Développement d’un livret de rééducation pour la prise en charge de la sialorrhée antérieure chez les enfants atteints de paralysie cérébrale

Introduction

As part of the TOXSIALO-2 study (currently underway) on the drug treatment of drooling in children with cerebral palsy (CP), training material has been developed to intensify and standardize rehabilitation management.

Methods

A working group of experts (6 speech and language therapists, 1 occupational therapist, 2 rehabilitation doctors) in the care of CP children with persistent drooling has drawn up a booklet of exercises based on their clinical expertise, presented in an accessible and fun way, to be carried out daily at home as part of an approach based on individualized objectives.

Results

Using the Goal Attainment Scaling methodology, the booklet enables the functional goals to be defined with the child and his or her family (based on the difficulties encountered in daily life as a result of hypersialorrhoea). The therapist can then choose exercises that relate to the deficient skills and individualize them from among the 29 clearly illustrated exercises described in the booklet, divided into 4 key areas of swallowing: nasal breathing, oral sensory information, swallowing reflex and orofacial muscle strengthening. The booklet also enables therapists to monitor compliance with the rehabilitation program.

Discussion and conclusion

The booklet can help families to carry out self-rehabilitation or stimulation exercises at home to reduce sialorrhoea. In research, the booklet should also make it possible to better standardize oromotor rehabilitation associated with medical or surgical therapies in this indication, thereby improving the reliability of the therapy.