Validity, Reliability and Application of the Paediatric Posterior Drooling Scale.
Denise C R M Koeken, Karen van Hulst, Marloes L J Lagarde and 3 others
PMID 41236173WHAT IT FOUND
The Paediatric Posterior Drooling Scale reliably identifies saliva pooling in the airway when scored by trained speech therapists.
It correlates with eating ability but shows poor consistency over time, so it should be used as part of a broader assessment rather than a standalone diagnostic tool.
Key findings
01The scale showed good agreement between different trained raters (87% perfect agreement) and excellent consistency when the same rater scored the same recording twice (92% perfect agreement).
02Scores correlated moderately with established measures of eating and drinking ability, supporting its validity as a measure of swallowing function.
03Test-retest reliability over four weeks was poor, with only 84% agreement and no statistical significance, indicating posterior drooling severity fluctuates over time.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study population was skewed toward children with normal saliva control (68% scored zero), which may have inflated agreement statistics because 'no drooling' is easier to identify than 'some drooling'. Test-retest reliability was poor, likely because posterior drooling changes throughout the day due to factors like head position, fatigue, and medication. The study did not compare PPDS scores against the gold standard instrumental assessments (FEES or videofluoroscopy), so its accuracy in detecting actual aspiration is not directly proven. The sample size for the test-retest analysis was small (19 children), limiting confidence in those findings.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not rely on a single PPDS score to diagnose posterior drooling or determine treatment. The scale showed poor consistency over time, meaning a child might score zero in the clinic but have significant drooling at home or in different positions. Always consider the clinical history of coughing and respiratory infections alongside the score.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →