前流口水和后流口水是神经发育障碍儿童普遍存在的合并症。考虑到患者人群的异质性和流口水的多因素病因,跨学科和个性化的治疗方法是不可或缺的。然而,以前尚未开发出在儿科流口水治疗中逐步决策的工具.在RadboudumcAmalia儿童医院内,由唾液控制小组与来自六个学科的医疗保健专业人员协调对神经发育障碍继发的前和/或后流口水儿童的护理。与国际文献一致,公布的指导方针,从我们团队二十年的经验和研究中获得的证据,本文提出了一种反映我们临床应用的评估和治疗方法的算法。首先,提供指导以决定唾液控制治疗的必要性,采取流口水的类型,孩子的年龄,以及流口水的严重程度和影响。第二,该算法为可用的治疗方案之间的选择提供了指导,强调在临床(共享)决策中考虑儿童特征以及儿童和照顾者偏好的重要性。
结论:使用此算法,我们的目标是强调在评估和治疗儿童童年时期流口水时反复进行逐步决策的重要性,鼓励医疗保健专业人员采用整体方法。
背景:•继发于神经发育障碍的前或后流口水的儿童是一个异质性群体,需要个性化的治疗方法。•没有逐步决策工具可用于治疗儿科流口水。
背景:•决定唾液控制治疗的必要性应该是一个有意识的过程,根据流口水的类型,年龄,流口水的严重性和影响。•类型的流口水,年龄,认知,口腔运动技能,自我意识,姿势,诊断,和儿童/照顾者的偏好需要考虑,以决定最佳的治疗。
Anterior and posterior
drooling are prevalent comorbidities in children with neurodevelopmental disabilities. Considering the heterogeneity of the patient population and the multifactorial aetiology of
drooling, an interdisciplinary and individualised treatment approach is indispensable. However, no tool for stepwise decision-making in the treatment of paediatric
drooling has been developed previously. Within the Radboudumc Amalia Children\'s Hospital, care for children with anterior and/or posterior drooling secondary to neurodevelopmental disabilities is coordinated by a saliva control team with healthcare professionals from six disciplines. In alignment with international literature, published guidelines, and evidence gained from two decades of experience and research by our team, this paper proposes an algorithm reflecting the assessment and treatment approach applied in our clinic. First, directions are provided to decide on the necessity of saliva control treatment, taking type of drooling, the child\'s age, and the severity and impact of
drooling into account. Second, the algorithm offers guidance on the choice between available treatment options, highlighting the importance of accounting for child characteristics and child and caregiver preferences in clinical (shared) decision-making.
CONCLUSIONS: With this algorithm, we aim to emphasise the importance of repeated stepwise decision-making in the assessment and treatment of drooling in children during their childhood, encouraging healthcare professionals to apply a holistic approach.
BACKGROUND: • Children with anterior or posterior drooling secondary to neurodevelopmental disabilities comprise a heterogeneous group, necessitating an individualised treatment approach. • No stepwise decision-making tool is available for the treatment of paediatric drooling.
BACKGROUND: • Deciding on the necessity of saliva control treatment should be a conscious process, based on type of drooling, age, and
drooling severity and impact. • Type of
drooling, age, cognition, oral motor skills, self-awareness, posture, diagnosis, and child/caregiver preferences need to be considered to decide on the optimal treatment.