Dear Doctor;

My child has speech difficulty and can hardly say a word without spitting. Saliva seems to always precede a word the child says. Also, he likes biting his tongue while sticking it out. We have tried urging and forcing him in vain. He is now six and growing. We want to help him. Is there a medical way to correct these? Frank. 

Dear Frank, 

Excess saliva in a 6-year-old child can be due to various reasons. Infections in the throat, in and around teeth like on gum or tongue  can cause excess salivation. This may be associated with pain on the affected part and around it, swelling, difficulty in speaking as well as eating. Fever may be present of absent. However, if none of these symptoms are present, then this could be just a manifestation of anxiety. Children also do something unknowingly and if they like the action, they may repeat it innocently just for the fun of it.  It could be part of obsessive compulsive disorder where an individual tends to repeat the same actions. You need not worry about this issue.  Get this child examined by a pediatrician to exclude any local infection, which if present can be treated. Just watch the child closely. Whenever he is about to spit or has just spitted try to divert his attentions by suggesting some enjoyable games, or conversation which is of interest to him. Try to keep him busy creatively. But do not criticise or scold him about this. Do not push him hard for studies, he is still  young. The stress generated by studies may be contributory for this habit