Essence Elements of Drooling Elimination

By Pam Marshalla

Q: What do you do for drooling? Do I need to be a swallowing expert to do it?

I see drooling as a three-fold problem––

  • The child doesn’t swallow often enough.
  • The child doesn’t swallow well enough. (He doesn’t evacuate completely).
  • The child isn’t aware when saliva is building up in his mouth, on his lips, etc. (He doesn’t notice it or doesn’t care about it).

So my therapy addresses all three of these issues––

  • I teach them to swallow every 1.5 minutes while we engaged in our other speech/language activities. (I use an eyedropper to shoot 2ccs of icy cold water or apple juice into the mouth between closed lips, and I tell them, “Here it comes. Time to swallow.”) Over time I fade the dropper and liquid and teach a dry swallow.
  • I make sure they are swallowing correctly. (This is where the knowledge of correct swallow comes in. I do some feeding activities for this.)
  • I help them become more aware of saliva and drooling, and I help them care about this. I use mirrors and direct verbal information (e.g., “Oh-oh, you are getting all wet.” “We don’t like that wetness.” “Most people try to stay dry.” “Being dry is nice.”  “Mommy likes dryness.”)

For a broader approach please see my little book called How to Stop Drooling.

9 thoughts on “Essence Elements of Drooling Elimination”

  1. Hi Pam, I just purchased your book today and can’t wait to receive it. I have a 3.5 year old late crawler/walker/talker. He’s been in speech therapy for over a year and he still drools. He has no trouble eating or swallowing, but doesn’t seem to care at all about the wetness or mess. He’s a very messy boy 🙂

    1. Hey- If he is a “messy boy” as you say, my guess is that his drooling problem is integral to an eating/swallowing problem. Feeding therapy is the thing to do if you know how to do it.

  2. Hi Pam,
    My 2.5 year old son was a late walker and received PT to help strengthen his core at about 19-24 months. He can swallow a “dry swallow” when told to , and is prompted throughout the day to swallow and keep his chin dry, and catch his dripping mouth. He has been drinking from a straw sippy cup in which he needs to suck hard to pull up the drink, so I would assume that would be helping his lip strengthening. ( I even cut the straw shorter so he’ll need to suck even stronger). With all this, he is still drooling quite often (mostly when concentrating on a task) and I’m not sure where to go from here. What would you recommend?
    Thank you,

    1. Drooling occurs when a child (1) does not swallow often enough, or (2) does not swallow well enough, or (3) both. Not swallowing often enough usually is related to not paying attention to the build-up of saliva–not knowing that it is time to swallow—either because the saliva cannot be felt or because the client is simply ignoring the sensation. Not swallowing well enough usually means that there is a motor component–the muscles are not moving the tongue to swallow correctly, and this usually means that there is a feeding problem too. So the therapy usually has two components: (1) learning to pay attention to the sensation of saliva building up and (2) learning to move the tongue correctly for a correct swallow. Your son is only 2.5, but it sounds like he is relying on you to remind him to swallow. This urge needs to be made internal. It sounds like he is unaware of the saliva building up or dribbling out. Start with the concept of wet and dry. Teach him that it is better for kids to stay dry. Teach him that we stay dry by swallowing. When he is wet, tell him he is wet (don’t tell him to swallow). Let him figure out that since he is wet he needs to do something to make himself dry. Let him work it out. Maybe draw pictures of faces that are wet and those that are dry. “Oh no! This boys face is wet! What does he need to do?” I hope that helps get you started.

  3. I wanted to also add that his speech is pretty articulate for his age, besides for his vowels that sound really off. I also notice an increase in jaw sliding lately, even sometimes when his mouth is at rest. What would you recommend?
    Thanks for your time,

    1. Leeba– I have missed the first part of your post, so I am going to respond to just this part- If his jaw is sliding out of position and his vowels are off, he has dysarthria. Stabilize the jaw using a jaw stabilizer and work on all the vowels. Start with the three most different vowel (/i/ as in “beet”, /u/ as in “boot” and /a/ as in “Box”). Teach him to match your vowels by prolonging them and amplifying them in isolation. From there teach the vowels that occur between these extremes. I have a recording called “Vowel Tracks” that you may be interested in.

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