<?xml version="1.1" encoding="utf-8"?>
<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">JCNR</journal-id><journal-title-group><journal-title>Journal of Clinical and Nursing Research</journal-title></journal-title-group><issn>2208-3685</issn><eissn>2208-3693</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/jcnr.v10i3.13998</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>Summary of the Best Evidence for Treatment and Management of Drooling in Children with Cerebral Palsy Based on Evidence-Based Approach</title><url>https://artdesignp.com/journal/JCNR/10/3/10.26689/jcnr.v10i3.13998</url><author>ZhouQinghuan,LiuHui,ZhouLingli,HuZhoujing,TianXingqin</author><pub-date pub-type="publication-year"><year>2026</year></pub-date><volume>10</volume><issue>3</issue><history><date date-type="pub"><published-time>2026-04-21</published-time></date></history><abstract>Objective: Literature review on the treatment and management of drooling in children with cerebral palsy was conducted. The literature was screened, evaluated, and compiled into an optimal evidence table to provide evidence-based reference for the treatment and management of drooling in children with cerebral palsy. Methods: A systematic search was conducted in the following databases for relevant evidence on the treatment and management of drooling in children with cerebral palsy: BMJ Best Practice, CINAHL, Cochrane Library, Clinical Trials, Embase, PubMed, UpToDate, Web of Science, GIN (Global Institution for Instruction), NGC (National Center for Health and Care Excellence), NICE (National Institute for Health and Care Excellence), JBI (Journal of the Institute of Evidence-Based Healthcare), Ontario Registered Nurses Association, SIGN (Scotland Institute of Instructions), Med live, CNKI (China National Knowledge Infrastructure), Chinese Medical Association, China Biomedical Research Center, Wan fang Data, and VIP (VIP Database). The literature types included guidelines, expert consensus, best clinical practice, evidence summaries, systematic reviews and randomized controlled trials. The search period was from database inception to July 30, 2025. All evidence related to the treatment and management of drooling in children with cerebral palsy was compiled, identified, and summarized to form the best evidence system. Results: A total of 22 articles were included, comprising 5 guidelines, 9 systematic reviews and systematic summaries, 3 expert consensus statements, and 5 randomized controlled trials. The optimal evidence framework contained 28 pieces of best evidence covering 10 aspects, including multidisciplinary team collaboration, comprehensive step-by-step assessment, overall treatment principles, behavioral therapy, physical therapy, drug therapy, intraglandular botulinum toxin injection, surgical treatment, radiotherapy, and dynamic follow-up. Conclusion: The best evidence summarized in this study is scientific and systematic. Healthcare professionals can use this best evidence to develop targeted interventions to alleviate drooling symptoms, reduce complications, and improve treatment efficacy and quality of life in children with cerebral palsy. Furthermore, when developing treatment plans, it is crucial to comprehensively consider the specific clinical context of the child with cerebral palsy, treatment effectiveness, follow-up adjustment results, and the wishes of both the child and caregivers.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Patel D, Bovid K, Rausch R, et al., 2024, Cerebral Palsy in Children: A Clinical Practice Review. Current Problems in Pediatric and Adolescent Health Care, 54(11): 101673.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>Walshe M, Smith M, Pennington L, 2012, Interventions for Drooling in Children with Cerebral Palsy. Cochrane Database of Systematic Reviews: CD008624.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B3" content-type="article"><label>3</label><element-citation publication-type="journal"><p>Reid S, McCutcheon J, Reddihough D, et al., 2012, Prevalence and Predictors of Drooling in 7- to 14-Year-Old Children with Cerebral Palsy: A Population Study. Developmental Medicine and Child Neurology, 54: 1032–1036.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B4" content-type="article"><label>4</label><element-citation publication-type="journal"><p>Reddihough D, Erasmus C, Johnson H, et al., 2010, Botulinum Toxin Assessment, Intervention and Aftercare for Paediatric and Adult Drooling: International Consensus Statement. European Journal of Neurology, 17(S2): 109–121.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B5" content-type="article"><label>5</label><element-citation publication-type="journal"><p>Speyer R, Cordier R, Kim J, et al., 2019, Prevalence of Drooling, Swallowing, and Feeding Problems in Cerebral Palsy across the Lifespan: A Systematic Review and Meta-Analyses. Developmental Medicine and Child Neurology, 61(11): 1249–1258.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B6" content-type="article"><label>6</label><element-citation publication-type="journal"><p>Glader L, Delsing C, Hughes A, et al., 2017, AACPDM Care Pathway for Sialorrhea in Cerebral Palsy, visited on 2025-12-31, http://www.aacpdm.org/publications/care-pathways/sialorrhea.