Changes in severity and impact of drooling after submandibular gland botulinum neurotoxin A injections in children with neurodevelopmental disabilities.
Karen Van Hulst, Jan Jw Van Der Burg, Peter H Jongerius and 2 others
PMID 31729034WHAT IT FOUND
Submandibular Botox injections reduced drooling severity in 70% of children with neurodevelopmental disabilities at 8 weeks.
Parents reported less daily care burden, such as fewer mouth wipes and bib changes, specifically in the group that responded to the treatment.
Key findings
01Seventy percent of children were classified as responders at 8 weeks, defined by a 50% reduction in observed drooling or a significant drop in parent-rated severity.
02Parents of responders reported significant decreases in the frequency of wiping the child's mouth and prompting them to swallow, while non-responders did not show these changes.
03Objective drooling measures and parent-reported severity showed only a weak correlation at baseline and a fair correlation at follow-up, suggesting they assess different aspects of the condition.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was observational with no control group, so natural fluctuations in drooling or other concurrent factors cannot be ruled out as causes for the improvement. The speech and language therapists assessing the DQ5 were not blinded to the treatment. The parent questionnaire used for impact assessment had not been fully validated for reliability and validity at the time of the study. Many participants had a low developmental age (below 4 years), making it difficult for parents to accurately report on social and emotional consequences.
Declared interests
The authors did not explicitly state funding sources or conflicts of interest in the provided text.
The easy way to misread this
Do not assume that a reduction in objective drooling scores automatically translates to a proportional improvement in parent-reported severity or social participation. The study found only a fair correlation between these measures, meaning a child could show significant clinical improvement on the DQ5 while parents perceive little change in daily life impact.