Awareness and Use of Different Techniques among Speech and Language Pathologists for Controlling Drooling in Children with Cerebral Palsy

Abstract

Background: Drooling is a prevalent and socially distressing condition affecting 25–35% of children with cerebral palsy (CP), with approximately 10% experiencing severe sialorrhea. It results from impaired oral-motor control rather than hypersalivation and leads to complications such as aspiration, skin breakdown, and psychosocial stigma. Speech-language pathologists (SLPs) employ various interventions to manage drooling, but inconsistencies in technique awareness and application hinder optimal outcomes. Objective: To assess the awareness and utilization of drooling control techniques among SLPs managing children with CP and examine associations with clinician demographics and qualifications. Methods: A cross-sectional survey was conducted from March to August 2017 among 120 SLPs from government, private, and semi-government rehabilitation institutions in Lahore, Pakistan. Participants completed a structured questionnaire evaluating awareness and use of evidence-based drooling interventions, including non-speech oral motor exercises (NSOMEs), behavioral techniques, and oral-facial facilitation. Data were analyzed using SPSS version 21.0 with chi-square tests for group comparisons. Results: While 85.8% of SLPs reported using NSOMEs and 95.0% employed oral-facial facilitation, only 40.8% utilized behavioral methods, with auditory cueing and compensatory strategies used by 30.8% and 24.2%, respectively. MS/MPhil-qualified SLPs demonstrated significantly higher awareness and technique adoption (p < 0.05). Experience level showed a positive trend but no statistically significant effect. Conclusion: SLPs exhibit strong awareness of motor-based drooling interventions, yet behavioral strategies remain underused despite their clinical relevance. Enhanced training and standardized protocols are needed to improve multidisciplinary drooling management in CP.