Rehabilitation of salivation

  Swallowing activity consists of a complex and continuous series of excitatory and inhibitory processes in the oral cavity, pharynx, larynx and esophageal muscles, which are generally divided into oral, pharyngeal and esophageal phases. The coordination of the swallowing process is controlled by the swallowing center in the brainstem reticular formation, and damage to the center can cause salivation. In children with cerebral palsy with salivation, the swallowing and esophageal phases of the swallowing activity are no different from those of normal children, mainly because the coordination of the oral muscles is significantly impaired and the pharyngeal muscles are poorly developed. Early training will not only help the child’s language development, but also strengthen the parents’ confidence in the child’s treatment.  Treatment methods (1) Functional training includes sucking and empty swallowing. Sucking method: You can let the child suck his own finger, so that he can experience the feeling of sucking, and then move on to sucking a thicker soft straw, and slowly move on to the usual straw we use. Empty swallowing method: This action is difficult for young children to cooperate, but we can use the child’s favorite snacks to induce this empty swallowing action, the therapist can hold the child’s favorite snacks, put them next to his mouth and give the command “ah”, so that the child will do an empty swallowing action, which can also This will increase the child’s interest in training.  (2) Lip smacking Method: Let the child practice lip smacking every day, as long as the child can cooperate, and practice until it does not flow. Many children are not very cooperative, we can put some honey on his lips, so that he will lick, lips closed, increase the strength of the lip muscle, so as to achieve the training effect.  (3) Tongue activity Method: First, train the child to do the tongue activity on his own initiative, including: flat stretching, tongue spreading, left and right, up and down activities in several directions, because the child’s control and coordination ability is poor, it is difficult to move to the full, so after the active training is completed, the therapist wraps the child’s tongue with a small clean towel, and then carry out the passive activities in these directions.  (4) Blowing training Methods: blowing blisters, blowing balloons, blowing long noses, etc. This can train the child’s airflow control and enhance the strength of the lip muscles.  (5) Swallowing training Method: Use cotton swabs dipped in ice water to gently stimulate the posterior pharyngeal wall, tongue root, tongue surface, and soft palate, and ask the child to do empty swallowing action. Cold stimulation can effectively strengthen the swallowing reflex and promote strong swallowing. Mendelson swallowing technique: The therapist promotes swallowing by pushing the larynx manually, i.e., as soon as the larynx starts to lift, the therapist places the thumb and index finger under the cricoid cartilage, gently pinches the larynx and pushes up on the larynx, and then fixes it. Note that the larynx should be felt to lift up first, and then consciously held in the upward position after the upward lift is induced. This method can increase the amplitude of laryngeal elevation during swallowing and prolong the time of keeping it from descending after elevation, thus also increasing the width and time of cricopharyngeal segment opening and playing a therapeutic role.  (6) Pronunciation training Pronunciation training can practice the coordination of the oral muscles of the child, by: pronouncing “a” “u” “y” “b ” “m” sound, each sound is pronounced 10 times, 2 to 3 times a day.  (7) Oral muscle massage For uncooperative children, mouth muscle strength training can be performed passively, and the therapist helps them to perform grinning, round lip, and double lip closure training. In combination with pressing the acupuncture points such as Dicang, Cheek Cheeks, and Shimonoseki, each point is pressed for 3 minutes.  (8) Behavioral therapy Behavioral therapy is applied to reinforce, for example, when the child does not drool, parents should verbally praise or reward the child’s favorite snacks, on the contrary, if the child drools, parents should remind the child to swallow saliva.  The above methods are adhered to training for 3 months as a course of treatment, which can receive better treatment effect.