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Management of drooling for children with neurological problems in Hong Kong
Winnie Ka Ling Yam1, Hellen Li Chien Yang, Victor Abdullah
1Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Chuen On Road, Tai Po, Hong Kong SAR, China. wklyam@hotmail.com
Insights
Oro-motor training can help manage drooling in children with developmental disabilities. This study found short-term benefits in reducing drooling severity and improving oral functions.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Speech-Language Pathology
Background:
- Drooling, or sialorrhea, is a common challenge in children with neurodevelopmental disorders, impacting quality of life.
- Effective management strategies are crucial for improving functional outcomes and caregiver well-being.
Purpose of the Study:
- To report the experience of managing drooling in Hong Kong.
- To describe the clinical characteristics of children with drooling.
- To evaluate the effectiveness of oro-motor training for drooling management.
Main Methods:
- Children with drooling attending a specialized clinic were assessed multidisciplinary.
- Interventions included medical optimization, oro-motor training, and surgery.
- Drooling severity was measured using a 10-point visual analogue scale (VAS).
Main Results:
- Eight children, with a mean age of 11.9 years, participated; most had cerebral palsy and intellectual disability.
- Common oro-motor difficulties included poor lip closure, inadequate jaw control, and delayed swallowing.
- Oro-motor training led to a significant reduction in drooling severity (mean VAS decrease of 3.0), with sustained benefits at 4 months post-training.
Conclusions:
- Short-term oro-motor training demonstrated a beneficial outcome in managing drooling.
- Improvements in sucking and swallowing functions were also observed.
- The study highlights the potential of oro-motor training as a non-surgical intervention for pediatric drooling.
Objectives:
To share our experience in the management of drooling in Hong Kong, to describe the clinical profile of children with this problem, and to report the clinical outcome of oro-motor training.
Methods:
Children attending the Drooling Clinic of Alice Ho Miu Ling Nethersole Hospital, Hong Kong between January 2000 and June 2003 were included. Multidisciplinary assessment was performed to ascertain the medical condition, functional status and oro-motor difficulties of each child. Intervention might include optimization of medical condition, oro-motor training and surgery. Severity of drooling was rated by a 10-point visual analogue scale (VAS). The outcome of oro-motor training was assessed by the change in VAS from baseline.
Results:
Eight children, with a mean age of 11.9 years, were included. Six children suffered from cerebral palsy and two had syndromal diagnoses. All had moderate or severe mental retardation. Poor lip closure, inadequate jaw control and delay in swallowing were common oro-motor difficulties. All children received oro-motor training. The mean duration of follow-up for seven children was 17 months. The mean baseline VAS was 7.1. When compared with the baseline, VAS rating during the training period decreased with a mean difference of 3.0. The difference remained at 1.9 at 4 months after training had stopped. Other functional gains, such as improved sucking and swallowing, were identified. Six caregivers declined surgery. One child improved and did not require surgery.
Conclusions:
Short-term follow-up of oro-motor training suggested beneficial outcome.
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