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 ¼ 0.75; absolute agreement ¼ 81%; ICC ¼ 0.94) and the second assessment (k ¼ 0.70; absolute agreement ¼ 77%; ICC ¼ 0.95). The intra-rater reliability of EDACS level showed almost perfect agreement at rater 1 (k ¼ 0.87; absolute agreement ¼ 91%) and rater 2 (k ¼ 0.87; absolute agreement ¼ 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. ä 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.
Background: Paediatric Acquired Brain Injury (ABI) is one of the leading causes of neuro-disability in childhood. The long-term effects of ABI on cognition, behaviour and emotions are well documented. Previous research has found that communication is difficult for adolescents with acquired brain injury (ABI) compared to typically developing peers. Quantitative studies have identified deficits in specific domains of speech and language but there are no research studies which have sought to capture adolescents' lived experiences of communication or explored the multidimensional nature of this. Aims:To explore adolescents' everyday experiences of communication following ABI. This research also offered adolescents an opportunity to give their views on an issue which has not previously been explored in relation to paediatric ABI. Method & Procedures: A qualitative study was undertaken using Interpretative Phenomenological Analysis (IPA) for in-depth exploration of the lived experiences of communication following ABI. Participants were recruited from an NHS Trust in England. Six adolescents (aged 11 to 18 years) participated in semi-structured interviews. Data analysis followed the guides for IPA. Outcomes & Results: The data revealed three main themes: the social world; communication competence and life in the classroom. Adolescents experienced communication changes and challenges, which affected functioning and 2 participation. Difficulties with communication affected identity, learning, relationships and confidence. Conclusions & Implications: These findings provide insight into how communication is experienced in everyday life from the perspectives of adolescents with ABI. The study revealed that adolescents' individual experiences of communication were dependent on contextual factors. Sensitivity to communication changes was associated with the age when the ABI occurred. Difficulties with communication impacted on identity. Negative communication experiences at school affected sense of belonging; peer group support helped some adolescents to cope with the communication challenges they faced. Further research is needed to explore how participation in communication is affected by paediatric ABI and what could be done to support this. It is recommended that increased attention should be paid by professionals to the psychological impact of communication changes and difficulties experienced by this population. What is already known on this subject?Previous research has identified that despite good recovery of physical skills the quality of life for children with ABI is reduced compared to typically developing peers.Speech, language and communication skills are reported as problematic in this population but the full impact of these difficulties may not become apparent until adolescence. Whilst experiences of communication have been explored in other groups, no previous research studies have focused specifically on how communication is experienced following paediatric ABI. What this study adds?This study provided an in-d...
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