for children with hearing loss: a scoping review

BMC Pediatrics volume 25, Article number: 218 (2025) Cite this article

Abstract

Balance dysfunction exists in children with hearing loss, especially sensorineural loss, impacting on cognitive development, socio-emotional development and literacy. However, there is limited assessment of balance in this population, which further impedes childhood development. The objective of this review was to identify clinical, low- technology and inexpensive tools used to evaluate balance in children with hearing loss. Methods: A scoping review method with reference to the JBI, was used where a search was conducted on electronic databases including, but not limited to, EBSCOHost, MEDLINE, PubMED, Web of Science and Wiley. In addition, grey literature and hand searches were also used. The review included children between 3 and 15 years of age with hearing loss. Results: A total of 68 articles were found where 27% of the tests were norm-referenced tests, 64% were criterion referenced tests and 9% could not be identified. Conclusion: Tests such as the Tandem gait test, Pediatric Balance Scale (PBS), Clinical Test of Sensory Interaction for Balance (mCTSIB)/Pediatric Version of Clinical Test for Sensory Interaction of Balance (P-CTSIB), Dynamic Gait Index and the Timed-up-and-Go were identified to be relatively inexpensive and low-technology clinical tools and have thus, been summarized in this review.

Peer Review reports

Introduction

The balance system is a complex system that facilitates multisensory integration of vestibular, visual, proprioceptive and cognitive input to maintain balance and equilibrium [1, 2]. Throughout childhood, this system continues to develop such that it reaches a stage of adult-like sensory integration by the age of 12 years [3]. Furthermore, spatial cues received from the auditory system assist with maintaining posture and balance [4]. In children, balance involves maintaining postural control and ensuring the coordination and accuracy of movement with ongoing motor development [5]. Thus, injury or defect to either the auditory or vestibular system can result in balance dysfunction [4, 6, 7].

Due to the anatomical and physiological relationship between hearing and the vestibular system, children with hearing loss have been noted to present with motor and balance deficits [8]. Hearing loss is often accompanied by debilitating effects on children such as impaired language, communication, socio-emotional, psychological and academic difficulties [9]. In addition, it has been found that children with severe to profound hearing loss usually present with significant delays in fine and gross motor development [10], postural and balance deficits [11], and poor visual and spatial orientation [12]. Psychological issues such as hyperactivity and increased risk of anxiety-related disorders have also been noted in children with more severe forms of hearing impairment [13]. Moreover, negative impact on cognitive development, socio-emotional development and literacy may also be noted; such that hearing-impaired children may later experience learning difficulties, developmental delays and poor academic performance (Martens et al., 2020; Rine & Wiener-Vacher, 2013). Due to such difficulties, children have increased risk of falls and injuries [14]. Falls are the most common cause of hospitalizations (30%) and visits to the emergency department (15%) in children [15]. In a low-middle income country like South African, falls were found to be the second commonest cause of unintentional injury to children [16, 17].

Regardless of the aforemetioned evidence, vestibular and balance dysfunction in the paediatric population have been historically underdiagnosed [18]. Although caregivers and teachers may report clumsiness and coordination difficulties, healthcare professionals who service this population often lack the appropriate training and time to effectively screen for both balance and developmental issues during routine clinic visits [19]. High patient caseload, expensive equipment and lack of competence in training have contributed to balance dysfunction going unheeded [19,20,21,22,23,24]. Assessment tools such as dynamic posturography, electrophysiological measures and other high-technology equipment may not be readily available to audiologists, especially those in low- and middle-income countries (LMIC) [25]. Thus, further restricting access to balance assessment services. Therefore, the need to collate a battery of clinical tools for balance assessment may address such an issue, as they may be relatively inexpensive and easily available.

Although hearing screening programmes have been able to provide early identification of hearing; the screening is limited in its inclusion of balance and motor assessments [21, 26]. Although some countries like Belgium have initiated vestibular screening in neonates, it is not routinely performed on all children with hearing loss; unless obvious vertigo and balance disorders are noted or for cochlear implant candidacy [21]. Consequently, limitations in the management of the adverse effects of vestibular and resultant balance deficits can be noted as assessments are not incoporated as part of a standard healthcare service [27, 28]. There is evidently a significant gap in practice for vestibular and balance screening in children with hearing loss, especially those presenting with severe to profound SNHL, and psychological disorders such as hyperactivity and anxiety disorders [10, 13]. Therefore, the main objective of this review was to develop a literature map of clinical balance assessment tools for children between the ages of three to fifteen years with hearing loss. Thereafter, it also aimed to identify gaps in literature for future research. A scoping review was an appropriate method to achieve these objectives as it is necessary to uncover the existing and available body of literature regarding a particular topic, in order to provide clarity and create a platform for the development of a systematic review [29].

A preliminary search was conducted in the JBI Database of Systematic Reviews, Cochrane Database of Systematic Reviews and PROSPERO databases to outline the availability and characteristics of balance assessments in children. Thus, the current scoping review sought to critically analyse and synthesize findings from existing literature relating to clinical balance assessment tools which are suitable for children with hearing loss.

Methods

A scoping review was conducted. Scoping reviews are necessary to uncover the existing and available body of literature regarding a particular topic, in order to provide clarity and create a platform for the development of a systematic review (Munn et al., 2018). The methodology followed Arksey and O’Malley’s framework for scoping reviews (Arksey & O’Malley, 2005). Arksey and O’Malley (2005) recommend following a five-step process for scoping reviews, that was the method used for this study and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the data.

Selection criteria

The review included studies involving (1) children older than 3 years to 15 years of age, by this age children should have received intervention for hearing impairment [30], also taking into account late diagnosis of hearing loss. Furthermore, the function of the vestibular system is present from birth and continually matures until the age of fifteen years [31] (2) clinical assessment tools that measure paediatric balance function (3) all research methodological frameworks written in English. The Joanna Briggs Institute (JBI) recommendations for pilot testing was followed using two randomly sampled databases (Cochrane Library PROSPERO and MEDLINE). The researcher screened titles and abstracts of 25 randomly sampled literature and thereafter, consultation with supervisor was done (M.D.J. Peters et al., 2021).

