Balance Function Assessment and Management

Third Edition

Gary P. Jacobson, Neil T. Shepard, Kamran Barin, Robert F. Burkard, Kristen Janky, Devin L. McCaslin

Details: 717 pages, B&W, Hardcover, 8.5" x 11"

ISBN13: 978-1-63550-188-9

© 2021 | Available

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The third edition of Balance Function Assessment and Management, the leading textbook on the subject, continues to comprehensively address the assessment and treatment of balance system impairments through contributions from top experts in the areas of dizziness and vertigo. Designed for use in graduate audiology programs and by practicing audiologists, this is also a valuable text for those in the fields of physical therapy, otolaryngology, and neurology.

New to the Third Edition

  • Reorganized with the expertise of four additional Editors: Kamran Barin, PhD, Robert F. Burkard, PhD, Kristen Janky, AuD, PhD, and Devin L. McCaslin, PhD
  • Three new chapters:
    • An Historical Perspective of the Perception of Vertigo, Dizziness, and Vestibular Medicine (Zalewski)
    • Vestibular Balance Therapy for Children (Christy)
    • Challenging Cases (Shepard)
  • All existing chapters have been revised and updated
  • An effort has been made to make the text more concise
  • Three new helpful appendices:
    • Appendix I covers the pathophysiology behind dizziness. The authors provide a list of disorders that cause symptoms of dizziness and balance disorders going from common peripheral disorders to rare central disorders. For each of the disorders a vignette is included that provides the symptoms, test findings, treatments, prognosis, and site-of-lesion.
    • Appendix II deals with the development of codes that are used for billing services. The discussion includes the movement in the United States for changing to Alternative Payment Models; reimbursement based on quality of care and away from fee-for-service billing.
    • Appendix III provides an overview of interprofessional education (IPE) and interprofessional practice (IPP) and how the hope is that IPE will lead to IPP.

As with prior editions, the text comes with access to a PluralPlus companion website that contains videos of eye movements associated with the cases described in the text and PowerPoint lecture slides for instructors.


"Now in its third edition, this textbook provides an extensive amount of up-to-date information on the assessment and management of the vestibular system. Four new editors have been recruited for this edition and all chapters have been reviewed and reorganised to offer improved readability with a flow that makes its condensed 717 pages easier to digest.
The breadth of the information provided suits anyone with an interest in the subject, from students to the practising experts. It can be used both in an academic context or as a reference textbook in the clinic. Various specialties (audiology, physiotherapy, otolaryngology and neurology) can greatly benefit from this textbook.
The supplementary materials to the book, found on the companion website and referenced throughout the text, furnish the reader with very useful and practical video content. This book comprehensively covers all aspects related to dizziness and vertigo assessments and treatments for all patient demographics. Each chapter is organised well and in a way that can be read independently or as a precursor to the next one.
Three new chapters have been added to this edition:

  • An Historical Perspective of the Perception of Vertigo, Dizziness, and Vestibular Medicine: This chapter offers a thought-provoking insight to the topic.
  • Vestibular Balance Therapy for Children: This short chapter provides a physiotherapy program tailored to the paediatric vestibular dysfunction.
  • Challenging Cases: Four complex cases are discussed.

Three new appendices have also been added to the end of the book. Appendix I provides a concise list of different pathologies’ symptoms, signs, classic treatments, prognosis for recovery and suspected lesion site that clinicians are expected to encounter when dealing with dizzy and balance disorder patients. Appendix II is [...] relevant to the US coding and billing system and Appendix III argues for interprofessional education and practice.
Overall, this textbook is informative, value for money and provides the reader with the necessary tools to become a clinician with above-average knowledge on the management of the dizzy patient."
—Raúl García-Medina, Founder and CEO, The Audiology Clinic, in ENT & Audiology News (May 2021)

