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Speaking of Apps

Drooling Over an App

Published July 9, 2012 8:30 AM by Megan Sutton
Sometimes there's a beautifully simple and inexpensive solution to a troublesome problem. The problem is drooling, and the solution has been installed on my iPad for months, but I've only recently come to appreciate the power of a little app called Swallow Now.

Every time you hear the click, you swallow - so simple, yet so effective. This interval timer can be set from 5-180 seconds. It also has options to use vibration or the Bluetooth earpiece on the iPhone to discretely cue the users to swallow their saliva. A spontaneous swallow of saliva happens about once per minute during waking hours in people with normal sensation. For those with decreased sensation, setting the app to go off every 30-60 seconds cues patients to swallow their saliva before it spills from their lips. This app is a perfect solution for stroke survivors with unilateral facial droop and numbness, as well as those with Parkinson's, MS, and other neurological conditions that reduce sensation.

 

 

After using this app for a period of time, users can develop a more consistent and frequent swallowing pattern that eliminates or reduces drooling, one of the most embarrassing sequelae of these conditions. Medications used to reduce saliva production can have undesired side effects; adding a medication to an already complicated regimen just for drooling also has its risks. This behavioral training program is a wonderful alternative and can be just as effective.

My patient just moved to rehab from acute care where she learned to rely on Yankauer suction for her saliva while being tube fed. Without suction available at the new facility, she quickly learned to dab at her lips with a towel or napkin. On day 2 of rehab, I tucked the iPod into her seatbelt and she successfully did not drool for hours, though her habit of wiping was still there. We're working on breaking that habit now, but I know that if this program had been implemented much earlier in her care, the results could have been even better.

Pros: The price ($2.99) is very reasonable. The sound it emits when the interval is reached is a very subtle wood-block knock; just loud enough to be heard without being too invasive. Nobody even needs to know you're using this app--the vibrate and Bluetooth options enable discrete use.

Cons: You have to turn off the sleep-mode on your device for it to keep working, which drains the battery pretty quickly. The app also advises that the vibration mode should not be used long-term, as that drains the battery even faster.  You can't use any other app while using this one, limiting your device to a single-function; ideally it would run in the background. The sliding timer bar can be difficult to set to an exact number.

 

Note: This app is also sold as part of the Speech Pathology Toolkit, a multi-function app that contains a voice recorder, delayed auditory feedback, sound level meter, speech amplifier, and text-to-speech for $23.99.  A promotional copy of this app was provided by the developer. 

3 comments

I like what you did but as you said it drains the battery very quickly. I bought the program but it is not very useful because

of reasons you have explained yourself. I wish could use it at the back ground on my IP5.

Tks

Martin July 13, 2015 12:53 PM
Toronto

Were are the drolings at? were they?

Hallie Pennel, CSC August 7, 2012 10:54 PM
Englwood OH

Thanks for this review Megan. It's fantastic to hear such a positive case with your patient and to know that Swallow Now is working out there for people. If anyone is interested the inspiration for this is from the 2001 paper, "Drooling in Parkinson's Disease: A Novel Speech and Language Therapy Intervention" by Marks et al. from the International Journal of Language and Communication Disorders. This paper found that 60% of people with sialorrhea secondary to Parkinson's Disease had improved saliva management after therapeutic use of a swallow reminder for a set period.

With the Swallow Now app we have tried to update the technology used and increase social acceptability. Thanks again and we'll definitely have a think about the areas for improvement in future upgrades! If anyone would like to ask anything about it, feel free to drop me a line (mike@speechlanguagesolutions.co.uk).

Mike Richards

Mike Richards July 9, 2012 1:47 PM

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About this Blog


    Speaking of Apps
    Occupation: Speech-Language Pathologist
    Setting: Rehabilitation
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