Effectiveness of oral motor therapy on drooling in children with severe mental handicap (SMH)

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Effectiveness of oral motor therapy on drooling in children with severe mental handicap (SMH)


Author: Chan, Tsz-man
Title: Effectiveness of oral motor therapy on drooling in children with severe mental handicap (SMH)
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Children with mental disabilities -- Behavior modification.
Drooling -- Prevention.
Oral habits.
Motor learning.
Department: Dept. of Rehabilitation Sciences
Pages: ix, 58 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2174196
URI: http://theses.lib.polyu.edu.hk/handle/200/915
Abstract: The purpose of this study was to examine the effectiveness of oral motor therapy on drooling for children with severe mental handicap. We received written informed consent from the guardians of 18 children to join the study. These 18 participants were randomly assigned into Group A (n=9) and Group B (n=9). Group A act as experimental group, with oral motor home program and Group B act as comparision group with once a week oral motor therapy. A mixed design repeated measure was employed in this study, i.e. the baseline assessment phase (Al) followed by a three-month treatment phase (T phase), and then the post treatment evaluation (A2). Outcome measures consisted of 1) measurement of drooling: objective drooling rate measurement by weight changes on the absorbent bib in three 30 minutes lessons, subjective measures of drooling severity and frequency perceived by caregivers; 2) measurement of oral motor ability, underling cause of drooling, by Beckman Oral Motor Assessment protocol; 3) measurement of secondary effect of drooling: subjective measures of effect of drooling on learning, daily living and hygiene perceived by caregivers. During the treatment phase, an introductory session on the basis of drooling management and oral motor therapy was delivered to the caregivers, followed by individual coaching for caregiver on the individualized protocol for their children. In addition, each caregiver received a Homework Package that included the tools for the therapy, and guidelines and instructions sheet with oral motor therapy techniques diagrams. It was then followed by weekly review sessions on the techniques. In terms of drooling conditions, Group A showed significantly more improvement for objective measure - the drooling rate (p=0.031), as well as the subjective measures - including the severity of drooling (p=0.003) and borderline significant improvement in frequency of drooling ((p=0.057). Eight variables (Lower lip strength, Left upper and lower cheek range, right lower cheek range, right and left cheek strength, and right and left jaw strength) in the oral motor aspect were shown to have significantly better results for participants in Group A experimental group than in Group B comparison group after the treatment phase (p<0.05). For the secondary effect of drooling, impact of daily living and learning were having more significant improvement in Group A experimental group that in Group B comparison group (p=0.13). This study demonstrated the effect of oral motor home program to better control drooling than the weekly oral motor individual training. Further study was recommended on investigating: (1). the long term effect of oral motor therapy; (2). assessment and intervention targeting on swallowing abilities which is another important cause of drooling; and (3). The effect of oral motor therapy on other oral motor related function of the children (e.g. eating and drinking).

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