Balance and Vestibular Program
The Balance and Vestibular Program Program at Children’s National Hospital treats children experiencing dysfunction of the vestibular system such as dizziness, imbalance, delayed motor function development and vertigo.
As one of a few pediatric vestibular and balance programs in the country, our highly specialized program can:
- Identify your child's vestibular and balance condition
- Correct the vestibular and balance dysfunction
- Minimize your child's symptoms
- Promote overall wellness
Choosing Children's National for Balance and Vestibular Care
We understand that vestibular testing and treatment is at the forefront of innovation for pediatric audiology, which is why we can ensure that your child will receive the best possible care for their condition.
Highlights of our program include:
- State-of-the-art technology. Children’s National has the most innovative technology available for pediatric vestibular testing. This allows us to not only determine the exact cause of your child’s condition, but we are better equipped to provide targeted, precise rehabilitation for your child.
- Multidisciplinary team. Our team works together to support the patient and their family through. Meet the team.
- Tailored care plans. We conduct comprehensive evaluations in order to develop individualized care plans with specialized treatments, which include vestibular rehabilitation therapy (VRT), medication or surgery.
Understanding Pediatric Vestibular Testing
Your child's body has two centers for balance control. One is located in the brain (central system) and one in the inner ear (peripheral system). The part located in your child's inner ear is called the vestibular system and it is comprised of the semicircular canals, the utricle and the saccule.
In a vestibular testing appointment, our team will run a series of tests to determine the root cause of your child’s dizziness or imbalance. Since your child’s vestibular system will be stimulated during testing, we ask that you avoid food or drink up to one hour prior to the appointment time.
Your child will sit in a rotary chair. The chair will move and spin in different directions to elicit dizziness. We may also remove your child’s visual cues, by asking him or her to close their eyes. These actions stimulate the vestibular system, allowing our team to analyze it and diagnose the root cause. This test will take approximately 30 minutes.
During this test, an otoscope directs the flow of cool and warm air to the tympanic membrane to stimulate a response from your child's vestibular system in the inner ear. This test takes approximately 15 minutes.
Because the inner ear is made up of semicircular canals (balance system) and cochlea (organ of hearing), we need to evaluate both systems for comprehensive review of the organ. Hearing testing consists of finding different levels of hearing at a number of pitches, and words in each ear.
During this test, you child will wear goggles while the camera records their eye movement in different positions (e.g. laying flat or on their side) to elicit dizziness. Your child's right eye is covered so there is no visual input, but eye movement is still monitored. This test takes approximately 20 minutes.
This test analyzes your child’s balance by isolating and testing the different systems that help to maintain balance. We will test the visual, vestibular and somatosensory systems.
Your child will stand on a force plate in front of a digital projector and a screen. The tester will walk the patient through different conditions that will help to discriminate which systems are helping us to balance or impairing their balance. Your child will be asked to remain as still as possible during the testing and be closely guarded by the tester while a harness for safety is worn.
The test takes about 30-45 minutes and it is the will help our therapists assess your child's balance and guide their treatment and goals based on the outcomes.
This test is commonly termed VNG, which stands for video nystagmography. During the test, your child will wear a pair of goggles that have a video camera over the left eye. Your child will be asked to follow different pictures on a screen to evaluate for any visual influence to dizziness stimulation. This test will take approximately 30 minutes.
During the evaluation process, our team will review your child's case history which details the start, duration and description of their symptoms.
Vestibular rehabilitation focuses on addressing your child's functional limitations and participation restrictions due to their vestibular dysfunction. During the rehabilitation process, we will focus on exercises that improve function and promote the use of your child's vestibular system as well as compensatory exercises for safety during your child's recovery.
Children’s National addresses vestibular rehabilitation in a novel way with both traditional vestibular rehab exercises in natural environments and an immersive virtual rehab experience with our Bertec CDP. This approach allows for more specific training exercises which will help improve your child's results.
For more information or to schedule an appointment with the Balance and Vestibular Program, please email Tracey Ambrose, AuD, CCC-A, F-AAA, or call 202-476-5600.
Our program may be helpful for providers with patients that are experiencing true vertigo symptoms, balance problems, reading difficulties, frequent falls and poor coordination. Learn about when to refer a patient.
Balance and Vestibular Program Team
Tommie L. Robinson JR
Division Chief, Hearing and Speech
Division Chief, Ear, Nose, and Throat (Otolaryngology)
Co-Director of the Cochlear Implant Program
Co-Director of the Cochlear Implant Program
Associate Director, Child Neurology Fellowship Program
Director, Headache Infusion Program
Medical Director, Neurology Education