Managing excessive drooling in children with disability

Drooling is a common part of early childhood, but for some children – especially those with disability – it can persist beyond the typical developmental stages. While it may seem like just a minor inconvenience, excessive drooling can have a real impact on comfort, health, and social interactions. Parents and caregivers often wonder if their child’s drooling is something to be concerned about and what can be done to manage it effectively.

The following questions will walk you through the key aspects of excessive drooling, from identifying when to seek help to exploring treatment options, therapy techniques, and home strategies.

When should I be concerned if my child is drooling?

Drooling is common in infants and toddlers, but if it continues beyond the age of two or interferes with daily activities, it may require further evaluation. Persistent drooling can indicate underlying medical or developmental conditions. If drooling leads to frequent skin irritation, dehydration, choking risks, or social difficulties, it’s time to seek professional advice.

Why does it matter?

Excessive drooling isn’t just a hygiene issue – it can affect a child’s health, comfort, and confidence. Constant moisture can cause skin rashes, infections, and dental problems. It may also impact speech development, feeding, and social interactions, leading to self-consciousness or bullying.

What causes excessive drooling?

Drooling can result from several factors, including:

Neuromuscular impairments: Conditions like cerebral palsy, autism, or Down syndrome can affect muscle control in the mouth and throat.

Oral sensory challenges: some children struggle to sense when saliva builds up, leading to delayed swallowing.

Poor posture: Difficulty maintaining an upright head position can make saliva control harder.

Dental or structural issues: Problems like misaligned teeth or enlarged tonsils can contribute to excessive drooling.

Increased saliva production: While less common, some medical conditions or medications can cause excessive saliva output.

How should persistent drooling be assessed?

A healthcare professional-such as a paediatrician, speech-language pathologist, or occupational therapist – can evaluate the underlying causes of drooling through:

• Medical history and physical examination
• Assessment of oral-motor skills and swallowing function
• Postural and sensory evaluations
• Saliva production analysis

The goal is to determine whether the issue is related to muscle control, sensory awareness, or another medical condition, allowing for an effective treatment plan.

How can my child’s drooling be treated?

Treatment depends on the severity and underlying cause of the drooling. Options may include:

• Oral motor therapy: Strengthening muscles involved in swallowing

• Postural adjustments: Improving head control and positioning

• Behavioural techniques: Teaching children to be more aware of saliva and swallow frequently

• Medical or surgical interventions (if necessary).

A combination of these strategies is often the most effective approach.

Can speech therapy help?

Yes! Speech therapy can be a valuable tool in managing drooling. Speech-language pathologists (SLPs) work on strengthening the muscles involved in swallowing and improving saliva control. Therapy may also focus on increasing the child’s awareness of saliva and teaching strategies to manage it more effectively.

What might happen in a speech therapy session for drooling?

A speech therapy session may include:

• Exercises to strengthen lips, tongue, and jaw muscles

• Techniques to improve oral sensory awareness

• Swallowing drills to encourage better saliva control

• Use of cues or reminders to prompt swallowing

• Training in proper head positioning and posture

Sessions are typically tailored to the child’s specific needs and abilities.

What medical interventions are there?

If conservative methods don’t provide sufficient improvement, medical interventions may be considered, including:

MEDICATIONS: Anticholinergic drugs can help reduce saliva production but may have side effects.

BOTULINUM TOXIN (BOTOX) INJECTIONS: Temporarily reduce saliva production by targeting the salivary glands.

SURGICAL PROCEDURES: In severe cases, surgery to reposition or remove some salivary glands may be an option.

These treatments should always be discussed with a healthcare provider to weigh benefits and risks.

What activities can I do at home to help my child?

There are many simple strategies you can incorporate into daily routines to help manage drooling (always consult with a therapist or help provider before carrying out any home strategies):

• Encourage regular swallowing by prompting your child to swallow throughout the day
• Oral motor exercises, like blowing bubbles, sucking through a straw, or practicing lip closure, can improve muscle tone
• Use chewy foods (like carrot sticks or dried fruit) to strengthen jaw muscles and encourage active chewing
• Promote good posture, especially while eating or engaging in focused activities
• Provide absorbent clothing (such as waterproof bibs or scarves) to help manage saliva and keep your child comfortable.

Drooling can be challenging, but with the right combination of therapy, interventions, and home-based strategies, significant improvements are possible. Consulting healthcare professionals andexploring different treatment options can help your child feel more comfortable and confident in daily life.