CHILDRENS BALANCE TESTS Your child has been referred for Balance tests. Why? These tests are carried out on children when:

There is a history of dizziness There is some difficulty with balance The child has a hearing loss - particularly when:

There has been delay in learning to sit or walk The hearing loss is one-sided or asymmetric The hearing loss is changing A Cochlear implant is being considered The cause of the hearing loss is being examined in detail.

The tests:

Help to determine the cause of balance problems and dizziness Give more information about the function of the inner ear May help us find the cause of your childs hearing loss.

The inner ear consists of the organ of hearing (cochlea) and the organ of balance (vestibular organ). These two organs share the same fluids. Sometimes the organs of hearing and balance are affected by the same problem and so hearing difficulties and balance difficulties can occur together. However, this is not always the case and many children with hearing problems have excellent balance while dizzy children can have normal hearing. My child is deaf but his balance is good. It can still be useful to look more closely at balance. Children are clever at compensating for weaknesses in the balance system and it may not be obvious until full testing is done. Identification of balance problems can help us understand more about your child and can sometimes help us to understand the cause of the hearing loss. The Appointment You will be invited up to Dr Harrop-Griffiths Balance clinic. The appointment will last at least two hours. Before the appointment If your child is on tablets for dizziness or travel sickness please stop these for at least 48 hours before the tests. Patients should also refrain from alcoholic drinks for 24 hours before the test. Please contact the department on 020 7915 1641 if in doubt about medication.

If you are unable to come to your appointment please let us know as soon as you can so that another patient can be given the appointment. On the day Please be on time for your appointment. Your child will:

1. Have a hearing test unless one has been done recently 2. Have a tympanogram a test to measure the pressure in the ears 3. Be seen with you by the doctor. 4. Have a variety of balance tests see below.

The doctor will ask questions and examine your child to determine the most appropriate tests for your child. Balance Tests Most children find these tests fun! The tests we do are modified according to your childs age and ability to cooperate. Ideally we would like to perform Electronystagmography (ENG) - this involves sticking some metal discs (electrodes) on your childs head in order to record eye movements. Fine movements of the eyes reflect the function of the balance organs. With the discs in place your child will sit in a large, specially adapted chair. The tests involve looking at a series of small red lights, and then a striped curtain followed by gentle rotation of the chair. Most of these initial tests are carried out in complete darkness. You will be able to sit with your child throughout the tests and a technician or doctor will be available at all times. The above tests look at the balance function of both ears together. For the majority of children undergoing balance tests it is very important that we measure the function of the ears separately and this entails pouring water into the ear canals: initially cool water and then warm water. This test usually makes your child feel a little dizzy for a short time. Most children cope very well with this test, some even enjoy it and ask for more! We are very used to testing children of all ages, including children with dizziness, hearing loss and fear of the dark tests are modified accordingly. How can I prepare my child? You can help by reassuring your child that the tests are fun. While adults tend to fear dizziness most children enjoy the sensation, which is why theme parks make such a profit! We liken the tests to astronaut tests, theme park rides or fairy flights if this helps. Children who fear dizziness or the dark need reassurance that we will only do tests with which they are comfortable they can ask us to stop and we will!

CHILDRENS BALANCE TESTS The inner ear consists of the organ of hearing (cochlea) and the organ of balance (vestibular organ). These two organs share the same fluids. Sometimes the organs of hearing and balance are affected by the same problem and so hearing difficulties and balance difficulties can occur together. However, this is not always the case and many children with hearing problems have excellent balance while dizzy children can have normal hearing. Balance Tests Most children find these tests fun!