Table 1. VEMP Testing Modifications for Children.

Test Procedure Characteristic	Modification
Shorten testing time	– Perform bilateral, simultaneous cVEMP and oVEMP – Use a bone conduction stimulus
Increase attention span	– Use interesting toys, stickers, or videos as distractors and targets
Improve sustained muscle contraction	cVEMP: – Rotate the head and stimulate rooting reflex for newborns – Sit child on parent's lap or have him/her lie on a table with head turned toward a toy or video
	oVEMP: – Use of a sitting position with target (light bar or video adhered to the wall) elevated at ∼ 30 degrees – Use eye-closed testing for small children who cannot perform testing with eyes open
Utilize EMG monitoring	– Use an animated cartoon that plays when contraction level is met
Improve electrode tolerance	– Use one reference electrode (e.g., chin) – Put oVEMP active electrodes on after cVEMP testing
Improve safety for air-conduction VEMP	– Present at 120 dB SPL if ear canal volume is ≤ 0.8 mL – Use a 750-Hz tone burst stimulus – Use an ascending threshold search approach – Use a bone-conduction stimulus

Abbreviations: cVEMP, cervical vestibular evoked myogenic potential; oVEMP, ocular vestibular evoked myogenic potential.