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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Validity, Reliability and Application of the Paediatric Posterior Drooling Scale.

Denise C R M Koeken1, Karen van Hulst2, Marloes L J Lagarde2

  • 1Rijndam Rehabilitation, Rotterdam, the Netherlands.

Child: Care, Health and Development
|November 14, 2025
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Summary

The Paediatric Posterior Drooling Scale (PPDS) is a valid and reliable tool for speech-language pathologists to screen posterior drooling in children with neurological disorders. This non-invasive method aids in early detection and management, reducing respiratory complications.

Keywords:
central neurological disorderscervical auscultationdroolingoropharyngeal dysphagiapaediatric

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Area of Science:

  • Pediatric Neurology
  • Speech-Language Pathology
  • Clinical Assessment Tools

Background:

  • Posterior drooling is a common issue in children with neurological disorders, often linked to oropharyngeal dysphagia.
  • Early identification and management are crucial for reducing associated respiratory complications.

Purpose of the Study:

  • To evaluate the construct validity, inter-rater, and intra-rater reliability of the novel Paediatric Posterior Drooling Scale (PPDS).
  • To assess the clinical applicability of the PPDS as a screening tool for posterior drooling in pediatric patients.

Main Methods:

  • A cross-sectional observational study involving 69 children (aged 1-18 years) with central neurological disorders.
  • Cervical auscultation (CA) was performed by trained speech-language therapists (SLTs).
  • Convergent construct validity was assessed using the Functional Oral Intake Scale (FOIS) and the Eating and Drinking Ability Classification System (EDACS).

Main Results:

  • The PPDS demonstrated moderate negative correlation with FOIS (rho=-0.54, p<0.001) and moderate positive correlation with EDACS (rho=0.70, p<0.001).
  • Excellent intra-rater reliability (ICC=0.91, p<0.001) and good inter-rater reliability (ICC=0.85, p<0.001) were observed.
  • High test-retest reliability was noted, with 84% agreement for a score of 0.

Conclusions:

  • The PPDS is a valid, reliable, and clinically applicable tool for SLTs to screen posterior drooling non-invasively.
  • Efficient identification of posterior drooling via PPDS can improve clinical management and reduce respiratory issues.
  • The PPDS serves as a bridge to instrumental assessment, guiding further diagnostic steps for pediatric posterior drooling.