Interdisciplinary assessment and treatment of paediatric drooling: two decades of experience by the Nijmegen saliva control team reflected in a stepwise algorithm.

Autor: Orriëns LB; Department of Paediatric Neurology, Division of Paediatrics, Donders Institute for Brain, Cognition and Behaviour, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands. Lynn.Orriens@radboudumc.nl., de Groot SAF; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands., van der Burg JJW; Department of Paediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.; School of Pedagogical and Educational Science, Radboud University Nijmegen, Nijmegen, the Netherlands., van den Hoogen FJA; Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands., van Hulst K; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands., Erasmus CE; Department of Paediatric Neurology, Division of Paediatrics, Donders Institute for Brain, Cognition and Behaviour, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
Jazyk: angličtina
Zdroj: European journal of pediatrics [Eur J Pediatr] 2024 Sep; Vol. 183 (9), pp. 3979-3985. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1007/s00431-024-05658-5
Abstrakt: Anterior and posterior drooling are prevalent comorbidities in children with neurodevelopmental disabilities. Considering the heterogeneity of the patient population and the multifactorial aetiology of drooling, an interdisciplinary and individualised treatment approach is indispensable. However, no tool for stepwise decision-making in the treatment of paediatric drooling has been developed previously. Within the Radboudumc Amalia Children's Hospital, care for children with anterior and/or posterior drooling secondary to neurodevelopmental disabilities is coordinated by a saliva control team with healthcare professionals from six disciplines. In alignment with international literature, published guidelines, and evidence gained from two decades of experience and research by our team, this paper proposes an algorithm reflecting the assessment and treatment approach applied in our clinic. First, directions are provided to decide on the necessity of saliva control treatment, taking type of drooling, the child's age, and the severity and impact of drooling into account. Second, the algorithm offers guidance on the choice between available treatment options, highlighting the importance of accounting for child characteristics and child and caregiver preferences in clinical (shared) decision-making.
Conclusions: With this algorithm, we aim to emphasise the importance of repeated stepwise decision-making in the assessment and treatment of drooling in children during their childhood, encouraging healthcare professionals to apply a holistic approach.
What Is Known: • Children with anterior or posterior drooling secondary to neurodevelopmental disabilities comprise a heterogeneous group, necessitating an individualised treatment approach. • No stepwise decision-making tool is available for the treatment of paediatric drooling.
What Is New: • Deciding on the necessity of saliva control treatment should be a conscious process, based on type of drooling, age, and drooling severity and impact. • Type of drooling, age, cognition, oral motor skills, self-awareness, posture, diagnosis, and child/caregiver preferences need to be considered to decide on the optimal treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
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