Balance and Motor Deficits and the Role of Occupational Therapy in Children Who Are Deaf and Hard of Hearing: A Critical Appraisal of the Topic

Abstract

Children who are deaf and hard of hearing (d/hh) have an increased risk of developing balance and gross-motor deficits compared to children with normal hearing. However, postural control and motor assessments are not routinely administered to children who are d/hh unless the child presents with easily observable deficits. The objective of this review is to analyze the literature regarding vestibular function, postural control and balance, and motor skills in children who are d/hh to determine the role for occupational therapy. Information was found using PubMed, OVID, Cochrane, EBSCO, and CINAHL with search terms “occupational therapy,” “children,” “deaf/hard of hearing,” “hearing loss,” “hearing impairment,” “participation,” “motor skills,” “postural control,” “vestibular,” and “balance.” Two reviewers independently screened titles and abstracts to identify the clinical use of each and identified randomized controlled trials, observational studies, and systematic reviews for full-text review. The reviewers each assessed study characteristics and rated study quality and indication-wide strength of evidence. Research on children who are d/hh often focuses on communication and social deficits. However, these children also demonstrate reduced levels of function in postural control, balance, and motor skills. Children who are d/hh often exhibit concurrent vestibular dysfunction; however, screening for these impairments is not a standard of practice. This literature review highlights the essential role of early intervention occupational therapy to prevent motor delays resulting in decreased participation for children who are d/hh.

Keywords:

• Occupational therapy
• children
• deaf/hard of hearing
• hearing loss
• hearing impairment
• participation
• motor skills
• postural control
• vestibular
• balance

Acknowledgements

The author thanks Campbell Mikush, OTD/S, for her editing assistance and Sara Baldocchi, Ashley Somraty, and Courtney Johnson for their contributions to the manuscript.