The Eating and Drinking Ability Classification System in a population-based sample of preschool children with cerebral palsy

Authors

  • Katherine A Benfer,

    Corresponding author
    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
    • Correspondence to Katherine Benfer at Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Level 6, Centre for Children's Health Research, 62 Graham St, South Brisbane, Qld 4101, Australia. E-mail: katherine.benfer@uqconnect.edu.au.

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  • Kelly A Weir,

    1. Menzies Health Institute of Queensland, Griffith University, Gold Coast, Qld, Australia
    2. Gold Coast University Hospital, Gold Coast Health, Gold Coast, Qld, Australia
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  • Kristie L Bell,

    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
    2. Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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  • Robert S Ware,

    1. Menzies Health Institute of Queensland, Griffith University, Gold Coast, Qld, Australia
    2. Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Brisbane, Qld, Australia
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  • Peter SW Davies,

    1. Children's Nutrition Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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  • Roslyn N Boyd

    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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Abstract

Aim

To determine (1) the reproducibility of the Eating and Drinking Ability Classification System (EDACS); (2) EDACS classification distribution in a population-based cohort with cerebral palsy (CP); and (3) the relationships between the EDACS and clinical mealtime assessment, other classifications, and health outcomes.

Method

This was a cross-sectional population-based cohort study of 170 children with CP at 3 years to 5 years (mean 57.6mo, standard deviation [SD] 8.3mo; 105 males, n=65 females). Functional abilities were representative of a population sample (Gross Motor Function Classification System level I=74, II=34, III=21, IV=18, V=23). The EDACS was the primary classification of mealtime function. The Dysphagia Disorders Survey was the clinical mealtime assessment. Gross motor function was classified using the Gross Motor Function Classification System.

Results

EDACS classification had 88.3% intrarater agreement (κ=0.84, intraclass correlation coefficient=0.95; p<0.001) and 51.7% interrater agreement (κ=0.36, intraclass correlation coefficient=0.79; p<0.001). In total, 56.5% of children were classified as EDACS level I. There was a strong stepwise relationship between the Dysphagia Disorders Survey and EDACS (r=0.96, p<0.001). Parental stress (odds ratio=1.3, p=0.05) and feeding tubes (odds ratio=6.4, p<0.001) were significantly related to more limited function on the EDACS.

Interpretation

The EDACS presents a viable adjunct to clinical assessment of feeding skills in children with CP for use in surveillance trials and clinical practice. A rating addendum would be a useful contribution to the tool to enhance reproducibility.

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