The purpose of this study was to determine significant changes in the Dizziness Handicap Inventory (DHI) scores in patients before and within 1 year after a vestibular rehabilitation program. Efficacy of a vestibular rehabilitation program was tested retrospectively in 37 patients by comparison of pretreatment and posttreatment DHI scores. A significant improvement in test scores was found, indicated by the Sign test at the 0.05 level after vestibular rehabilitation. This difference is evident in the total score and in the functional and physical subscore component. Prerehabilitation and postrehabilitation differences among diagnostic categories were analyzed by using the Kruskal-Wallis test. Patients with peripheral lesions demonstrated greater improvement in the emotional component of the DHI as compared with patients with central or mixed lesions. The Wilcoxon two-sample test assessed the influence of compliance with a home exercise program after discharge from a vestibular physical therapy program. There was no significant difference in improvement between patients who performed home exercises for at least a month after discharge and those who did not.

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The identification, assessment, and management of hearing impairment in the pediatric population can be a challenging endeavor. Nevertheless, newer technology, improved techniques, and the cooperative efforts of various professional organizations and their constituencies have made significant strides toward achieving this goal. As more precise objective technologies are introduced, there will be a tendency to rely more heavily on their application. Both IA and OAEs have already made significant impact in pediatric practices because of their ease and simplicity. Within a short period of time, trained technical staff can become proficient in their usage and test interpretation. Their application in conjunction with basic audiometry can provide a global picture of auditory status (Table 2). However, it is critical to recall that the basic building block of auditory assessment is the audiogram, a true measure of behavioral threshold sensitivity. Therefore, when test results suggest hearing impairment, appropriate audiological referral to the will ensure continuity of services and provision of rehabilitative measures. It is equally essential for primary care providers to understand the therapeutic needs of their patients and to manage and coordinate the medical aspects of the infant or child when hearing loss is suspected.

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