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Collecting Saliva is Hard – Here Are Some Ways to Make it Easier

Photo of a woman swabbing a boy's cheek to obtain saliva

Emily Singer

Date Published: March 19, 2020

For Natalie Cuzcu, mother of twin girls who have autism, the most challenging part of joining SPARK was collecting the saliva samples. Saliva is an important component of SPARK’s research. Scientists collect DNA from saliva and then analyze the DNA for gene changes that are linked to autism.

Cuzcu’s twins are young and easily overwhelmed, so she worried that they wouldn’t be able to complete the process. It can take up to half an hour to collect the required teaspoon of spit. Cuzcu had help from a staff member at the Seattle Children’s Autism Center, who has developed different strategies to help collect saliva in children.

The staff member sometimes counts or sings to distract them or reduce stress. For those who are having an especially hard time, she might spread the process over a few sessions. She’ll show them the collection sponge and practice the first steps of the process to help them get comfortable. In Cuzcu’s case, she collected the sample as the girls were sleeping in their car seats.

If you’re having trouble collecting saliva, here are some tips to help.

Consider where to collect the sample

  • Choose an area that has few distractions and where you or your child can sit, such as a chair, couch, or table.

Decide which method to use to collect the sample

  • Will you or your child be able to produce about a teaspoon of saliva? If not, try collecting it using the sponge. Instructions for both methods are included in the kit.

Think about how to encourage your child or another person during the process

  • Use non-edible rewards, such as bubbles, a preferred toy, coloring, or a tablet during or after the collection.
  • Allow the person to choose a special snack AFTER they have given the saliva sample. It is important not to eat 30 minutes before or during the collection.
  • Make spit collection fun and engaging! Use LOTS of praise and reinforcement.
    • Be encouraging and offer verbal praise or high fives when the person spits or tolerates the sponge.
    • Praise effort and small successes. This builds momentum and helps the person feel successful throughout the spit collection.
    • Some people respond well to treating spit collection as a game. For example, there can be a “race” among family members to fill their tubes.
  • Provide choices. Allow the person to choose:
    • Where they want to sit — such as the specific chair or room — during the process.
    • Whether to sit or stand.
    • What kind of toy they want to play with during the collection.
    • What kind of reward they want afterwards.
  • Take breaks as needed to minimize frustration and fatigue.

For sponge-based collection

To help produce saliva

  • Place the sponge in the parts of the mouth that produce the most saliva.
    • Place the sponge under the tongue or next to one of the jaws.
  • On the outside of the mouth, stimulate saliva production by gently rubbing the cheeks behind the back teeth.
    • Any stimulation involving taste, smell, or chewing motions of the jaw will also help to produce more saliva.
  • Stay hydrated
    • Staying well hydrated throughout the day and drinking water prior to the collection (but not within the 30 minute time frame before the collection) can also help with saliva production.

Take breaks

  • Have the person put the sponge in their mouths for 30 seconds to 1 minute to earn a brief break of 1 to 2 minutes. Offer a toy or other rewarding activity during breaks.
  • Be clear about how to earn breaks or rewards. Use ‘First-Then’ strategies, such as:
    • ‘FIRST you spit or sponge, THEN you get bubbles.’
  • Use counting strategies, such as:
    • ‘Spit 3 more times and then we can take a break.’
    •  Count to 10 with the sponge in mouth and then earn a break.
  • This also allows you time to get the saliva off of the sponge.
  • Repeat this process until you have enough saliva to fill to the line on the collection tube.

Distractions can help

  • Enjoyable tasks, such as watching a movie on a tablet, can help distract people who are having a hard time.
    • Encourage the person to open their mouth and accept the sponge while the movie is playing.
    • If the person refuses the sponge, pause the movie until they accept it. Or try one of the other strategies, such as the ‘First-Then’ strategy mentioned above.

Break the process into steps

  • Some people who have autism are anxious about new things. It can be helpful to introduce and reward each step in the process to gradually get people used to it.
  • For example, start by having the person open his or her mouth and briefly touch the sponge to the lips. Then briefly touch the sponge to the inside of the mouth or tongue. Gradually build up tolerance to have the sponge in the mouth for an extended period of time.
  • Reinforce and praise each successful step during the spit collection.

Get the most saliva out of the sponge

  • Once a sponge has collected saliva, twist the sponge at the top of the tube to wring out the most saliva, rather than scraping.

Learn more by watching our collection videos

View SPARK’s saliva collection videos on YouTube.