Development of balance functions in infants and children can be delayed for various reasons. However, there are three major causes unless particular neurological problems are associated with the delay. These three major etiologies are congenital vestibular loss, congenital blindness and mental retardation. In infants and young children, vestibular loss is assessed by electronystagmography recordings by the damped rotation test, but not by the caloric test.
The damped rotation test in infants and children with congenital vestibular loss, shows very poor rotational nystagmus, but in infants and children with congenital blindness only or mental retardation only, the test shows normal rotational nystagmus. Normal children initially begin walking at approximately 12 months of age, but children with these problems frequently begin walking after two years of age. Because vestibular and visual information converge in the cerebellum, it is speculated that this contributes to the delay in the development of balance functions in infants and children with congenital vestibular loss or blindness. However, mental retardation may influence overall development. Development of balance functions can be delayed by various causes, and careful examination is required.