Social interaction and self-esteem of children with cerebral palsy after treatment for severe drooling

Burg, J.J.W. van der; Jongerius, Peter H.; Limbeek, Jacques van; Hulst, Karen van; Rotteveel, J.J.

doi:10.1007/s00431-005-1759-z

Cited by 78 publications

(74 citation statements)

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“…15 A caretaker visual analogue scale score (range 0-10) reflected the severity of drooling, with 0 indicating 'no drooling' and 10 indicating very severe drooling. 5 Based on direct SLT observations and parental reports, the viscosity of saliva was judged before and after BoNT-A (more serous/ more mucus/unchanged).…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Negative effects of submandibular botulinum neurotoxin A injections on oral motor function in children with drooling due to central nervous system disorders

Hulst

Kouwenberg

Jongerius

et al. 2016

Develop Med Child Neuro

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AIM The aims of this study were: (1) to determine the incidence and nature of adverse effects on oral motor function after first injections of botulinum neurotoxin A (BoNT-A) in submandibular glands for excessive drooling in children with central nervous system disorders; and (2) to identify independent predictors of these adverse effects.METHOD A cohort study involved 209 children (123 males, 86 females, aged 4-27y, median 8y 4mo), who received submandibular BoNT-A injections for drooling. Adverse effects were categorized into swallowing, eating, drinking, articulation, and other problems. Univariable logistic regression was used to study differences in patients with and without adverse effects. Possible predictors were identified using multivariable logistic regression.RESULTS Transient adverse effects occurred in 33% of the 209 BoNT-A treatments. Almost 80% of these were mild, versus 8.7% severe. Approximately 54% of the adverse effects spontaneously resolved within 4 weeks; 3% still existed after 32 weeks. A diagnosis of cerebral palsy, higher range of BoNT-A dosage, and a pre-treatment drooling quotient <18% were found to be independent predictors of adverse effects.INTERPRETATION Before using submandibular BoNT-A injections for drooling, potential adverse effects should be discussed. Oral motor function needs to be monitored, because existing dysphagia may be worsened. The identified clinical predictors could be helpful to optimize patient selection.Treatment with botulinum neurotoxin (BoNT) in the salivary glands is a widely accepted effective intervention for drooling in children with central nervous system (CNS) disorders. When injected into the salivary glands, BoNT inhibits the acetylcholine release at the terminal nerve endings, decreasing the secretion of saliva and diminishes drooling in the majority of patients. 1The main group of children with neurological impairments treated with BoNT injections are children with cerebral palsy (CP), a vulnerable group with a spectrum of oral motor problems (estimated 40% drooling prevalence).2-4 Drooling has a serious impact on the children's social interaction, self-esteem, and health. 5 The effectiveness of salivary gland BoNT has been studied extensively, although the debate about which glands should be injected is still going on. Several studies demonstrated that, after BoNT, drooling is significantly reduced. In Scheffer's study a clinically notable response was found in 46.6% of children. 6 The duration of this effect was approximately 2 to 6 months (median 24wks). [6][7][8] In most of these studies, botulinum neurotoxin A (BoNT-A) was used. 9Considering the increasing use of BoNT for drooling, studies to identify possible risk factors for adverse effects on oral motor functions before treatment are urgently needed. 10Post-intervention assessments showed that adverse effects on oral motor functions with a potential negative effect on swallowing occurred from 0% 11-13 up to 17.8% 6 of the cases after submandibular gland injections, and up to 33% 14 of the ...

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Section: Patient Characteristicsmentioning

confidence: 99%

“…[2][3][4] Drooling has a serious impact on the children's social interaction, self-esteem, and health. 5 The effectiveness of salivary gland BoNT has been studied extensively, although the debate about which glands should be injected is still going on. Several studies demonstrated that, after BoNT, drooling is significantly reduced.…”

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confidence: 99%

Negative effects of submandibular botulinum neurotoxin A injections on oral motor function in children with drooling due to central nervous system disorders