Search strategy

A qualified librarian was consulted to assist in developing search terms and an appropriate strategy. The following keywords were used: Population: child/paediatric/pediatric AND balance dysfunction/balance deficits/motor deficits/ instability, Concepts: balance assessment/balance tests/balance scales/functional balance test AND balance performance, Context: hearing loss/HL/hearing impairment. An example of the search term and strategy used in this study is displayed in Table 1.

Table 1 Example of search strings used in the review
Full size table

Literature published in Medline (via Ebsco Host), ERIC, Health Source: Nursing/Academic edition, CINAL, Africa wide information, Psych-info, PubMed, Academic search premier, Wiley online, Scopus and Web of Science databases was searched. In addition, a search was conducted on OpenGrey and a manual search through references of included articles was done to account for grey literature. Although it is recommended that literature must not be older than 10 years (Cronin, Ryan, & Coughlan, 2008); for this review, a stipulated time frame was not used due to the novelty of the area of interest.

Data extraction

The data were extracted from the literature search using the draft data charting tool recommended by the JBI (M.D.J. Peters et al., 2021). Figure 1 demonstrates the data extraction process. A search through the abovementioned databases yielded a total of 704 studies. A total of 320 duplicates were removed, leaving 384 studies for abstract screening. Of these studies, 240 articles were selected for full-text review and 172 articles were removed. Full-text review yielded 68 articles which met the selection criteria.

Fig. 1
figure 1

PRISMA diagram

Full size image

Results

The findings of this review reflect instruments used in both high-income countries and LMIC [8, 14, 19, 24, 32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95].

In total, 44 different assessment tools were used in the researchers’ protocols to examine balance in children with hearing loss (Table 2). These tools evaluated static balance, dynamic balance, functional balance and motor development. A total of 27% of these tests were norm-referenced tests, 64% were criterion referenced tests and 9% could not be identified. The assessment tools that were most commonly used were the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), Bruininks-Oseretsky Test of Motor Proficiency Second edition (BOT-2), Movement Assessment Battery for Children (2nd edition) and the Single Leg Stance in evaluating motor performance and static balance respectively.

Table 2 Findings of the scoping review
Full size table

There are a range of low-technology, clinical tools which have been used to assess for balance deficits in children with hearing loss. The researcher further classified assessment tools according to costs as seen in Table 3. Eleven assessment tools were noted to have cost implications and were copyrighted, 22 tests were easily available and required minimal equipment, while eight could not be identified.

Table 3 Classification of assessment tools according to cost
Full size table

Discussion

Recent technological advances have allowed for the quantification of balance, however, some of these assessments are costly and may therefore, be inaccessible in many clinical settings [96]. The objective of this review was to explore clinical balance assessment tools administered to hearing-impaired children between the ages of 3 to 15 years of age. The findings of this review reflect that there is an assortment of balance tools, assessing different aspects of balance function. For the purpose of this review, only the inexpensive and easily available clinical assessment tools (Table 3) will be discussed. Furthermore, the reliability, validity and applicability of these tools will also be discussed.

The literature reviewed in this study reflected that authors [8, 14, 37, 79, 90, 91, 93, 97] utilized the Paediatric Balance Scale (PBS) as part of their balance assessment test battery for children with hearing loss. The PBS is an adaptation of the Berg Balance Scale and it is a criterion-referenced test assessing functional balance in children 2 years − 7 years and older (Franjoine, Darr, Held, Kott, & Young, 2010). It is a valid and reliable balance tool that assesses for functional balance using 14 tasks which are similar to activities of daily living [98]. Within the tasks, the PBS incorporates the conditions similar to the Romberg, Sharpened Romberg, Functional Reach Test and Standing on One Leg test. These tasks can be scored from 0 to 4 where a high score indicates good performance and the test can be completed in approximately 20 min with the aid of easily accessible equipment e.g., chair, bench, stopwatch etc. [99]. The PBS has an interrater reliability of (ICC [3,2] = 0.90–0.92), test-retest (ICC [2,1] = 0.923), and intra-rater reliability (ICC [2,1] = 0.895–0.998) allowing for adequately identifying children with balance dysfunction [99]. This review also shows that authors used the Romberg test [24, 50, 59], Sharpened Romberg [50, 93, 100], Functional Reach Test [8, 70, 72, 73, 81, 85, 88], Standing on One Leg test [8, 14, 19, 41, 46, 52, 57, 64, 68, 70, 81, 93, 100, 101], and the Berg Balance Scale [65] from which the PBS is adapted. Thus, in settings where healthcare practitioners are burdened by high case-loads and have restricted resources, this test could be particularly useful.

The tandem gait test [24, 59] is an assessment procedure used for dynamic postural control [102]. It is a simple test and easy to administer, requiring minimal equipment [103]. It can be conducted in different conditions including eyes open, eyes closed or with dual tasking. This test requires children to walk barefoot along a 3 m line in an alternating heel-to-toe motion, make a turn of 180°, repeat the same action back to the starting line [102]. Four trials are conducted and each trial is timed. The child passes the test if they can walk along the line without stepping over the it, deviating from line or having gait of < 14 s [104]. The tandem gait test has good reliability (intraclass correlation coefficient; ICC [3,1] = 0.86; 95% confidence interval [CI] = 0.73–0.93) [103].

The modified Clinical Test of Sensory Interaction for Balance (mCTSIB) and Pediatric Version of Clinical Test for Sensory Interaction of Balance (P-CTSIB) are modifications of the Clinical Test of Sensory Interaction in Balance (CTSIB) test. These tests were noted in four [19, 64, 68, 105] (mCTSIB) and three [37, 93, 97] (P-CTSIB) studies in this review. The mCTSIB assesses the impact of sensory integration in maintaining balance and postural ability (Lotfi, Javanbakht, Sayaf, & Bakhshi, 2018). The m-CTSIB can be used to evaluate all age groups from 2 years (Horn et al., 2015), while the P-CTSIB shows good reliability for children 4–6 years (Lotfi, Kahlaee, Sayadi, Afshari, & Bakhshi, 2017). It is a criterion reference test that requires minimal equipment that assesses balance in four conditions; eyes open on firm surface, eyes closed on firm surface, eyes open on foam surface and eyes closed on foam surface and each condition is held for 30 s [106]. Three trials are given with performance on each trial timed and recorded. In the P-CTSIB, children are given one-minute rest between each test condition [37]. Maturation is a great factor in these tests. For 6–12year olds, the reliability of the m-CTSIB has good sensitivity (88%) and specificity (85%); and reliability was high (0.78), except for condition 4 (0.56) [105]. For the P-CTSIB for 4–6 years, the interrater reliability was also good (standing duration, antero-posterior sway, and lateral sway = 0.92, 0.77, and 0.84, respectively). The intraclass correlation coefficient (ICC) ranged from 0.70 to 0.92 for standing duration [107].

