More than one in 20 (nearly 3.3 million) children between the ages of three and 17 have a dizziness or balance problem, according to an analysis of the first large-scale, nationally representative survey of these problems in U.S. children. Prevalence increases with age, with 7.5 percent of children ages 15-17 and 6.0 percent of children ages 12-14 having any dizziness or balance problem, compared with 3.6 percent of children ages six to eight and 4.1 percent of children ages 3-5. The research was led by investigators at the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health.

Researchers found that girls have a higher prevalence of dizziness and balance problems compared to boys, 5.7 percent and five percent, respectively. In addition, non-Hispanic white children have an increased prevalence of dizziness and balance problems (6.1 percent) compared with Hispanic (4.6 percent) and non-Hispanic black (4.3 percent) children. The findings were published online in the January Journal of Pediatrics.

“These findings suggest that dizziness and balance problems are fairly common among children, and parents and providers should be aware of the impact these problems can have on our children,” said James F. Battey, Jr., M.D., Ph.D, director of the NIDCD and a pediatrician. “Parents who notice dizziness and balance problems in their children should consult a health care provider to rule out a serious underlying condition.”

Previous estimates of dizziness and balance problems in children have ranged from 5 to 18 percent and have been based on limited, foreign, population-based studies. To better understand the prevalence of these problems among U.S. children, a team led by researchers from theepidemiology and statistics program at the NIDCD analyzed data from the Child Balance Supplement to the 2012 National Health Interview Survey (NHIS).

The NHIS is an annual survey conducted by the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention. The survey uses personal household interviews to gather information about a range of health topics. The Child Balance Supplement was included in 2012 and was the first large-scale supplement added to the NHIS survey to assess dizziness and balance problems among children. The NIDCD provided funding for the 2012 Child Balance Supplement.

The researchers analyzed data on nearly 11,000 children, ages 3 to 17, based on parents’ responses to the survey. Parents were asked if in the past year, their children had been bothered by symptoms of dizziness or balance problems such as vertigo, poor balance/unsteadiness when standing up, clumsiness/poor coordination, frequent falls, fainting or light-headedness, or other dizziness and balance symptoms.

The researchers report that:

Among children with dizziness and balance problems, 46.0 percent of parents reported that the children had poor coordination; 35.1 percent reported light-headedness; 30.9 percent had poor balance; 29.0 percent had vertigo; 25.0 percent reported frequent falls; and 8.5 percent had other dizziness and balance problems.
Parents reported moderate or serious difficulties in 18.6 percent of children with dizziness and balance problems.
Overall, 36.0 percent of children with dizziness and balance problems were seen by a health professional and 29.9 percent received treatment. Of those whose parents reported moderate or serious difficulties with dizziness and balance problems, 71.6 percent were seen by a health professional, and 62.4 percent were treated.

The researchers also found that only one-third, or 32.8 percent, of parents with a child with a dizziness or balance problem reported having received a diagnosis of an underlying condition. The percentage of children diagnosed rose to 59.6 percent among children whose parents reported they had moderate to serious difficulties with dizziness and balance problems. Reported causes included neurological problems; ear infections; head or neck injuries or concussions; developmental motor coordination disorder; genetic causes; metabolic problems such as hypoglycemia; prescription medication or drugs; severe headaches or migraines; malformation of the ear; and vision problems.

Children with any reported difficulty hearing were two times more likely to have dizziness or balance problems compared with children who had normal hearing. Other risk factors associated with dizziness and balance problems included impairments that limit a child’s ability to crawl, walk, run, or play; frequent headaches or migraines; certain developmental delays; a history of seizures in the past 12 months; stuttering/stammering; and anemia during the last 12 months.

The analysis also revealed gender-specific risk factors. For example, attention deficit hyperactivity disorder, attention deficit disorder, and stuttering were linked to dizziness and balance problems in boys, while anemia, hearing difficulties, and respiratory allergies were associated with the condition in girls. Girls with dizziness and balance problems also reported having more headaches and migraines compared to boys with dizziness and balance problems.

“Our findings are consistent with the limited prevalence data in other countries, and provide much-needed baseline estimates of dizziness and balance problems in U.S. children,” said Howard J. Hoffman, M.A., co-author of the study and director of epidemiology and statistics at the NIDCD. “Dizziness and balance problems in children continue to be an understudied area, and we hope that this analysis leads to a better understanding of the scope and risk factors associated with these issues.”

Chuan-Ming Li, M.D., Ph.D., an NIDCD statistician, was the lead author. Researchers from the Johns Hopkins School of Medicine, Baylor College of Medicine, and Marshall University also contributed to the analysis. The data will be used to track the increase in children’s use of the healthcare system to diagnosis and treat these disorders as part of the Healthy People 2020 initiative. Healthy People 2020 was launched in 2010 by the U.S. Department of Health and Human Services and aims to prevent disease and promote health, in part by increasing use of health care services.

This work was supported by the NIDCD and NCHS through an interagency agreement (Y1-DC-7001).

The NIDCD provides health information on balance disorders.