“I proudly carry this heavy hardcover from home to the clinic often. It is undeniably the most comprehensive and in-depth book in our field, and the clinician who owns it will not be disappointed or short for answers. Once again, the editors did a terrific job curating the best authors for each of the 27 chapters and 4 appendices.
A highlight is the companion website where you can watch several videos accompanying chapter 10 on ocular motility testing, excellent videos on the technique to perform video head impulse test on all planes, and a fun virtual reality posturography recording. …
The following chapters on practical anatomy and physiology of the systems involved in balance function encourage the clinician to strengthen their foundational knowledge and prepare them for the dense following chapters on the various types of vestibular assessment tools.
The ever-evolving and highly relevant pediatric vestibular field is well represented with a dedicated chapter on assessment and a good overview of vestibular balance therapy for children.
Another superb addition to the third edition is Appendix I - Pathophysiology Signs and Symptoms of Dizziness. Neil Shepard lets the reader into his genius mind and guides them through the vestibular diagnostic maze, beginning with collecting a particular set of symptom descriptions. It felt genuinely validating to me, given that I spend as much time on my case history as I do on testing. He then summarizes symptoms, signs,
treatment, prognosis, and lesion site for several vestibular disorders, from the most common and simple BPPV, to the more obscure and rare CANVAS. This is an invaluable resource for students and clinicians as a quick reference.
Instructors and managers will greatly appreciate Appendix III, where Shepard and Burkard discuss the value of interprofessional education and practice and provide supportive evidence towards this model of care, which aligns well with the nature of the balance system.”

–Erica Zaia, MSc, University of British Columbia, in the Canadian Audiologist (March 2022)

Reviews of the Previous Edition

"...well written textbook and necessary resource covering all aspects of balance function and remediation. ...This text is well researched, with comprehensive and appropriate references for further review. In addition, the videos supplied on the companion website are effective supplemental learning tools for the clinical concepts discussed throughout the text. Moreover, nearly all chapters provide clinical cases or clinical examples to reinforce clinical decisions for best care. Overall, this is an excellent compilation of the most state-of-the art assessment and management topics and techniques that I will most certainly include for my graduate students and for my own reference in clinical practice."
Julie Honaker, PhD, Department of Special Education and Communication Disorders, University of Nebraska - Lincoln, in the International Journal of Audiology (2015)

"To summarize, this book provides a comprehensive review of topics in assessment of balance and vestibular function, as well as management options of vertigo and imbalance. The contents are up to date and it can be a resourceful text for audiologists, otolaryngologists, neurologists and other clinicians who may have an interest in this field."
Guangwei Zhou, Balance and Vestibular Program, Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital at Waltham, in the International Journal of Pediatric Otorhinolaryngology (2016)


About the Editors



Chapter 1. An Historical Perspective of the Perception of Vertigo and Dizziness and Vestibular Medicine

Christopher K. Zalewski


Chapter 2. Ontogeny of the Vestibular System and Balance

Timothy A. Jones and Sherri M. Jones


Chapter 3. Practical Anatomy and Physiology of the Ocular Motor System

Scott D. Z. Eggers


Chapter 4. Practical Anatomy and Physiology of the Vestibular System

Jamie M. Bogle and Robert F. Burkard


Chapter 5. Practical Biomechanics and Physiology of Balance

Lewis M. Nashner


Chapter 6. Clinical Neurophysiology of Vestibular Compensation

Kamran Barin


Chapter 7. The Vertigo Case History

Jay A. Gantz, Belinda C. Sinks, and Joel A. Goebel


Chapter 8. Assessing Dizziness-Related Quality of Life

Erin G. Piker, Gary P. Jacobson, and Craig W. Newman


Chapter 9. Bedside Assessment of the Vestibular System

Carrie W. Hoppes, Karen H. Lambert, and Devin L. McCaslin


Chapter 10. Eye Movement Recording and Ocular Motility Testing

Neil T. Shepard, Michael C. Schubert, and Scott D. Z. Eggers


Chapter 11. Positional Testing and Treatment

Richard A. Clendaniel


Chapter 12. Caloric Testing

Kamran Barin


Chapter 13. Rotational Vestibular Assessment

Christopher K. Zalewski


Chapter 14. The Video Head Impulse Test (vHIT)