The Dynamic Gait Index (DGI) [46] is a criterion-based test used to assess postural control and dynamic balance. It measures functionality using 8 items; with a total score of 24, scored from 3 (independent walking) to 0 (severe impairment) [108]. Furthermore, Evkaya (2020) found that the DGI has an internal consistency with a Cronbach’s alpha coefficient of 0.969, a test-retest reliability of (ICC = 0.970 Cl (0.915-0990)) and an inter-rater reliability of DGI was excellent (ICC = 0.983 Cl (0.882-0990). These results are applicable for children 6- 14years of age.

The Timed Up and Go Test (TUG) is another measure which can be used to assess dynamic balance in children [109]. In this review, it was utilized by three authors [8, 86, 93]. It is a fairly reliable test of dynamic balance that can be conducted with children as young as 3 years [110]. A standard chair (approx. height of 46 cm) with backrest or armrest can be used [111]. The test requires the child to sit on a chair, get up and walk along a 3 m line, turn around and walk back to the starting position and sit down [112]. The entire process is timed, three trials are conducted and the best of the three is recorded [109, 112]. The TUG is a reliable test with a test-retest, intra-rater, and interrater reliability (intraclass correlation coefficient [ICC] ≥ 0.85) for children between 3–18years of age [109]. The Standardized Walking Obstacle Course test (SWOC) [86] is a similar test to the TUG where a child is required to get up from a sitting position, walk in one direction and then sit. It further consists of three conditions such as walking, walking with a tray and walking with reduced vision (shaded glasses) [113]. It has an intraclass correlation coefficient of 0.99 and with 0.94–0.99 number of steps in children, it has good screening capabilities [114]. Furthermore, this test has showed significant correlation with the TUG (p = < 0.05) [115, 116].

Authors in this review also utilized the Modified Bass Test [87] and the Balance Error Scoring System [91]. This is a simple and quick test to conduct, measuring a child’s ability to jump from one marked spot to the next without losing balance [117]. Targets are placed on the floor by the examiner in a 2.5 cm x 2 cm pattern, the starting point is also marked and the child is expected to jump to the next target while maintaining a steady position for 5 s. This is done until they jump to all marked targets and they are scored 5 points for accurately landing on the mark and 1 point for each second they are able to hold their balance a higher score indicates good balance [117]. This test is appropriate for assessing static and dynamic balance as it has an ICC of 0.82 [117, 118]. Similarly, the BESS test can be used to assess static balance. With this test, examiners can assess balance in 6 positions which are double leg stance, single leg stance and tandem stance which are done on flat surface and on a foam pad [117]. It is noteworthy that these conditions are similar to that of the P-CTSIB, mCTSIB and the single leg stance test which have been discussed above. Time limit is kept and errors such as touching down with opposite foot, excessive hip movement, moving out of test position and taking a step, stumbling or falling [119]. Less errors indicate better static balance [117]. This measure has moderate to good reliability and can be used by clinicians who do have access to advanced balance assessments [120].

Last, the development of the new Geneva Balance Test (GBT) [92] assists in the screening for balance deficits in very young children. This test utilizes two conditions: walking at normal pace on a foam mat in bright condition, and walking at normal pace on a foam mat in dim light condition. Each condition is repeated 3 times, a deviation from the midline is observed and a score from 0 to 9 is given where the maximum score is 18. The lower the score, the better the balance performance. This test is differentiate between children with bilateral vestibulopathy against the control, thus could be useful in quantifying balance deficits in children [92].

The balance assessment tools discussed in this review were primarily designed for adults; however, researchers have made strides to develop normative data applicable for children of different ages. The findings of this review reflect the heterogenous nature of balance assessments available, thus, allowing clinicians the opportunity to select the appropriate tool to use based on the child’s age and aspect of balance they would like to assess. The tools (DGI, TUG, m-CTSIB) are also clinically recommended by VEDGE Task Force [121] as tools which can be used to assess balance function; and literature supports the clinical utility in children [122, 123]. Furthermore, due to limited cost implications and low-technological nature of these tools, they could be easily adopted into clinical practice by professionals from different contexts and disciplines. The early identification of balance deficits in children with hearing loss can have far reaching effects, allowing for early intervention and subsequent improvement in the child’s quality of life. Ultimately, making the integration of balance assessments across a continuum of care for children with hearing loss feasible.

Limitations

In this review, the quality of the studies included was not assessed. Although this may not be typical of a scoping review, it can be seen as a limitation as poorly designed studies have not been identified. The analysis of this review was based on balance assessments in children with hearing loss, thus, it may be important to consider the impact of balance impairment in children and the related interventions. A further limitation to this scoping review was the inclusion of studies written in English only, thus, limiting the extent to which the literature could be explored in other languages. As recommendation, future research in this field could provide sufficient data through systemic reviews or meta-analyses to inform the development of a standard paediatric balance assessment battery.

Conclusion

The finding of this review demonstrates a robustness in clinical balance assessments used to assess children with hearing loss. Tests such as the Tandem gait test, Paediatric Balance Scale, Modified/ Pediatric Clinical Test of Sensory Interaction for Balance (mCTSIB/PCTSIB), Dynamic Gait Index (DGI) or Timed Up and Go Test (TUG) can be used to evaluate different aspects of balance which can be vital for the identification of balance dysfunctions.

Balance dysfunction plays a detrimental role in childhood development and may contribute to global developmental delay as well as a delay in cognitive development [124]. Therefore, assessment and management of such dysfunctions becomes imperative. The abovementioned instruments that are reliable, quick and easy to administer and can be suitable for any clinical context. More importantly, these tools may be appropriate for use in primary healthcare settings as they require minimal equipment and are easily accessible. However, there is room to further explore paediatric balance assessment tools in both research and clinical practice to aid in the development of a standardized protocol for balance assessment in children with hearing loss. This could inform policy makers and relevant stakeholders in healthcare institutions about the need to review current practices and protocols regarding the management of children with hearing loss.

