{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:45:27Z","timestamp":1783035927979,"version":"3.54.6"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T00:00:00Z","timestamp":1573689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine changes in objective and subjective drooling severity measures after submandibular botulinum neurotoxin A injection in children with neurodevelopmental disabilities, explore their relationship, and evaluate if clinically relevant responses relate to changes in the impact of drooling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This longitudinal, observational cohort study involved 160 children (92 males, 68 females; 3\u201317y, mean 9y 1mo, SD 3y 6mo) treated between 2000 and 2012 at the Radboud University Medical Center, Nijmegen, the Netherlands. Repeated measures analysis of variance was used to compare the 5\u2010minute Drooling Quotient (DQ5) and Visual Analogue Scale (VAS) for drooling severity pretreatment and posttreatment, and Pearson\u2019s rho to assess their association. A parent questionnaire was used to assess drooling impact in responders (defined as \u226550% reduction in DQ5 and\/or \u22652 SD reduction in VAS for drooling severity 8wks postintervention) and non\u2010responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and twelve children (70%) were responders. Their mean VAS for drooling severity and DQ5 scores were significantly lower 32 weeks postintervention compared to baseline. At baseline, the VAS for drooling severity\u2010DQ5 relationship was \u2018weak\u2019 (<jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>=0.15, <jats:italic>p<\/jats:italic>=0.060), whereas it was \u2018fair\u2019 at 8 weeks\u00a0(<jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>=0.43, <jats:italic>p<\/jats:italic>=0.000) and 32 weeks (<jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>=0.30, <jats:italic>p<\/jats:italic>=0.000). For responders, a significant change was found regarding the impact of drooling on daily care and social interactions at 8 weeks after intervention; most of these effects were maintained at 32 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>A clinically relevant response based on a combination of objective and subjective measures of drooling severity was accompanied by positive changes regarding the impact of drooling on daily care and social interactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Botulinum neurotoxin A injection into the submandibular glands reduced drooling severity in 70% of children with neurodevelopmental disabilities.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Objective (5\u2010minute Drooling Quotient) and subjective (Visual Analogue Scale for drooling severity) measures correlated 8 and 32 weeks after treatment.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Objective and subjective measures complemented each other when changes in drooling severity were assessed.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Reduced drooling severity was accompanied by positive changes with regard to the impact of drooling.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14391","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T04:17:58Z","timestamp":1573791478000},"page":"354-362","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Changes in severity and impact of drooling after submandibular gland botulinum neurotoxin A injections in children with neurodevelopmental disabilities"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-3450","authenticated-orcid":false,"given":"Karen","family":"Van Hulst","sequence":"first","affiliation":[{"name":"Radboud University Medical Center Donders Institute for Brain Cognition and Behaviour Department of Rehabilitation Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan JW","family":"Van Der Burg","sequence":"additional","affiliation":[{"name":"Rehabilitation Center Sint Maartenskliniek Department of Rehabilitation Nijmegen the Netherlands"},{"name":"Radboud University School of Pedagogical and Educational Science Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H","family":"Jongerius","sequence":"additional","affiliation":[{"name":"Rehabilitation Center Sint Maartenskliniek Department of Rehabilitation Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander CH","family":"Geurts","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Donders Institute for Brain Cognition and Behaviour Department of Rehabilitation Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrie E","family":"Erasmus","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Donders Institute for Brain Cognition and Behaviour Department of Pediatric Neurology Nijmegen the 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