Ian S. Curthoys, Hamish G. MacDougall, Leigh A. McGarvie, Konrad P. Weber, David Szmulewicz, Leonardo Manzari, Ann M. Burgess, and G. Michael Halmagyi


Chapter 15. Computerized Dynamic Posturography: Methodology & Interpretations

Lewis M. Nashner and Neil T. Shepard


Chapter 16. Vestibular-Evoked Myogenic Potentials (VEMPs)

Devin L. McCaslin and Gary P. Jacobson


Chapter 17. Electrocochleography (ECochG)

Paul R. Kileny and Devin L. McCaslin


Chapter 18. Pediatric Vestibular Testing

Kristen Janky and Neil T. Shepard


Chapter 19. Vestibular Balance Therapy for Children

Jennifer B. Christy


Chapter 20. Medical Management of Vertigo That Is Otologic in Origin

Brian Neff and R. Mark Wiet


Chapter 21. Surgical Management of Vertigo That Is Otologic in Origin

R. Mark Wiet


Chapter 22. Neurologic Origins of Dizziness and Vertigo

Joseph M. Furman and Susan L. Whitney


Chapter 23. Behavioral Factors in Dizziness and Vertigo

Jeffrey P. Staab


Chapter 24. Vestibular Rehabilitation

Susan L. Whitney and Joseph M. Furman


Chapter 25. The Aging Vestibular System: Implications for Rehabilitation

Dara Meldrum and Courtney D. Hall


Chapter 26. Topographical Localization of Vestibular System Impairment

Gary P. Jacobson, Erin G. Piker, Richard A. Roberts, Devin L. McCaslin, and Nabih M. Ramadan


Chapter 27. Challenging Cases

Neil T. Shepard


Appendix I. Pathophysiology Signs and Symptoms of Dizziness

Neil T. Shepard


Appendix II. Coding and Billing

Robert F. Burkard, Neil T. Shepard, and Stuart Trembath


Appendix III. Interprofessional Education & Practice

Neil T. Shepard and Robert F. Burkard


Appendix IV. Specialty Rotational Vestibular Assessments

Christopher K. Zalewski



Gary P. Jacobson

Gary P. Jacobson, PhD, is Professor in the Department of Hearing and Speech Sciences and Director of the Divisions of Audiology and Vestibular Sciences at the Vanderbilt University Medical Center.  Prior to that he served as the Director, Division of Audiology for the Henry Ford Health System. He completed his undergraduate studies at California State University at Fullerton. He received his MS in Communicative Disorders (Audiology) at the University of Wisconsin–Stevens Point and received his PhD from Kent State University.  He is a past-editor of the American Journal of Audiology (ASHA) and is the current Editor-in-Chief of the Journal of the American Academy of Audiology (AAA). Dr. Jacobson has authored or co-authored 120 peer-reviewed publications and has co-edited 4 textbooks in the area of vestibular system function. Dr. Jacobson is a Fellow of ASHA and recipient of ASHA’s highest honor, the Honors of the Association.  Dr. Jacobson received the Lifetime Achievement Award from the American Balance Society.  Lastly, he received both the Distinguished Achievement Award and the Jerger Career Award for Research in Audiology from the American Academy of Audiology.

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Neil T. Shepard

Neil T. Shepard, PhD is director of the Dizziness and Balance Disorders Program at Mayo Clinic - Rochester, Minnesota, and a professor of audiology in the Mayo Clinical School of Medicine. He received his undergraduate and master's training in electrical and biomedical engineering from University of Kentucky (Lexington, Kentucky) and Massachusetts Institute of Technology (Cambridge, Massachusetts). He completed his PhD in auditory electrophysiology and clinical audiology from the University of Iowa (Iowa City, Iowa) in 1979. He has specialized in clinical electrophysiology for both the auditory and vestibular systems. Activity over the last 34 years has concentrated on the clinical assessment and rehabilitation of patients with balance disorders and clinical research endeavors related to both assessment and rehabilitation.