Data availability

No datasets were generated or analysed during the current study.

References

  1. Morita H, Kaji H, Ueta Y, Abe C. Understanding vestibular-related physiological functions could provide clues on adapting to a new gravitational environment. J Physiol Sci. 2020;70(1):17.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Melo RS, Lemos A, Wiesiolek CC, Soares LG, Raposo MC, Lambertz D et al. Postural sway velocity of deaf children with and without vestibular dysfunction. Sens [Internet]. 2024; 24(12).

  3. Varedi M, Lu L, Phillips NS, Partin RE, Brinkman TM, Armstrong GT, et al. Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations. J Cancer Surviv. 2021;15(2):311–24.

    Article  PubMed  Google Scholar 

  4. Horowitz G, Ungar OJ, Levit Y, Himmelfarb M, Handzel O. The impact of conductive hearing loss on balance. Clin Otolaryngol. 2020;45(1):106–10.

    Article  PubMed  Google Scholar 

  5. Walicka-Cupryś K, Przygoda Ł, Czenczek E, Truszczyńska A, Drzał-Grabiec J, Zbigniew T, et al. Balance assessment in hearing-impaired children. Res Dev Disabil. 2014;35(11):2728–34.

    Article  PubMed  Google Scholar 

  6. Vitkovic J, Le C, Lee SL, Clark RA. The contribution of hearing and hearing loss to balance control. Audiol Neurootol. 2016;21(4):195–202.

    Article  PubMed  Google Scholar 

  7. Sokolov M, Gordon KA, Polonenko M, Susan I, Blaser SI, Papsin BC, Cushing SL. Vestibular and balance function is often impaired in children with profound unilateral sensorineural hearing loss. Hear Res. 2019;372:52–61.

    Article  PubMed  Google Scholar 

  8. Karakoc K, Mujdeci B. Evaluation of balance in children with sensorineural hearing loss according to age. Am J Otolaryngol. 2021;42(1):102830.

    Article  PubMed  Google Scholar 

  9. Mulwafu W, Kuper H, Ensink RJ. Prevalence and causes of hearing impairment in Africa. Trop Med Int Health. 2016;21(2):158–65.

    Article  CAS  PubMed  Google Scholar 

  10. Hazen M, Cushing LS. Implications of concurrent vestibular dysfunction in pediatric hearing loss. Curr Otorhinolaryngol Rep. 2020;8:267–75.

    Article  Google Scholar 

  11. Yassin O, Elshafey M, Hamdy B, Gamal R, Abdelazeim F. Comprehensive evaluation of vestibular dysfunction in deaf children. J Crit Reviews. 2020;7(18):3586–94.

    Google Scholar 

  12. Ionescu E, Reynard P, Gouleme N, Becaud C, Spruyt K, Ortega-Solis J, et al. How sacculo-collic function assessed by cervical vestibular evoked myogenic potentials correlates with the quality of postural control in hearing impaired children? Int J Pediatr Otorhinolaryngol. 2020;130:109840.

    Article  PubMed  Google Scholar 

  13. Antoine MW, Vijayakumar S, McKeehan N, Jones SM, Hebert JM. The severity of vestibular dysfunction in deafness as a determinant of comorbid hyperactivity or anxiety. J Neurosci. 2017;37(20):5144–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Soylemeza E, Ertugrulb S, Doganc E. Assessment of balance skills and falling risk in children with congenital bilateral profound sensorineural hearing loss. Int J Pediatr Otorhinolaryngol. 2019;116:75–8.

    Article  Google Scholar 

  15. Grivna M, Al-Marzouqi HM, Al-Ali MR, Al-Saadi NN, Abu-Zidan FM. Pediatric falls from windows and balconies: incidents and risk factors as reported by newspapers in the united Arab Emirates. World J Emerg Surg. 2017;12(1):45.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lack V, Fru PN, Van Rensburg C, Van Rensburg K, Loveland JA. The epidemiology of traumatic brain injuries sustained by children under 10 years of age presenting to a tertiary hospital in Soweto, South Africa. South Afr Med J. 2021;111(Electronic):2078–5135.

    Google Scholar 

  17. Tupetz A, Friedman K, Zhao D, Liao H, Isenburg MV, Keating EM, et al. Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review. PLoS ONE. 2021;15(12):e0243464.

    Article  Google Scholar 

  18. Kelly A, Liu Z, Leonard S, Toner F, Adams M, Toner J. Balance in children following cochlear implantation. Cochlear Implant Int. 2017.

  19. Said EAF. Clinical balance tests for evaluation of balance dysfunction in children with sensorineural hearing loss. Egypt J Otolaryngol. 2013;29(3):189–201.

    Article  Google Scholar 

  20. Zhou G, Kenna MA, Stevens K, Greg Licameli G. Assessment of saccular function in children with sensorineural hearing loss. Arch Otolaryngol Head Neck Surg. 2009;135(1):40–4.

    Article  PubMed  Google Scholar 

  21. Martens S, Dhooge I, Dhondt C, Leyssens L, Sucaet M, Vanaudenaerde S, et al. Vestibular infant Screening - Flanders: the implementation of a standard vestibular screening protocol for hearing-impaired children in Flanders. Int J Pediatr Otorhinolaryngol. 2019;120(Electronic):1872–8464.

    Google Scholar 

  22. Božanić Urbančič N, Vozel D, Kordiš Š, Hribar M, Urbančič J, Battelino S. Indicators of pediatric peripheral vestibular disorder: A retrospective study in a tertiary referral center. Int J Pediatr Otorhinolaryngol. 2022;159:111221.

    Article  PubMed  Google Scholar 

  23. Martens S, Dhooge I, Dhondt C, Vanaudenaerde S, Sucaet M, Rombaut L, et al. Pediatric vestibular assessment: clinical framework. Ear Hear. 2023;44(Electronic):1538–4667.

    Google Scholar 

  24. Singh A, Heet H, Guggenheim DS, Lim M, Garg B, Bao M, et al. A systematic review on the association between vestibular dysfunction and balance performance in children with hearing loss. Ear Hear. 2022;43(3):712.

