Treating Excessive Drooling In Children With Developmental Disabilities

Excessive drooling (sialorrhea) has been associated with a 10%-37% of children with developmental disabilities. Among children with cerebral palsy who attend special schools, the incidence is 58%. In a survey of parents of 1,437 children with cerebral palsy, approximately 50% reported that drooling is an issue for their child both physically and psychologically. 16% even stated that excessive drooling requires daily changes of clothing.

Many of the complications related to sialorrhea can generate health problems such as:

  • Perioral chapping, irritation, and maceration, with secondary infection of the facial skin
  • Dehydration due to chronic loss of fluids
  • Increased risk of silent saliva aspiration that can result in recurrent respiratory infections

Social limitation is another complication for children in the education system, where drooling can:

  • Cause an embarrassing wetness and odor
  • Inhibit vocational opportunities
  • Prevent children from experiencing basic developmental skills such as sharing and independence

In an attempt to manage drooling problems associated with cerebral palsy and other neurological conditions, I studied the effectiveness of using glycopyrrolate oral solution (1 mg/5 mL) with these children.

38 patients ages 3-23 years were studied, some given glycopyrrolate oral solution, some given a placebo. All patients were considered to have severe drooling (clothing damp 5-7 day/week).

The results show that improvements started 2 weeks after treatment initiation, with improvements at the 8-week mark being even greater. In addition, 100% of parents/caregivers regarded glycopyrrolate oral solution to be worthwhile, while just 56% found the placebo worthwhile.

Only a few mild side effects were associated with this glycopyrrolate in this study, mainly dry mouth, constipation, and vomiting.

Drooling can be a serious problem for children, and our hope is to find the best ways to manage this concern in children with development disabilities.

About Dr. Robert Zeller, Pediatric Neurologist

I am the Medical Director of the Blue Bird Circle Clinic for Pediatric Neurology and Professor of Pediatric Neurology at Baylor College of Medicine with board certifications in Pediatrics and Psychiatry and Neurology with Special Qualification in Child Neurology.

My clinical focus is in child neurology.

Posted in Neurology, Parenting, Research

2 Responses to Treating Excessive Drooling In Children With Developmental Disabilities

  1. Mary Pollack (Deiss) says:

    Hello Dr. Zeller. My son was your patient around 1971. His name is Keith Deiss. He was 5 years old. He was diagnosed with Spastic Familial Paraplegia. He quit going to drs when he reached adulthood. He is such a wonderful person. His disability has not held him back, He walks with the aid of crutches and braces. Just wanted to thank you for caring so much for him. I wish there had been clinical trials back then. There just weren’t enough families involved then.

  2. oha sopuru says:

    my son is 3yr 10 months he drools so much that it wets his shirt.with runny nose,he snores if sleep or awake.thou he has difficult in speech and limps at little.

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