PP1102 - Online Screening Tool for Pediatric Vestibular Issues

Abstract: Children with hearing loss are more likely to have balance disorders, with the incidence rate ranging between 20-70%. However, pediatric vestibular evaluations are often delayed or not recommended in favor of hearing health-focused appointments. The purpose of this project was to evaluate the Standing Leg Stance (SLS) test as an efficient screening measure for balance issues in children to be completed prior to the diagnostic appointment. The results could assist in identifying the need to refer children with sensorineural hearing loss for further vestibular assessment.

Summary: Rationale:
The SLS test, also known as the one-leg stance test, is a widely used clinical balance measure that assesses postural stability by requiring children to maintain balance on one leg for as long as they can with eyes open and then eyes closed. It is quick to administer, requires no specialized equipment, and has established reliability and validity in pediatric populations. Previous research from Karakoc & Mujdeci (2021) found a significant difference between performance in children with normal hearing and those with sensorineural hearing loss (SNHL) in children when utilizing the SLS as a static balance measure.

Method:
A Qualtrics survey was developed and approved by the UTD Institutional Review Board. Children were instructed to stand on one leg while leaving their arms hanging by their sides. The test was performed on each leg, with two conditions: eyes open and eyes closed. Each trial was timed to record how long the child could stand on one leg without grabbing for support, with 3 trials per condition per leg

Results:
The results of the online Qualtrics survey for the Standing Leg Stance test showed participants with typical hearing, ages 9 to 16, could stand on one leg for near the maximum time of 60 seconds (mean = 56 to 58 sec) averaged over 3 trials when eyes were open. The average time with eyes closed for standing on one leg over the 3 trials was determined to be about half the time with eyes open (mean = 26 to 34 sec). However, if the best time was taken across the 3 trials, the eyes open averaged across participants was 60 sec while the eyes closed was an average of 49 sec across the initial 6 participants. This suggests that there is a learning effect and justifies the protocol of using both average and best scores for each participant for comparisons. The next phase will include participants with atypical hearing. These results agree with those reported in the literature when testing was conducted in person and showed similar results (Condon & Cremin, 2014).

Conclusions:
The SLT can be used for screening for balance problems through an online assessment.

Clinical Implications:
The development of the online protocol could lead to more wide scale testing and corroboration with more extensive vestibular workup to determine the sensitivity and specificity of the SLS as a screening for vestibular issues in children ages 7 to 17 with sensorineural hearing loss.

A fundamental instructional level was selected, as all procedures and conclusions focus on the general principles of pediatric balance testing via new screening practices without the need for prior in-depth knowledge of vestibular diagnostics or counseling.