    Article  PubMed  Google Scholar 

  25. Seedat T, Khoza-Shangase K, Sebothoma B. Vestibular assessment and management in adults: current practice by South African audiologists. Hear Balance Communication. 2018;16:1–13.

    Google Scholar 

  26. Rajendran V, Roy FG. An overview of motor skill performance and balance in hearing impaired children. Ital J Pediatr 2011;37(33).

  27. Callahan AJ, Lass NJ, Reed S, Willis M. Pediatric vestibular evaluation/balance assessment: audiologists’ perceived skills and clinical practices. Audiol Today. 2012;24(5):28–37.

    Google Scholar 

  28. Martens S, Dhooge I, Dhondt C, Vanaudenaerde S, Sucaet M, Rombaut L et al. Vestibular infant screening (VIS)-Flanders: results after 1.5 years of vestibular screening in hearing-impaired children. Sci Rep. 2020;10(2045–2322 (Electronic)):21011.

  29. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Joint Committee on Infant Hearing. Year 2019 position statement: principles and guidelines for early hearing detection and intervention programs. J Early Hear Detect Intervention. 2019;4:1–44.

    Google Scholar 

  31. O’Reilly R, Grindle C, Zwicky EF, Morlet T. Development of the vestibular system and balance function: differential diagnosis in the pediatric population. Otolaryngol Clin North Am. 2011;44(2):251–.– 71, vii.

    Article  PubMed  Google Scholar 

  32. Cohen H, Friedman EM, Lai D, Pellicer M, Duncan N, Sulek M et al. Balance in children with otitis media with effusion. 1997.

  33. Potter CN, Silverman LN. Characteristics of vestibular function and static balance skills in deaf children. Phys Ther. 1984;64:1071–5.

    Article  CAS  PubMed  Google Scholar 

  34. Gayle GW, Pohlman RL, COMPARATIVE STUDY O F T H E DYNAMIC STATIC. A N D ROTARY BALANCE O F DEAF AND HEARING CHILDREN ‘. 1990.

  35. Hart MC, Nichols DS, Butler EM, Barin K. Childhood imbalance and chronic otitis media with effusion: effect of tympanostomy tube insertion on standardized tests of balance and locomotion. Laryngoscope. 1998;108:665–70.

    Article  CAS  PubMed  Google Scholar 

  36. Butterfield SA, Ersing WF. Influence of age, sex, etiology, and hearing loss on balance performance by deaf children. Percept Mot Skills. 1986;62(2):659–63.

    Article  CAS  PubMed  Google Scholar 

  37. Wong TPS, Leung EYW, Poon CYC, Leung CYF, Lau BPH. Balance performance in children with unilateral and bilateral severe-to-profound-grade hearing impairment. Hong Kong Physiother J. 2013;31(2):81–7.

    Article  Google Scholar 

  38. Fellinger MJ, Holzinger D, Aigner M, Beitel C, Fellinger J. Motor performance and correlates of mental health in children who are deaf or hard of hearing. Dev Med Child Neurol. 2015;57(10):942–7.

    Article  PubMed  Google Scholar 

  39. Wolter NE, Gordon KA, Papsin BC, Cushing SL. Vestibular and Balance Impairment Contributes to Cochlear Implant Failure in Children. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2015;36(6):1029-34.

  40. Malekabadizadeh Z, Barati A, Khorashadizadeh M. The effect of hearing impairment and intellectual disability on children’s static and dynamic balance. 2016.

  41. Gronski M. Balance and motor deficits and the role of occupational therapy in children who are deaf and hard of hearing: A critical appraisal of the topic. J Occup Therapy Schools Early Intervention. 2013;6(4):356–71.

    Article  Google Scholar 

  42. Venkadesan R, Finita GR. Motor development and postural control evaluation of children with sensorineural hearing loss: A review of three inexpensive assessment tools-PBS, TGMD-2, and P-CTSIB. Iran J Child Neurol. 2010;4(4):7–12.

    Google Scholar 

  43. Maes L, De Kegel A, Van Waelvelde H, Dhooge I. Association between vestibular function and motor performance in hearing-impaired children. Otology Neurotology. 2014;35(10):e343–7.

    Article  PubMed  Google Scholar 

  44. Ertugrul G, Sennaroglu G, Karakaya J, Sennaroglu L. Postural instability in children with severe inner ear malformations: characteristics of vestibular and balance function. Int J Audiol. 2021;60(2):115–22.

    Article  PubMed  Google Scholar 

  45. Cushing SL, Chia R, James AL, Papsin BC, Gordon KA. A test of static and dynamic balance function in children with cochlear implants. ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY. 2008;134(1):34– 8.

  46. Janky KL, Givens D, Vestibular. Visual acuity, and balance outcomes in children with cochlear implants: A preliminary report. Ear Hear. 2015;36(6):E364–72.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Eustaquio ME, Berryhill W, Wolfe JA, Saunders JE. Balance in children with bilateral cochlear implants. OTOLOGY NEUROTOLOGY. 2011;32(3):424–7.

    Article  PubMed  Google Scholar 

  48. Uysal SA, Erden Z, Akbayrak T, Demirturk F, COMPARISON OF BALANCE, AND GAIT IN VISUALLY OR HEARING IMPAIRED CHILDREN. Percept Mot Skills. 2010;111(1):71–80.

    Article  Google Scholar 

  49. Jafari Z, Malayeri SA. The effect of saccular function on static balance ability of profound hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2011;75(7):919–24.

    Article  PubMed  Google Scholar 

  50. Melo RD, Marinho SED, Freire MEA, Souza RA, Damasceno HAM, Raposo MCF. Static and dynamic balance of children and adolescents with sensorineural hearing loss. EINSTEIN-SAO PAULO. 2017;15(3):262–8.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Lindsey D, O’Neal J. Static and dynamic balance skills of eight year old deaf and hearing children. 1976;121:49.

  52. Rajendran V, Roy FG, Jeevanantham D. Postural control, motor skills, and health-related quality of life in children with hearing impairment: a systematic review. European archives of oto-rhino-laryngology: official journal of the European federation of Oto-Rhino-Laryngological societies (EUFOS): affiliated with the German society for Oto-Rhino-Laryngology -. Head Neck Surg. 2012;269(4):1063–71.

