Mini‐EDACS: Development of the Eating and Drinking Ability Classification System for young children with cerebral palsy

Abstract

Aim:To develop and test Mini-EDACS to describe developing eating and drinking abilities of children with cerebral palsy (CP) aged between 18 and 36 months. Method:The existing Eating and Drinking Ability Classification System (EDACS) was modified to define Mini-EDACS content. Mini-EDACS was developed in three stages: (1) EDACS was modified after application to videos of standardized feeding evaluations of children with CP aged 18 to 36 months (n = 130); (2) refined content and validity of Mini-EDACS was established through an international Delphi survey; (3) interobserver reliability was assessed by comparing Mini-EDACS levels assigned by speech and language therapists (SaLTs) from video data and parent report. Results:Mini-EDACS provides age-appropriate descriptions for children aged 18 to 36 months with CP. Eighty-nine stakeholders participated in the Delphi survey; required levels of agreement were met after one round (i.e. >80% agreement). Thirteen SaLTs completed paired ratings from 43 video recordings: absolute agreement was 58% (kappa 0.43; intraclass correlation coefficient 0.78; 95% confidence interval 0.63-0.87).Interpretation: Mini-EDACS provides a valid system for classifying eating and drinking performance of children with CP under 3 years old. Results suggest moderate agreement and good reliability when rating Mini-EDACS levels from video recordings of young children with CP.

Reliability and Validity of Non-Instrumental Clinical Assessments for Adults with Oropharyngeal Dysphagia: A Systematic Review

“…Measures ranged from one single scale to five subscales, with item numbers ranging from 1 [ 31 ] to 42 [ 32 ]. All measures were developed for clinical use, whilst the Eating and Drinking Ability Classification System (EDACS) can also be administered by a caregiver [ 33 ].…”

“…Content validity was reported for 11 of 16 (69%) of the measures: DSRS [ 26 ], EDACS [ 33 ], EDSQ [ 35 ], FOIS [ 23 ], IDDSI-FDS [ 36 ], MASA [ 27 ], MASA-C [ 29 ], MISA [ 37 ], mMASA [ 22 ], Swallowing Status [ 39 ], and TOMASS [ 40 ]. Relevance was evaluated for three of these six measures (DSRS, IDDSI-FDS, and Swallowing Status) based on feedback from experts, either through a Delphi, survey, panel, or focus group.…”

“…Eight measures included items specific to the first domain of ‘ Skills Related to Eating and Drinking ’, with MASA [ 27 ] and MASA-C [ 29 ] including six of seven elements (all but ‘self-feeding skills) from this domain and EDACS [ 33 ] and TOMASS [ 40 ] each only including one element. All but one measure (TOMASS [ 40 ]) included items specific to the second domain of ‘ Making Adjustments to Facilitate Eating and Drinking ’, with DDS [ 28 ] and DMSS [ 28 ] including all five elements whilst seven measures—EDSQ [ 35 ], IDDSI-FDS [ 36 ], MASA [ 27 ], MASA-C [ 29 ], M-MASA [ 22 ], Swallowing Status [ 39 ], and SPEAD [ 30 ]—included only one element.…”

“…All but one measure (TOMASS [ 40 ]) included items specific to the second domain of ‘ Making Adjustments to Facilitate Eating and Drinking ’, with DDS [ 28 ] and DMSS [ 28 ] including all five elements whilst seven measures—EDSQ [ 35 ], IDDSI-FDS [ 36 ], MASA [ 27 ], MASA-C [ 29 ], M-MASA [ 22 ], Swallowing Status [ 39 ], and SPEAD [ 30 ]—included only one element. Thirteen of the measures (81.3%) included items specific to the third domain of ‘ Swallowing Act ’, with EDACS [ 33 ] including six of the seven elements (all but Trache) from this domain whilst SPEAD [ 30 ] and TOMASS [ 40 ] each only including one element (Speed). Of the elements in the first domain, ‘Skills related to eating and drinking’, ‘Oral preparation’ was included the most (seven of sixteen) and ‘Sensory perception’ was included the least (two of sixteen).…”

Nutritional status and function after high-calorie formula vs. Chinese food intervention in undernourished children with cerebral palsy

“…Gross motor functions were classified by the Gross Motor Function Classification System (GMFCS), which is a wellestablished tool to assess the severity of motor impairment in children with CP ( 19 ). Eating and drinking abilities were determined by the EDACS or Mini-EDACS, which are the standard levels for swallowing function ( 20 , 21 ).…”