The Eating and Drinking Ability Classification System: concurrent validity and reliability in children with cerebral palsy

Abstract

Aim As there is little evidence for concurrent validity of the Eating and Drinking Ability Classification System (EDACS), this study aimed to determine its concurrent validity and reliability in children and adolescents with cerebral palsy (CP). Method After an extensive translation procedure, we applied the German language version to 52 participants with CP (30 males, 22 females, mean age 9y 7mo [SD 4y 2mo]). We correlated (Kendall's tau or Kτ) the EDACS levels with the Bogenhausener Dysphagiescore (BODS), and the EDACS level of assistance with the Manual Ability Classification System (MACS) and the item ‘eating’ of the Functional Independence Measure for Children (WeeFIM). We further quantified the interrater reliability between speech and language therapists (SaLTs) and between SaLTs and parents with Kappa (κ). Results The EDACS levels correlated highly with the BODS (Kτ=0.79), and the EDACS level of assistance correlated highly with the MACS (Kτ=0.73) and WeeFIM eating item (Kτ=−0.80). Interrater reliability proved almost perfect between SaLTs (EDACS: κ=0.94; EDACS level of assistance: κ=0.89) and SaLTs and parents (EDACS: κ=0.82; EDACS level of assistance: κ=0.89). Interpretation The EDACS levels and level of assistance seem valid and showed almost perfect interrater reliability when classifying eating and drinking problems in children and adolescents with CP. What this paper adds The Eating and Drinking Ability Classification System (EDACS) correlates well with a dysphagia score. The EDACS level of assistance proves valid. The German version of EDACS is highly reliable. EDACS correlates moderately to highly with other classification systems.

The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time

“…Like the other FCSs, EDACS has been shown to be valid and reliable for children and young people with CP 19 . Studies have demonstrated that EDACS meets quality standards for inter-observer reliability between health professionals, and between parents and health professionals 19,20,21,22 . High intra-rater-reliability 20 and strong construct validity 21,22 have also been demonstrated.…”

Survival, Mortality, and Life Expectancy

“…Therefore, for the sake of comparing results across time and place, we advise forming cohorts according to Gross Motor Function Classification System (GMFCS) [60] level or other commonly employed measures of gross motor functioning. For similar reasons, when possible, scales such as the Manual Ability Classification System (MACS) [61], the Communication Function Classification System (CFCS) [62], and the Eating and Drinking Ability Classification System (EDACS) [63] should be utilized. Other factors to account for can be gleaned from Section 4, perhaps chief among them gastrostomy status.…”

Measurement tools in a globalized world: is translation or redevelopment the best approach?

“…Having followed standard translation procedures, the authors demonstrate that the German version of the EDACS correlates moderate to high with other motor classification systems . This suggests that other systems measure different motor domains, such as ambulatory abilities, manual skills, or speech/language patterns.…”

“…The Eating and Drinking Ability Classification System (EDACS) is a classification system in English designed to help communicate the eating and drinking ability of children with cerebral palsy . The study by Tschirren et al . focusses on this topic, though the language written and spoken in the geographic area of their study is German.…”

“…The study by Tschirren et al . has opened the door to future studies of psychometric properties using the German version of the EDACS.…”