Excessive Spitting in a Child with CP

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    • Carrie, I have a low cognitive, 8 year old CP child who is constantly spitting. He is not able to communicate orally but we are in the process of having him evaluated for an eye gaze augmentative device. He has to chew on a tube or something all day or he will grind his teeth. By the end of the day his shirt is totally soaked. His spitting appears to be purposeful because after he does it, he laughs. We have tried ignoring, short time outs and we were going to try a surgical mask but his mother said she had tried it and he ripped it off. In two weeks he is going to have a Baclofen pump implanted in his spine to administer medication to help with his rigidity. The doctors have said it may increase or decrease his saliva issues, they are not sure either way. I’m at a loss. HELP!!

Figure out the Function:

      • Need to figure out the cause of the behavior.  If you have access to a behavioral specialist who can do a formal FBA, go that route.
      • If not, take data on the antecedent (what happens before the spitting, include observations about what happens in the environment, as well as with him, like does he start drooling or have excess saliva), the behavior itself (is it directed at anyone?), and the consequence (what do others do, how does the interaction with the child change).  Get as many data points as you can.
      • Look for patterns and try to figure out if he is using it to try to communicate something (escape, avoidance, attention, to get something) or if it seems to be purely sensory (too much saliva in the mouth, meeting a sensory need, etc.).

If you Can Figure Out the Function:

      • You may have to take a guess but try to figure out a different way for the student to get that need met or to communicate that thing and gradually replace the behavior.

If you Can’t Figure Out the Function:

    • If it seems very random, it may just be sensory and there may not be a lot you can do.  Ask the OT to get involved with providing the child with extra oral sensory input during the day or work on teaching the child to swallow more (or use suction) to decrease saliva build-up.