ABSTRACT
Drooling may be a normal feature in young children up to the age of 4 years, and occasionally slightly older than this in children whose development is otherwise normal. About a third of the children seen in the clinic aspirate as well as drool. The presence of aspiration makes a difference to almost all of the decision-making in the clinic. It is very useful to have the opinion of an experienced speech and language therapist in clinic. They can assess oral motor skills appropriate for the child's age and development, and can judge likely ability and motivation to comply with behavioural therapy. In order to minimize complications, it is important to consider which botulinum toxin preparation to use and to place the injections accurately. Surgery has an advantage over botulinum toxin in that it is a one-off intervention with long-lasting results, but obviously surgery comes with risks and discomforts and the need for a general anaesthetic.
