Reliability and validity of the Eating and Drinking Ability Classification System (EDACS) for children with cerebral palsy in Taiwan

Disabil Rehabil. 2021 Aug 16;1-7. doi: 10.1080/09638288.2021.1962989. Online ahead of print.

Abstract

Purpose: The study was to assess the inter- and intra-rater reliability, construct validity and utility of the Eating and Drinking Ability Classification System (EDACS).

Methods: EDACS was translated into in Taiwan using an interactive process. Agreement between health professionals and teachers when using EDACS was assessed using Kappa and the Intraclass Correlation Co-efficient.

Results: Paired ratings of 4 (13%) health professionals (either speech or occupational therapists) and 26 (87%) teachers were obtained for 53 children with CP aged 6.7 years (SD 4.1 years), who worked in six education institutions. The raters used EDACS independently to classify children's eating and drinking ability and re-classified children's eating and drinking abilities after one month. Pairs of raters showed substantial agreement for the EDACS level at the first assessment (k = 0.75; absolute agreement = 81%; ICC = 0.94) and the second assessment (k = 0.70; absolute agreement = 77%; ICC = 0.95). The intra-rater reliability of EDACS level showed almost perfect agreement at rater 1 (k = 0.87; absolute agreement = 91%) and rater 2 (k = 0.87; absolute agreement = 91%).

Conclusions: We conclude that the Chinese version of EDACS is valid and reliable to be easily used by health professionals and teachers to classify functional eating and drinking abilities in children with cerebral palsy.IMPLICATIONS FOR REHABILITATIONThe Chinese version of EDACS is valid and reliable to be easily used.EDACS can be used by health professionals and teachers to classify functional eating and drinking abilities in children with cerebral palsy.The EDACS is analogous to other functional classification systems (i.e., GMFCS, MACS and CFCS) and specifically represents eating and drinking ability.

Keywords: Cerebral palsy; drinking; eating; efficiency; functional classification system; safety; swallowing.