    Google Scholar 

  53. Fernandes R, Hariprasad S, Kumar VK. Physical therapy management for balance deficits in children with hearing impairments: A systematic review. J Paediatr Child Health. 2015;51(Electronic):1440–754.

    Google Scholar 

  54. Hartman E, Houwen S, Visscher C. Motor skill performance and sports participation in deaf elementary school children. Adapted Phys Activity Q. 2011;28(2):132–45.

    Article  Google Scholar 

  55. Livingstone N, McPhillips M. Motor skill deficits in children with partial hearing. Dev Med Child Neurol. 2011;53(9):836–42.

    Article  PubMed  Google Scholar 

  56. Geddes D. Motor development profiles of preschool deaf and hard-of-hearing children. Percept Mot Skills. 1978;46(1):291–4.

    Article  CAS  PubMed  Google Scholar 

  57. Gheysen F, Loots G, Van Fau - H, Van Waelvelde H. Motor development of deaf children with and without cochlear implants. J Deaf Stud Deaf Educ. 2008;13(Print):1081–4159.

    Google Scholar 

  58. Lewis S, et al. Development of an exercise program to improve the static and dynamic balance of profoundly Hearing-Impaired children. Am Ann Deaf. 1985;130(4):278–81.

    Article  CAS  PubMed  Google Scholar 

  59. Apeksha K, Singh S, Rathnamala M, Varalakshmi S, Preethu DJ, Kavya V, et al. Balance assessment of children with sensorineural hearing loss. Indian J Otolaryngol Head Neck Surgery: Official Publication Association Otolaryngologists India. 2021;73(1):12–7.

    Article  Google Scholar 

  60. An M-h, Yi C-h, Jeon H-s, Park S-y. Age-related changes of single-limb standing balance in children with and without deafness. Int J Pediatr Otorhinolaryngol. 2009;73(11):1539–44.

    Article  PubMed  Google Scholar 

  61. Siegel JC, Marchetti M, Tecklin JS. Age-related balance changes in hearing-impaired children. Phys Ther. 1991;71(3):183–9.

    Article  CAS  PubMed  Google Scholar 

  62. Holderbaum FMI, et al. A study of otoneurologic and balance tests with deaf children. Am Ann Deaf. 1979;124(6):753–9.

    CAS  PubMed  Google Scholar 

  63. Engel-Yeger B, Golz A, Parush S. Impact of middle ear effusion on balance performance in children. Disabil Rehabilitation. 2004;26(2):97–102.

    Article  CAS  Google Scholar 

  64. De Kegel A, Dhooge I, Peersman W, Rijckaert J, Baetens T, Cambier D, et al. Construct validity of the assessment of balance in children who are developing typically and in children with hearing impairments. Phys Ther. 2010;90(12):1783–94.

    Article  PubMed  Google Scholar 

  65. Lima R. Balance assessment in deaf children and teenagers prior to and post capoeira practice through the Berg balance scale. Int Tinnitus J. 2017;21(2):77–82.

    Article  PubMed  Google Scholar 

  66. Horak FB, Shumway-Cook A, Crowe TK, Black FO. Vestibular function and motor proficiency of children with impaired hearing, or with learning disability and motor impairments. Dev Med Child Neurol. 1988;30(1):64–79.

    Article  CAS  PubMed  Google Scholar 

  67. Shall MS. The importance of saccular function to motor development in children with hearing impairments. Int J Otolaryngol. 2009;2009:1–5.

    Article  Google Scholar 

  68. De Kegel A, Maes L, Baetens T, Dhooge I, Van Waelvelde H. The influence of a vestibular dysfunction on the motor development of hearing-impaired children. Laryngoscope. 2012;122(12):2837–43.

    Article  PubMed  Google Scholar 

  69. Martin W, Jelsma J, Rogers C. Motor proficiency and dynamic visual acuity in children with bilateral sensorineural hearing loss. Int J Pediatr Otorhinolaryngol. 2012;76(10):1520–5.

    Article  PubMed  Google Scholar 

  70. Patel H, Malawade M, Butte-Patil S, Khairnar P, Gawade S, Student I. Comparison of balance in children with and without hearing impairment. 2017.

  71. Hedayatjoo M, Rezaee M, Alizadeh Zarei M, Mirzakhany N, Nazeri A, Akbarzadeh Baghban A, et al. Effect of balance training on balance performance, motor coordination, and attention in children with hearing deficits. Arch Neurosci. 2020;7(1):e84869.

    Article  Google Scholar 

  72. Rajendran V, Roy FG, Jeevanantham D. A preliminary randomized controlled study on the effectiveness of vestibular-specific neuromuscular training in children with hearing impairment. Clin Rehabil. 2013;27(5):459–67.

    Article  PubMed  Google Scholar 

  73. Rajendran V, Roy FG, Jeevanantham D. Reliability of pediatric reach test in children with hearing impairment. Int J Pediatr Otorhinolaryngol. 2012;76(6):901–5.

    Article  PubMed  Google Scholar 

  74. Christy JB, Payne J, Azuero A, Formby C. Reliability and diagnostic accuracy of clinical tests of vestibular function for children. Pediatr Phys Ther. 2014;26(2).

  75. Cushing SL, Papsin BC, Rutka JA, James AL, Blaser SL, Gordon KA. Vestibular end-organ and balance deficits after meningitis and cochlear implantation in children correlate poorly with functional outcome. Otol Neurotol. 2009;30(4):488–95.

    Article  PubMed  Google Scholar 

  76. Ebrahimi AA, Jamshidi AA, Movallali G, Rahgozar M, Haghgoo HA. The effect of vestibular rehabilitation therapy program on sensory organization of deaf children with bilateral vestibular dysfunction. Acta Med Iran. 2017;55(11):683–9.

    PubMed  Google Scholar 

  77. Ebrahimi AA, Movallali G, Jamshidi AA, Haghgoo HA, Rahgozar M. Balance performance of deaf children with and without cochlear implants. Acta Med Iran. 2016;54(11):737–42.

    PubMed  Google Scholar 

  78. Oyewumi M, Wolter NE, Heon E, Gordon KA, Papsin BC, Cushing SL. Using balance function to screen for vestibular impairment in children with sensorineural hearing loss and cochlear implants. Otol Neurotol. 2016;37(7):926–32.

