Hypoactive Labyrinths and Motor Development

Abstract

This study examines the relation of hypoac tive labyrinths to the achievement of motor milestones such as sitting and walking. Two children with genetic sensorineural hearing losses with vestibular dysfunction who walked very late did not show any evidence to suggest a diffuse neurologic cause for this delay at follow-up examinations. A review of electronys tagmographic (ENG) vestibular tests of 353 children under age ten years discovered 17 children who had been tested twice or more. There was disagreement between the two tests in four (24%), suggesting less than adequate relia bility of ENG test results in infants and chil dren. Forty-nine children had hypoactive labyrinths. The records of 22 of these were suitable for surveying the relation of the vestibu lar dysfunction to age at walking. Ten of the 22 children walked at 18 months or later, indicating that some, but not all children with vestibular dysfunction will be late walkers. Some of the children who walked at a normal age were described as having "weak necks" or "floppy heads," and some sat late. Accordingly, counsel ing of parents of deaf children who walk late should be delayed until vestibular testing has been carried out to avoid false diagnoses of associated brain damage or mental retardation. It is urged that all deaf children undergo vestibular testing, and that those with abnormal tests be retested to make certain of the results. Procedures to test vestibular function in infants and children need to be standardized, as shown by personal observations and a survey of the pertinent literature.