**Results**

The composite GAS is transformed into a standardized measure with a mean of 50. If goals are set in an unbiased fashion, one would expect a normal distribution of scores, and the GAS thus performs at the interval level. If goals have been fully achieved, we would expect to see a score of 50 (**Table 1**).

Results indicated that IQoro does improve saliva control in children with CP, with improvements also demonstrated with oral motor skills. Using the measures of articulation, there was no change to speech. However, changes to voice were observed in the qualitative analysis (**Table 2**).


#### **Table 1.**

*Results showing GAS scores pre and post-treatment*.

**Table 2.** *Improved outcomes in swallowing and oral motor skills, but not speech.*

#### **Discussion, quantitative and qualitative analysis**

In this study, it has been possible to demonstrate an improvement with saliva control resulting from treatment using IQoro. On average, ratings reduced from 4 ("unable to control", saliva loss 75–100% of the time) to 2 ("moderate difficulty", saliva loss 25–50% of the time). However, at least half of the participants improved further to a score of 1 ("mild difficulty", saliva loss 10–25% of the time).

Qualitative data reported (but not measured) saw improvements with: teeth brushing; nasal breathing; breath control for speech; reduction in chest infections; sensory feedback (perception of saliva on chin) and tongue retraction. Positive feedback has been received from schools (less damage from saliva to IT equipment and worksheets) and physio colleagues (able to work in supine for longer periods due to an increase in swallowing of secretions).

Future plans include creating an assessment protocol and running a training program. Further research is indicated to see if this would be a cost-effective treatment that could be made available on the NHS.

#### **Conclusion**

It has been the case that there is a severe lack of options in treating children and young people with Cerebral Palsy with dysfunction that leads to drooling. Existing medication and surgical intervention alternatives are often ineffective, invasive, and even not strictly approved for patients in these age groups. Many medication alternatives are expensive when compared with IQoro treatment.

IQoro has been proved to be a suitable treatment for the group studied, including those at the higher end of the scale of motoric and other difficulties. In the case of some of the latter, two assistants were required to perform the training.

Swallowing and oral motor competence improved significantly to a level around the 50-point target of the GAS goals, although the measured speech ability did not. Other functions and abilities important in daily life also improved as reported above.

Much-improved drooling and saliva control had great influence in improving the patients' quality of life, not least where it allowed the use of laptops, books, and other educational material in schools.

#### *7.1.1.5 Study: IQoro dysphagia therapy in an NHS setting: A service evaluation*

Roseanne, Exell 1; Hayley McBain 2; Sam Turvey 2; Gill Hardy 1

1.Royal Devon and Exeter NHS Foundation Trust

2. South West Academic Health Science Network

A service evaluation was carried out in southern England in 2020 resulting in the following abstract.

#### **Background**

This evaluation explored the introduction of IQoro into a National Health Service (NHS) setting.

### **Method**

Patients with chronic dysphagia were recruited from acute and community settings and completed a 12-week program using IQoro. Clinical and well-being measures were taken pre and post-training. Feedback was gained from the Speech and Language Therapists delivering this program.

#### **Results**

25 patients were recruited into the evaluation, 21 completed the program. There were significant improvements in self-reported quality of life scores, including the