    Article  PubMed  Google Scholar 

  79. Melo LA, Raposo MCF, Belian RB, Ferraz KM. Balance performance of children and adolescents with sensorineural hearing loss: repercussions of hearing loss degrees and etiological factors. Int J Pediatr Otorhinolaryngol. 2018;110:16–21.

    Article  PubMed  Google Scholar 

  80. 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. Hear Res. 2019;372:52–61.

    Article  PubMed  Google Scholar 

  81. Ayanniyi O, Adepoju F, Mbada C. Static and dynamic balance in school children with and without hearing impairment. J Experimental Integr Med. 2014;4:245.

    Article  Google Scholar 

  82. Benjamin RS, Cushing SL, Blakeman AW, Campos JL, Papsin BC, Gordon KA. Evaluating the use of a balance prosthesis during balance perturbations in children and young adults with cochleovestibular dysfunction. Sci Rep. 2023;13(1):9721.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Chisari D, Vitkovic J, Clark R, Rance G. Vestibular function and balance performance in children with sensorineural hearing loss. Int J Audiol. 2023:1–9.

  84. Ekawati FF, Rahayu TW, Ismaryati I, Satyawan B, Meli Andani A. Balance assessment in students with hearing impairment. Jurnal SPORTIF: Jurnal Penelitian Pembelajaran. 2023;9(3):437–46.

    Article  Google Scholar 

  85. Çelik SE, Bek N, Özcebe LH, Kocaman H, THE EFFECTS OF SHOE, SUITABILITY ON PLANTAR PRESSURE DISTRIBUTION AND BALANCE PARAMETERS IN CHILDREN WITH HEARING IMPAIRMENT. Turkish J Physiotherapy Rehabilitation. 2022;33(2):54–62.

    Google Scholar 

  86. Ghaffar E, huda N, Fatima S, Fatima Q, Haider M, Ain N, et al. Prevalence of balance impairment in children with hearing impairment: balance issues in hearing-Impaired children. J Health Rehabilitation Res. 2024;4:1–8.

    Google Scholar 

  87. Ghosh S, bannetjee s, Biswas R. A study on the dynamic balance of schoolchildren in India with varying degrees of hearing impairments. J Phys Educ Sport. 2022;22:1177–89.

    Google Scholar 

  88. Hu F, Qiu X, Wu X, Wu X, Li H, Kim S. Effects of dance sports exercise on vestibular function and balance of children with sensorineural hearing loss; a randomized quasi-experimental trial. Front Pead. 2024;12.

  89. Janky KL, Patterson J, Thomas M, Al-Salim S, Robinson S. The effects of vestibular dysfunction on balance and self-concept in children with cochlear implants. Int J Pediatr Otorhinolaryngol. 2023;171:111642.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Metgud DC, Topkar P. Balance and agility testing in normal and Hearing-Impaired children: A Case–Control study. Indian J Phys Therapy Res. 2019;1(1).

  91. Mohamed ST, Hazzaa N, Abdel Rahman T, Ezz Eldin DM, Elhusseiny AM. Efficacy of vestibular rehabilitation program in children with balance disorders and sensorineural hearing loss. Int J Pediatr Otorhinolaryngol. 2024;179:111931.

    Article  PubMed  Google Scholar 

  92. Monin E, Bahim C, Baussand L, Cugnot J-F, Ranieri M, Guinand N et al. Development of a new clinical tool to evaluate the balance abilities of children with bilateral vestibular loss: the Geneva balance test. Front Neurol. 2023;14.

  93. Mujdeci B, Önder S, Alluşoğlu S, Boynuegri S, Kum O, Atan D. The effects of age at cochlear implantation on balance in children: A pilot study. Int J Artif Organs. 2020;44(6):440–5.

    Article  PubMed  Google Scholar 

  94. Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Balance control in individuals with hearing impairment: A systematic review and Meta-Analysis. Audiol Neurotology. 2023;29(1):30–48.

    Article  Google Scholar 

  95. Sinno S, Najem F, Dumas G, Abouchacra KS, Mallinson A, Perrin P. Correlation of SVINT and sensory organization test in children with hearing loss. Audiol Res [Internet]. 2022; 12(3):[316– 26 pp.].

  96. Ghai S, Hakim M, Dannenbaum E, Lamontagne A. Prevalence of vestibular dysfunction in children with neurological disabilities: A systematic review. Front Neurol. 2019;10:1294.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Venkadesan R, Fitina GR. Motor development and postural control evaluation of children with sensorineural hearing loss: A review of three inexpensive assessment tools-PBS, TGMD-2, and P-CTSIB. Iran J Child Neurol. 2010;4:7–12.

    Google Scholar 

  98. Wardani NK, Kusumawardani MK, Mayangsari JA, Wulan S. Correlation between one leg stand test and paediatric balance scale in children aged 7–12 years. Sri Lanka J Child Health. 2022;51(2):204–8.

    Article  Google Scholar 

  99. Franjoine MR, Darr N, Held SL, Kott K, Young BL. The performance of children developing typically on the pediatric balance scale. Pediatr Phys Ther. 2010;22(4):350–9.

    Article  PubMed  Google Scholar 

  100. Holderbaum Fm Fau -, Ritz S, Ritz S, Fau - Hassanein KM, Hassanein Km Fau -, Goetzinger CP, Goetzinger CP. A study of otoneurologic and balance tests with deaf children. Am Ann Deaf. 1979;124:753–9. (0002-726X (Print)).

    Google Scholar 

  101. Maes L, De Kegel A, Van Waelvelde H, De Leenheer E, Van Hoecke H, Goderis J, et al. Comparison of the motor performance and vestibular function in infants with a congenital cytomegalovirus infection or a connexin 26 mutation: a preliminary study. Ear Hear. 2017;38(1):e49–56.

    Article  PubMed  Google Scholar 

  102. Howell DR, Brilliant AN, Meehan WP. 3rd. Tandem gait Test-Retest reliability among healthy child and adolescent athletes. Ournal Athletic Train. 2019;54:1254–9. 1938-162X (Electronic).

    Article  Google Scholar 

  103. Galea OA, Bristow HD, Chisholm SM, Mersch ME, Nullmeyer J, Reid CR, et al. Single and dual tandem gait assessment post concussion: what performance time is clinically relevant across adult ages and what can influence results? Musculoskelet Sci Pract. 2019;42:166–72.

