Objective:
Chronic vestibular dysfunction impacts the normal psychomotor development of children. Early identification is needed to allow for clinical management, ensuring better global development. To this purpose, our research group has developed the Geneva Balance Test (GBT) aiming to quantify objectively the balance capacity of children over a broad age range, to screen for bilateral vestibulopathy (BV) and to quantify the improvement of balance abilities in children.
Methods:
We conducted an observational prospective study with three populations: 11 children with BV, and two age-matched control groups composed of (1) 15 healthy subjects without vestibular or auditory disorder (HS) and (2) 11 pediatric cochlear implant recipients (CI) without vestibular disorders. Results of the three populations have been compared in 3 different age sub-groups (3-5 years, 6-9 years, ≥10 years), and with results of a short, modified version of the Bruininks-Oseretsky test of Motor deficiency Ed. 2 (mBOT-2).
Results:
Statistical analyses demonstrated significant differences in the scores of the GBT between children aged 3-5, 6-9 and ≥10 years with BV and in both control populations (HS and CI). BV scores reflected poorer balance capacities at all ages. Children in the youngest CI sub-group (3-5 years) showed intermediate GBT scores (between HS and BV), but reached HS scores at 6-9 years, reflecting improvement of their balance capacities. All the results of the GBT were significantly correlated with mBOT-2 results, although only few BV achieved the mBOT-2 completely.
Conclusion:
The GBT allowed to quantify balance deficits in children with BV. The GBT seems to be better tolerated in all age and group populations than the mBOT-2. Furthermore, mBOT-2 results saturated, reaching maximum values by 6-9 years whereas the GBT did not, suggesting the GBT could be a useful tool for monitoring the development of balance capacities with age, and could be used in the follow-up of children with severe vestibular disorders. Interestingly, we observed a significant difference in balance capacities in very young CI children which normalized by 6-9 years, potentially due to hearing rehabilitation with the CI. A study with a larger population is necessary to confirm these results.

**Objective:**
Chronic vestibular dysfunction impacts the normal psychomotor development of children. Early identification is needed to allow for clinical management, ensuring better global development. To this purpose, our research group has developed the Geneva Balance Test (GBT) aiming to quantify objectively the balance capacity of children over a broad age range, to screen for bilateral vestibulopathy (BV) and to quantify the improvement of balance abilities in children.
**Methods:**
We conducted an observational prospective study with three populations: 11 children with BV, and two age-matched control groups composed of (1) 15 healthy subjects without vestibular or auditory disorder (HS) and (2) 11 pediatric cochlear implant recipients (CI) without vestibular disorders. Results of the three populations have been compared in 3 different age sub-groups (3-5 years, 6-9 years, ≥10 years), and with results of a short, modified version of the Bruininks-Oseretsky test of Motor deficiency Ed. 2 (mBOT-2).
**Results:**
Statistical analyses demonstrated significant differences in the scores of the GBT between children aged 3-5, 6-9 and ≥10 years with BV and in both control populations (HS and CI). BV scores reflected poorer balance capacities at all ages. Children in the youngest CI sub-group (3-5 years) showed intermediate GBT scores (between HS and BV), but reached HS scores at 6-9 years, reflecting improvement of their balance capacities. All the results of the GBT were significantly correlated with mBOT-2 results, although only few BV achieved the mBOT-2 completely.
**Conclusion:**
The GBT allowed to quantify balance deficits in children with BV. The GBT seems to be better tolerated in all age and group populations than the mBOT-2. Furthermore, mBOT-2 results saturated, reaching maximum values by 6-9 years whereas the GBT did not, suggesting the GBT could be a useful tool for monitoring the development of balance capacities with age, and could be used in the follow-up of children with severe vestibular disorders. Interestingly, we observed a significant difference in balance capacities in very young CI children which normalized by 6-9 years, potentially due to hearing rehabilitation with the CI. A study with a larger population is necessary to confirm these results.

Development of a new clinical tool to evaluate the balance abilities of children with bilateral vestibular loss: The Geneva Balance Test (GBT)

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,