Objective: The purpose of this study was to determine the effect of exercise intervention on the progressive motor development delay and postural control impairments in children with sensorineural hearing loss and concurrent vestibular impairment. Methods: Twenty-one children with sensorineural hearing loss and vestibular impairment were randomly assigned to two groups (exercise and placebo) matched for age and gross motor development level. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. Placebo intervention focused on language development activities. Each intervention was administered three times weekly for 12 weeks. Motor development and posturography testing was completed pre- and post-intervention. To examine the mechanisms of change, somatosensory, visual and vestibular functional effectiveness ratios were calculated from posturography stability scores. Children in the placebo group later participated in exercise intervention, and a second post-test completed. Data were analyzed by group, as well as merged once all had received exercise intervention. Results: Post-intervention, motor development scores significantly improved in the exercise, not the placebo group (P=0.004). Although not significant, improvement in posturography scores were evident in the exercise group. Once the post-exercise data from both groups were merged (n=21), improvements in these scores were significant (≤0.02). The difference from the normative sample was eliminated. Conclusions: Exercise intervention focused on the enhancement of sensory integrative postural control abilities is effective for the arrest of the progressive motor development delay in children with sensorineural hearing loss and vestibular impairment. © 2004 Elsevier Ireland Ltd. All rights reserved.