ArticleChildren (Basel, Switzerland)2026
The Italian Version of the Drooling Impact Scale: Translation and Psychometric Validation in Children with Neurodevelopmental Conditions.
Article in Children (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesDrooling is a common and clinically relevant issue in children with neurodevelopmental conditions, with important consequences for daily functioning, social participation, and caregiver burden. The lack of validated tools in Italian makes it difficult to quantify the impact of drooling on daily life, support appropriate care pathways, and evaluate the effectiveness of interventions. The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Italian version of the Drooling Impact Scale (DIS) in a pediatric population.
methodsThe DIS is a 10-item caregiver-reported outcome measure, with each item rated on an ordinal 0-10 scale, designed to assess the functional and psychosocial impact of drooling. It was translated using a standard forward-backward procedure, followed by expert review and cognitive debriefing with caregivers. Caregivers of children aged ≥2 years with heterogeneous neurodevelopmental conditions and feeding/swallowing impairments were consecutively recruited from a tertiary pediatric hospital. Psychometric properties were assessed in line with COSMIN recommendations, including internal consistency (Cronbach's α), structural validity through exploratory factor analysis, inter-rater and test-retest reliability (intraclass correlation coefficients, ICC), measurement error (standard error of measurement, SEM; smallest detectable change, SDC), and construct validity through correlation with the Pediatric Quality of Life Inventory (PedsQL).
resultsThe Italian DIS was completed by caregivers of 126 children. It showed excellent internal consistency (Cronbach's α = 0.92). Factor analysis indicated a clear dominant factor, explaining 56.5% of the variance, while additional factors contributed only marginally. Agreement between caregivers was excellent (ICC = 0.94), and test-retest reliability was good (ICC = 0.85). Measurement error analysis yielded SEM = 8.66, SDC_individual = 24.00, and SDC_group = 2.14. As expected, DIS scores were associated with health-related quality of life.
conclusionsThe Italian version of the DIS appears to be a reliable and structurally sound instrument for assessing the impact of drooling in children with neurodevelopmental conditions. It may be useful in both clinical practice and research, although further studies are needed to explore its responsiveness and confirm these findings in different settings.
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