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Kamran Barin

Kamran Barin, PhD is Assistant Professor Emeritus, Department of Otolaryngology-Head & Neck Surgery and Department of Speech & Hearing Science, The Ohio State University. He established and served as the Director of Balance Disorders Clinic at the Ohio State University Medical Center for over 25 years until his retirement in June 2011. Dr. Barin received his Master’s and Doctorate degrees in Electrical/Biomedical Engineering from the Ohio State University. He has published over 80 articles and book chapters and has taught national and international courses and seminars in different areas of vestibular assessment and rehabilitation. Dr. Barin has served on the Board of Directors of the Vestibular Disorders Association (VeDA) since 2017 and is currently a consultant to Interacoustics and Bertec Corp. He previously served as a consultant to Otometrics.

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Robert F. Burkard

Robert Burkard, Ph.D., CCC-A is a Professor in the Department of Rehabilitation Science, University at Buffalo.  His research interests include calibration, auditory electrophysiology (in particular, auditory evoked potentials), vestibular/balance function/dysfunction, functional imaging and aging. His professional interests include health care economics and interprofessional education/practice.


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Kristen Janky

Kristen Janky, AuD, PhD, CCC-A is the clinical coordinator of Vestibular Clinical Services and Director of the Vestibular and Balance Research Laboratory at Boys Town National Research Hospital. She received her PhD from the University of Nebraska and completed a post-doctoral fellowship at Johns Hopkins University. Her research focus is on the clinical assessment of dizziness and balance disorders in patients of all ages, with a particular emphasis on vestibular assessment and management in the pediatric population.  She currently serves on the Editorial Board for the American Journal of Audiology and is President-Elect of the American Balance Society.

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Devin L. McCaslin

Devin L. McCaslin, PhD received a Master’s degree in Audiology from Wayne State University and a PhD in Hearing Science from The Ohio State University. He currently serves as the Director of the Vestibular and Balance Laboratory at Mayo Clinic in Rochester and is an Associate Professor in the Mayo Clinic College of Medicine. He has authored and coauthored publications that cover the areas of tinnitus, dizziness, auditory function, and outcome measures development. Dr. McCaslin’s major academic, clinical and research interests relate to clinical electrophysiology, vestibular assessment, and the application of artificial intelligence to manage and treat dizzy patients. He also serves as the Deputy Editor-in-Chief of the Journal of the American Academy of Audiology and is the Past President of the American Balance Society.

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Balance Function Assessment and Management, Third Edition comes with access to supplementary student and instructor materials on a Pluralplus companion website.

To access the instructor materials, you must contact Plural Publishing, Inc. to be verified as an instructor and receive your access code.


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Rotational Vestibular Assessment

First Edition

Christopher K. Zalewski

Details: 322 pages, Full Color, Softcover, 8.5" x 11"

ISBN13: 978-1-59756-797-8

© 2018 | Available

Rapid Interpretation of Balance Function Tests

First Edition

Michael J. Ruckenstein, Sherrie Davis

Details: 168 pages, B&W, Softcover, 6" x 9"

ISBN13: 978-1-59756-443-4

© 2015 | Available

Vestibular Testing Interpretation: Drill and Practice

First Edition

Matthew G. Crowson, Douglas B. Garrison, Kristal M. Riska, Debara L. Tucci, David Kaylie

Details: 145 pages, B&W, Spiral, 8.5" x 11"

ISBN13: 978-1-63550-105-6

© 2020 | Available

Manual of Pediatric Balance Disorders

Second Edition

Robert C. O'Reilly, Thierry Morlet, Jacob R. Brodsky, Sharon L. Cushing

Details: 458 pages, B&W, Softcover, 7" x 10"

ISBN13: 978-1-63550-146-9

© 2020 | Available

Electronystagmography and Videonystagmography (ENG/VNG)

Second Edition

Devin L. McCaslin

Details: 278 pages, B&W, Softcover, 8.5" x 11", Includes videos

ISBN13: 978-1-63550-081-3

© 2020 | Available

Diagnostic Vestibular Pocket Guide: Evaluation of Dizziness, Vertigo, and Imbalance

First Edition

Julie A. Honaker

Details: 288 pages, B&W, Softcover, 4.5" x 8"

ISBN13: 978-1-63550-312-8

© 2021 | Available