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

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 K-t ) 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 (kappa). RESULTS The EDACS levels correlated highly with the BODS (K-tau = 0.79), and the EDACS level of assistance correlated highly with the MACS (K-tau = 0.73) and WeeFIM eating item (K-tau = -0.80). Interrater reliability proved almost perfect between SaLTs (EDACS: kappa = 0.94; EDACS level of assistance: kappa = 0.89) and SaLTs and parents (EDACS: kappa = 0.82; EDACS level of assistance: kappa = 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.