Drooling outcome measures in paediatric disability: a systematic review

Abstract

Drooling, or sialorrhea, is a common condition in patients with cerebral palsy, rare diseases, and neurodevelopmental disorders. The goal of this review was to identify the different properties of sialorrhea outcome measures in children. Four databases were analysed in search of sialorrhea measurement tools, and the review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist was used for quality appraisal of the outcome measures. The initial search yielded 891 articles, 430 of which were duplicates. Thus, 461 full-text articles were evaluated. Among these, 21 met the inclusion criteria, reporting 19 different outcome measures that encompassed both quantitative measures and parent/proxy questionnaires. Conclusions: Among the outcome measures found through this review, the 5-min Drooling Quotient can objectively discriminate sialorrhea frequency in patients with developmental disabilities. The Drooling Impact Scale can be used to evaluate changes after treatment. The modified drooling questionnaire can measure sialorrhea severity and its social acceptability. To date, the tests proposed in this review are the only tools displaying adequate measurement properties. The acquisition of new data about reliability, validity, and responsiveness of these tests will confirm our findings. What is Known:• Although sialorrhea is a recognized problem in children with disabilities, especially those with cerebral palsy (CP), there is a lack of confidence among physicians in measuring sialorrhea. What is New:• Few sialorrhea measures are available for clinicians that may guide decision-making and at the same time have strong evidence to provide confidence in the results.• A combination of both quantitative measures and parent/proxy questionnaires might provide an adequate measurement of sialorrhea in children.

Cross‐cultural adaptation and validation of the Italian version of the Montreal Children's Hospital Feeding Scale in a special healthcare needs population

“…The original source, developed for French and English speakers, had previously been translated into Brazilian Portuguese (Diniz et al., 2021) following the International Test Commission (ITC) Guidelines for Translating and Adapting Tests, into Polish (Bąbik et al., 2019) following the Sousa et al. guideline (Sforza et al., 2022) and into Thai (Benjasuwantep et al., 2015) though translation guidelines were not referenced.…”

Management of nutritional and gastrointestinal issues in RASopathies: A narrative review

“…A delayed acquisition of oral motor functions may also be observed (Armour & Allanson, 2008), whereas drooling, which would be expected due to marked oral motor involvement, has been scarcely evidenced (Sforza et al, 2022).…”

“…It is furthermore necessary to exclude structural malformations involving the larynx, as first‐degree laryngeal cleft and trachea/laryngomalacia, since, even though rarely reported, they would make oral feeding unsafe (Armour & Allanson, 2008; Grebe & Clericuzio, 2000). A delayed acquisition of oral motor functions may also be observed (Armour & Allanson, 2008), whereas drooling, which would be expected due to marked oral motor involvement, has been scarcely evidenced (Sforza et al, 2022).…”

The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study

“…This means that the patient was not able to exhibit head and trunk control, nor any locomotion activities [ 8 , 9 , 24 ]. The inclusion criteria were difficulties with sucking, swallowing, and excessive salivation during eating according to the Castillo Morales Questionnaire [ 3 , 25 ]. We only used part of the Castillo Morales Questionnaire as it was not fully translated into the Polish language.…”