Hulst

Kouwenberg

Jongerius

et al. 2016

Develop Med Child Neuro

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“…It occurs more frequently and severely in patients with neurological deficits such as cerebral palsy, motor neuron disease or Parkinson's disease 1,2. Persistent drooling may cause adverse events such as problems in social development and dignity of patients, as well as hygiene problems including unpleasant odor, contaminated clothing and furniture, and skin damage by repeated stimulation 3,4. Additionally, in patients with brain injury who have swallowing disorders, posterior drooling may cause coughing, nausea, vomiting, aspiration into the airway, and if severe, aspiration pneumonia 5…”

Section: Introductionmentioning

confidence: 99%

Effect of Botulinum Toxin Type A on Morphology of Salivary Glands in Patients with Cerebral Palsy

et al. 2011

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ObjectiveTo investigate the effect of botulinum toxin type A (BTXA) on drooling and the morphologic change of the salivary gland in patients with cerebral palsy.MethodEight cerebral palsy patients suffering from severe drooling participated in this study. BTXA was injected into both submandibular and parotid glands under intravenous sedation and with ultrasound guidance (1 unit/gland/kg: maximum 100 units) in an outpatient or inpatient procedure. The severity of drooling was measured before injection and 3 weeks after injection using the Teacher Drooling Scale, the Drooling Score-severity, frequency and the Visual Analog Scale. To investigate the morphologic change of the salivary glands, the size of salivary glands were measured before injection and 3 weeks after injection using computed tomography of the neck. The measurement values were analyzed by Wilcoxon signed rank test.ResultsStatistically significant improvements were shown in all three parameters for assessing the severity of drooling after BTXA injections (p<0.05). Size of the salivary glands were significantly decreased at 3 weeks after BTXA injection (p<0.05).ConclusionSalivary gland injection with BTXA could be a useful treatment method to reduce drooling in patients with cerebral palsy and decreased size of salivary glands may partially explain the mechanism.

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“…They often have a short attention span, a low self-esteem, faced with difficulties in developing relationships with the outside world, family and peers, and are easily frustrated (4). In general, behavioral problems of mentally retarded children can be divided into two categories: external behavior and internal behavior.…”

Section: Effect Of Aerobic Training On the Social Adjustment Of Childmentioning

confidence: 99%

The Effect of 8 Weeks Aerobic Training on the Social Adjustment in Mentally Retarded Children with Hemiplegic Cerebral Palsy

Ardakani

Rahmati

2015

Ann. Appl. Sport Sci

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One of the most important and basic problems in mentally retarded children which can form the basis of their behavior is impairment in social adjustment and performance. The purpose of the present work was to study the effect of 8 weeks aerobic training on the social adjustment in mentally retarded children with hemiplegic cerebral palsy. The statistical population included all mentally retarded children with hemiplegic cerebral palsy in District 1 of Tehran who were under the coverage of Exceptional Education Organization in 2013-2014 academic year. Among 38 mentally retarded children, 24 (with a mean age of 9±2 years) were randomly selected and divided into two groups: experimental and the control groups. To assess the social adjustment, Vineland Adjustment Behavior Scale (VABS) (1984) was used. Quasi-experimental method with pretest and posttest design and a control group was used for this research. The findings showed that 8 weeks aerobic exercises could increase the social adjustment in children with hemiplegic cerebral palsy (P≤0.001). Finally, it can be concluded that aerobic exercises have a positive impact on the social adjustment in children with hemiplegic cerebral palsy by increasing their communication with peers.

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Social interaction and self-esteem of children with cerebral palsy after treatment for severe drooling

Abstract: Interventions to treat drooling should not only be evaluated using measurements of drooling, but the consequences on social interaction and self-esteem should also be assessed.

Cited by 78 publications

References 12 publications

Negative effects of submandibular botulinum neurotoxin A injections on oral motor function in children with drooling due to central nervous system disorders

Negative effects of submandibular botulinum neurotoxin A injections on oral motor function in children with drooling due to central nervous system disorders

Effect of Botulinum Toxin Type A on Morphology of Salivary Glands in Patients with Cerebral Palsy

The Effect of 8 Weeks Aerobic Training on the Social Adjustment in Mentally Retarded Children with Hemiplegic Cerebral Palsy

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