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B7" content-type="article"><label>7</label><element-citation publication-type="journal"><p>Delsing C, Bekkers S, Erasmus C, et al., 2021, Posterior Drooling in Children with Cerebral Palsy and Other Neurodevelopmental Disorders. Developmental Medicine and Child Neurology, 63: 1093–1098.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B8" content-type="article"><label>8</label><element-citation publication-type="journal"><p>van der Burg J, Jongerius P, van Limbeek J, et al., 2006, Social Interaction and Self-Esteem of Children with Cerebral Palsy after Treatment for Severe Drooling. European Journal of Pediatrics, 165(1): 37–41.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B9" content-type="article"><label>9</label><element-citation publication-type="journal"><p>Saniasiaya J, van der Meer G, Toll E, 2024, Drooling in Developmentally Normal Children: A Review. Journal of Laryngology and Otology, 138(11): 1061–1064.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B10" content-type="article"><label>10</label><element-citation publication-type="journal"><p>Hu Y, Zhou Y, 2021, Evidence-Based Nursing: Theory and Practice of Evidence-to-Clinic Translation. Fudan University Press.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B11" content-type="article"><label>11</label><element-citation publication-type="journal"><p>Gibson N, Blackmore A, Chang A, et al., 2021, Prevention and Management of Respiratory Disease in Young People with Cerebral Palsy: Consensus Statement. Developmental Medicine and Child Neurology, 63(2): 172–182.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B12" content-type="article"><label>12</label><element-citation publication-type="journal"><p>National Institute for Health and Care Excellence, 2017, Cerebral Palsy in Under 25s: Assessment and Management.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B13" content-type="article"><label>13</label><element-citation publication-type="journal"><p>Zhang J, Li X, Tang J, et al., 2022, Interpretation of the Core Content of China Cerebral Palsy Rehabilitation Guidelines (2022). Chinese Journal of Practical Pediatric Clinical Medicine, 37(24): 1841–1853.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B14" content-type="article"><label>14</label><element-citation publication-type="journal"><p>Bekkers S, van Ulsen K, Adang E, et al., 2020, Cost-Effectiveness of Botulinum Neurotoxin A versus Surgery for Drooling: A Randomized Clinical Trial. Developmental Medicine and Child Neurology, 62(11): 1302–1308.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B15" content-type="article"><label>15</label><element-citation publication-type="journal"><p>Bekkers S, Pruijn I, van der Burg J, et al., 2021, Surgery versus Botulinum Neurotoxin A to Reduce Drooling and Improve Daily Life for Children with Neurodevelopmental Disabilities: A Randomized Controlled Trial. Developmental Medicine and Child Neurology, 63(11): 1351–1359.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B16" content-type="article"><label>16</label><element-citation publication-type="journal"><p>Xu K, Xiao N, Huang Z, 2020, Rehabilitation Recommendations for Motor Disorders in Children with Cerebral Palsy. Chinese Journal of Pediatrics, 58(2): 5.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B17" content-type="article"><label>17</label><element-citation publication-type="journal"><p>Rodwell K, Edwards P, Ware R, et al., 2012, Salivary Gland Botulinum Toxin Injections for Drooling in Children with Cerebral Palsy and Neurodevelopmental Disability: A Systematic Review. Developmental Medicine and Child Neurology, 54(11): 977–987.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B18" content-type="article"><label>18</label><element-citation publication-type="journal"><p>Lam K, Hung A, Lau K, et al., 2024, Effects of Elastic Therapeutic Taping on Reducing Drooling in Children with Neurological Disorders: A Systematic Review of Randomized Controlled Trials. Journal of Neurodevelopmental Disorders, 16(1): 68.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B19" content-type="article"><label>19</label><element-citation publication-type="journal"><p>Oad H, Maltezeanu A, da Silva S, et al., 2024, Onabotulinum Toxin A for Drooling in Children: A Systematic Review and Meta-Analysis. Laryngoscope, 134(7): 3012–3017.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B20" content-type="article"><label>20</label><element-citation publication-type="journal"><p>Dias B, Fernandes A, Maia H, 2017, Treatment of Drooling with Sublingual Atropine Sulfate in Children and Adolescents with Cerebral Palsy. Arquivos de Neuro-Psiquiatria, 75(5): 282–287.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B21" content-type="article"><label>21</label><element-citation publication-type="journal"><p>Hung S, Liao C, Lin W, et al., 2021, Botulinum Toxin Injections for Treatment of Drooling in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis. Children, 8(12): 1089.