    Article  PubMed  Google Scholar 

  104. Oldham JR, DIFABIO MS, KAMINSKI TW, DEWOLF RM, HOWELL DR. Efficacy of tandem gait to identify impaired postural control after concussion. Med Sci Sports Exerc. 2018;50(6):1162–8.

    Article  PubMed  Google Scholar 

  105. Christy JB, Payne J, Azuero A, Formby C. Reliability and diagnostic accuracy of clinical tests of vestibular function for children. Pediatr Phys Ther. 2014;26(2):180–9.

    Article  PubMed  Google Scholar 

  106. Van Hecke R, Deconinck FJA, Wiersema JR, Clauws C, Danneels M, Dhooge I et al. Balanced Growth project: A protocol of a single-centre observational study on the involvement of the vestibular system in a child’s motor and cognitive development. BMJ Open. 2021;11(6).

  107. Yones L, Kahlaee AH, Sayadi N, Jalilzadeh Afshari P, Bakhshi E. Test-retest reliability of the pediatric clinical test of sensory interaction for balance in 4–6 years old children. Auditory Vestib Res. 2017;26(4).

  108. Evkaya A, Karadag-Saygi E, Karali Bingul D, Giray E. Validity and reliability of the dynamic gait index in children with hemiplegic cerebral palsy. Gait Posture. 2020;75:28–33.

    Article  PubMed  Google Scholar 

  109. Verbecque E, Schepens K, Theré J, Schepens B, Klingels K, Hallemans A. The timed up and go test in children: does protocol choice matter?? A systematic review. Pediatr Phys Ther. 2019;31(1):22–31.

    Article  PubMed  Google Scholar 

  110. Williams E, Carroll N, Reddihough SG, Phillips DS, Galea BA. Investigation of the timed ‘up & go’ test in children. Dev Med Child Neurol. 2005;47:518–24.

    Article  PubMed  Google Scholar 

  111. Nicolini-Panisson RD, Donadio MV. Timed up & go test in children and adolescents. Revista Paulista De Pediatria: Orgao Oficial Da Sociedade De Pediatria De Sao Paulo. 2013;31:377–83. (1984– 0462 (Electronic)).

    Article  PubMed  Google Scholar 

  112. Nicolini-Panisson RD, Donadio MV. Normative values for the timed ‘up and go’ test in children and adolescents and validation for individuals with down syndrome. Dev Med Child Neurol. 2014;56(5):490–7.

    Article  PubMed  Google Scholar 

  113. Kott KM, Held SL, Giles EF, Franjoine MR. Predictors of standardized walking obstacle course outcome measures in children with and without developmental disabilities. Pediatr Phys Ther. 2011;23(4).

  114. Kott KM, Held S, Franjoine MR. Reference data for performances on the standardized walking obstacle course in children developing typically. Gait Posture. 2016;49:398–401.

    Article  PubMed  Google Scholar 

  115. Held SL, Kott KM, Young BL. Standardized walking obstacle course (SWOC): reliability and validity of a new functional measurement tool for children. Pediatr Phys Ther. 2006;18(1).

  116. Ng S, Chan S, Chan A, Chung H, Lee N, Ngan A et al. Reliability and concurrent validity of standardized walking obstacle course test in people with stroke. J Rehabil Med. 2017;49.

  117. Ambegaonkar J, Caswell S, Winchester J, Shimokochi Y, Cortes N, Caswell A. Balance comparisons between female dancers and active nondancers. Res Q Exerc Sport. 2013;84:24–9.

    Article  PubMed  Google Scholar 

  118. Tsigilis N, Zachopoulou E, Mavridis T. Evaluation of the specificity of selected dynamic balance tests. Percept Mot Skills. 2001;92(3):827–33.

    Article  CAS  PubMed  Google Scholar 

  119. Jaffri A, Newman T, Smith B, Miller S. The dynamic leap and balance test (DLBT): A test-Retest reliability study. Int J Sports Phys Therapy. 2017;12:512–9.

    Google Scholar 

  120. Bell DR, Guskiewicz KM, Clark MA, Padua DA. Systematic review of the balance error scoring system. Sports Health. 2011;3(3):287–95.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Academy of Neurologic Physical Therapy, Vestibular EDGE, Roseville,:. ACADEMY OF NEUROLOGIC PHYSICAL THERAPY 2018 [Available from: https://www.neuropt.org/practice-resources/neurology-section-outcome-measures-recommendations/vestibular-disorders

  122. Sember V, Grošelj J, Pajek MA-O. Balance tests in Pre-Adolescent children: retest reliability, construct validity, and relative ability. LID– 10.3390/ijerph17155474 [doi] LID– 5474. Int J Environ Res Public Health. 2020;17:1660–4601. (Electronic)):5474.

    Article  Google Scholar 

  123. Sæther R, Helbostad J, Riphagen I, Vik T. Clinical tools to assess balance in children and adults with cerebral palsy: A systematic review. Dev Med Child Neurol. 2013;55.

  124. Dasgupta S, Mandala M, Salerni L, Crunkhorn R, Ratnayake S. Dizziness and balance problems in children. Curr Treat Options Neurol. 2020;22(3):8.

    Article  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

Study was funded by the National Research Foundation: Thuthuka Grant (TTK23031783533).

Author information

Authors and Affiliations

  1. Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa

    Sphilile Mbhele & Christine Rogers

  2. Brain Sciences, Imperial College London, London, England

    Yougan Saman

  3. Discipline of Audiology, University of KwaZulu-Natal, Durban, South Africa

    Sphilile Mbhele

Authors
  1. Sphilile Mbhele
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Christine Rogers
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Yougan Saman
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

All authors contributed equally to the conceptualization and revision and editing of this manuscript.

Corresponding author

Correspondence to Sphilile Mbhele.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

The author declares no conflict of/competing interest.

Ethical approval and consent to participate

Not applicable for this review.

Clinical trial number

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mbhele, S., Rogers, C. & Saman, Y. Clinical balance assessment tools for children with hearing loss: a scoping review. BMC Pediatr 25, 218 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12887-025-05563-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12887-025-05563-2

Keywords

BMC Pediatrics

ISSN: 1471-2431

Contact us