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Managing Sialorrhea

Many children lack sensory awareness in their facial muscles and don’t get the feedback that most of us do that saliva is near our mouths. Hypersalivation as the name suggests is the excessive production of saliva in the mouth, which maybe a result of decreased clearance of saliva.

Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or difficulty in swallowing the excess saliva which can lead to involuntary drooling.

It is usually caused by a neuromuscular dysfunction, hypersecretion, sensory dysfunction, or motor dysfunction. The most common cause is known as neuromuscular dysfunction.

Tips to manage hypersalivation

Ways to increase sensory awareness in the mouth:

Add sour and spicy foods like lemonade or salsa and cold foods such as frozen fruit or popsicles to the child’s diet to “wake up” the mouth

Apply flavored lip balm (containing only edible ingredients) to increase awareness.

Rub a variety of textured cloths around the child’s mouth.

Sometimes children just need a gentle reminder of the issue. Help them become aware of their drooling by deciding on a code word that alerts them to close their mouth.

Warm up activity suggestions

A Volcano of Bubbles

Fill a large bowl about half full of water. Add a few squirts of dishwashing liquid. A few drops of food colouring may be added too. Give the child a straw, preferably a curly, crazy straw and encourage them to blow into the water. The child should keep blowing until the bubbles spill over the rim of the bowl. This is a fun activity to do with two children. Small plastic animals can be placed at the bottom of the bowl and the children can time how long it takes until the animals are completely hidden.

Party Blower Target

Set up small animal figures on building blocks or cubes made of Lego. Ask the child to lie on their stomach in front of the figures. Using a large party blower (the ones that curl up and make a sound); the child can pretend to be a lizard or frog with a long tongue and knock down the figures. Lying on their stomach helps the child to regulate them and it is beneficial for proprioceptive feedback (see sensory integration). Other items can be used for the same game such as cut out cardboard figures.

Bubble Blowing

Use bubble mixture to blow a variety of shapes and sizes. Bubbles are a fun way of creating a different atmosphere in a room as they last awhile and the room can be filled with bubbles.


Crunchy foods are alerting and chewy foods are calming provide good sensory feedback for the mouth.. Observe the child's level of arousal or organisation and use the snacks throughout the day. Use them cautiously when doing movement activities.

Drippy Monsters

Create a fun “Drippy Monster” with a straw and paint. Choose colour of the individuals choice. Using bright colours can also be visually stimulating. Children can use a straw to blow the paint to create the body, arms, and legs of their monster. Oh and of course make sure that they give their monster an iris, pupil, and reflection of light in each eye!

Cup Race

Setting up a cup race. The first one to blow their cup to the end of the line wins! Blowing is a great oral motor exercise and this activity will keep blowing fun and exciting!

The set- up is pretty simple. Poke holes in the bottom of two plastic cups, with a pencil, thread a long piece of string through each cup and tie the ends to a couple of chairs, placed back to back, across the room from each other.The children will need to blow in the cups, to make them move. The first one to reach the opposite chair, with their cup, will be the winner.

Warming up exercises such as the one mentioned above are useful to practice before doing specific oral motor activities such as the one mentioned below:-

Oral Motor Awareness Activities

Individuals who have little awareness of their oral motor sensations or are hyposensitive may benefit from exercises that engage the oral motor movements as mentioned below after doing the warm up activities such as blowing bubbles, lip pouting, cheek puffing, chewing and so on.

Say "ooo" with exaggerated lip movement. Then say "eee." Combine them for "oo-ee." Really round the lips.

Say "puh" and pop the sound with emphasis.

Make a big smile. Relax and repeat.

Puff out the cheeks while keeping the lips sealed. Relax and repeat. Puff out one cheek, then the other, then both. Then puff out the upper lip followed by the lower lip (or vice versa). Relax and repeat.

Purse the lips to make a kiss. Slide the kiss to the right and then to the left or vice versa.

These exercises activate oral motor muscles and bring awareness to perform the above activities that further help to strengthen and manage hypersalivation.


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