Ringing in the ears. Motion sickness. Unsteady walking. Difficulty focusing. If your child has these symptoms, you may be struggling to make sense of them. Fortunately, there’s a place that can help.

It is estimated that up to 15 percent of all children have issues with dizziness, and as many as 50 percent of kids with hearing loss have dizziness or balance issues. These symptoms can be the result of an inner ear balance problem known as a vestibular disorder.

Rady Children’s Hospital San Diego launched the Richter Family Clinic for Balance Disorders in June 2017. The first of its kind in Southern California, the clinic evaluates children with balance and vestibular symptoms through a variety of specialized tests. If a vestibular disorder is suspected, parents can obtain a referral (from a pediatrician or specialist) for a medical evaluation with Rady Children’s Division of Otolaryngology (ENT) and for assessment with the Audiology department.

The Richter Family Clinic for Balance Disorders offers a range of vestibular disorder tests:

Videonystagmography (VNG)
This test documents a child’s ability to follow objects with his eyes and how well the eyes respond to information from the vestibular system. Children are guided through a variety of head and body positions, which allows assessment of the connection between the eyes and balance. Air or water is also introduced into the ear canals to determine if each ear responds appropriately.

Rotational Testing (Rotating Chair)
This test assesses the vestibulo-ocular reflex, which allows a person to focus while moving, such as reading a street sign while walking. The test is completed in a darkened room using a computerized swivel chair with the child either seated alone or on a parent’s lap. The child wears video goggles that record eye movements as the chair swivels back and forth.

Vestibular Evoked Myogenic Potentials (VEMP)
The VEMP assesses how well the cochlear nerve is working. Sound plays through earphones while the child reclines on a table and is asked to raise his head or eyes for various periods of time. The movement is recorded from electrodes that are placed on the head and body.

Video Head Impulse Testing (vHIT)
This test assesses all three semi-circular canals and both branches of the vestibular nerve. Goggles are placed on the child’s head and the examiner gently turns his head in different directions.

Computerized Dynamic Posturography (CDP)
CDP measures a child’s ability to remain still and maintain balance in everyday conditions. During this test, the child stands barefoot facing an image and is asked to remain as still as possible. Both the image and the platform on which the child stands move for portions of the test. This allows for the assessment of the vestibular, visual and oculomotor systems as they work together to help maintain balance.

The Richter Family Clinic for Balance Disorders is located near the Rady Children’s Hospital campus. For families who live outside central San Diego, screenings are offered at outpatient clinics in Escondido, Torrey Hills and Murrieta to determine if further testing at the balance clinic is needed. For more information, call 858-966-8100 or visit www.rchsd.org.


Julie Purdy, Ph.D, CCC-A, is the manager of audiology at Rady Children’s Hospital San Diego and Kelly Randich, PT, DPT, is the manager of physical therapy.