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B22" content-type="article"><label>22</label><element-citation publication-type="journal"><p>Banzato A, Cerchiari A, Pezzola S, et al., 2022, Evaluation of the Effectiveness of Functional Chewing Training Compared with Standard Treatment in a Population of Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials. Children, 9(12): 1876.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B23" content-type="article"><label>23</label><element-citation publication-type="journal"><p>Fan Q, Wu Z, Yu X, et al., 2020, A Prospective Randomized Controlled Study on the Treatment of Oral Motor Dysfunction in Children with Cerebral Palsy by Chewing Function Training. China Contemporary Pediatrics Journal, 22(6): 567–572.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B24" content-type="article"><label>24</label><element-citation publication-type="journal"><p>Fayoux P, Dinomais M, Shaw H, et al., 2024, Glycopyrronium 320 μg/mL in Children and Adolescents with Severe Sialorrhoea and Neurodisabilities: A Randomized Double-Blind Placebo-Controlled Trial. Developmental Medicine and Child Neurology, 66(7): 910–918.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B25" content-type="article"><label>25</label><element-citation publication-type="journal"><p>Orriëns L, de Groot S, van der Burg J, et al., 2024, Interdisciplinary Assessment and Treatment of Paediatric Drooling: Two Decades of Experience by the Nijmegen Saliva Control Team Reflected in a Stepwise Algorithm. European Journal of Pediatrics, 183(9): 3979–3985.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B26" content-type="article"><label>26</label><element-citation publication-type="journal"><p>National Institute for Health and Care Excellence, 2017, Severe Sialorrhoea in Children and Young People with Chronic Neurological Disorders: Oral Glycopyrronium Bromide.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B27" content-type="article"><label>27</label><element-citation publication-type="journal"><p>National Institute for Health and Care Excellence, 2019, Xeomin (Botulinum Neurotoxin Type A) for Treating Chronic Sialorrhoea.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B28" content-type="article"><label>28</label><element-citation publication-type="journal"><p>Sforza E, Onesimo R, Leoni C, et al., 2022, Drooling Outcome Measures in Paediatric Disability: A Systematic Review. European Journal of Pediatrics, 181(7): 2575–2592.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B29" content-type="article"><label>29</label><element-citation publication-type="journal"><p>Bai Z, Wang M, Lü X, 2024, Systematic Review of the Efficacy of Intrasalivary Botulinum Toxin Injection in Treating Drooling Caused by Cerebral Palsy. China Journal of Rehabilitation Medicine, 39(7): 1027–1031.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B30" content-type="article"><label>30</label><element-citation publication-type="journal"><p>Meningaud J, Pitak-Arnnop P, Chikhani L, et al., 2006, Drooling of Saliva: A Review of the Etiology and Management Options. Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, 101(1): 48–57.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B31" content-type="article"><label>31</label><element-citation publication-type="journal"><p>Riva A, Amadori E, Vari M, et al., 2022, Impact and Management of Drooling in Children with Neurological Disorders: An Italian Delphi Consensus. Italian Journal of Pediatrics, 48(1): 118.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B32" content-type="article"><label>32</label><element-citation publication-type="journal"><p>Porte M, Chaléat-Valayer E, Patte K, et al., 2014, Relevance of Intraglandular Injections of Botulinum Toxin for the Treatment of Sialorrhea in Children with Cerebral Palsy: A Review. European Journal of Paediatric Neurology, 18(6): 649–657.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B33" content-type="article"><label>33</label><element-citation publication-type="journal"><p>Platt M, Krageloh-Mann I, Cans C, 2009, Surveillance of Cerebral Palsy in Europe: Reference and Training Manual. Medical Education, 43(5): 495–496.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B34" content-type="article"><label>34</label><element-citation publication-type="journal"><p>Piscitelli D, Ferrarello F, Ugolini A, et al., 2021, Measurement Properties of Functional Classification Systems in Cerebral Palsy: A Systematic Review with Meta-Analysis. Developmental Medicine and Child Neurology, 63(11): 1251–1261.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B35" content-type="article"><label>35</label><element-citation publication-type="journal"><p>Rosenbaum P, 2020, How Do We Know if Interventions in Developmental Disability Are Effective. Developmental Medicine and Child Neurology, 62(12): 1344.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B36" content-type="article"><label>36</label><element-citation publication-type="journal"><p>Silva J, Faria L, Almeida R, et al., 2022, Effectiveness and Safety of Botulinum Toxin in Comparison with Surgery for Drooling in Paediatric Patients with Neurological Disorders: A Systematic Review. British Journal of Oral and Maxillofacial Surgery, 60(5): e691–e701.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
