Reliability, construct validity and usability of the Eating and Drinking Ability Classification System (EDACS) among Dutch children with Cerebral Palsy
Affiliations: [a] Departments of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands | [b] Department of Rehabilitation, Rehabilitation Centre Sint Maartenskliniek, Nijmegen, The Netherlands | [c] Heritage Clinical Services, Sussex, UK | [d] Departments of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
Correspondence:
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Corresponding author: Karen van Hulst, Department of Rehabilitation, Radboud University Medical Centre, PO Box 9101, local address 818, 6500 HB Nijmegen, The Netherlands. Tel.: +31 243615185, E-mail: Karen.vanHulst@Radboudumc.nl.
Abstract: PURPOSE: To assess the interrater reliability, construct validity and usability of the Eating and Drinking Ability Classification System (EDACS) among Dutch children with Cerebral Palsy (CP) when used by speech and language therapists (SLTs) familiar and unfamiliar with the child’s eating and drinking performance and parents. METHODS: Translation was undertaken using the method of Eremenco. Agreement between SLTs and parents when using EDACS was determined by intraclass correlation coefficient (ICC) and linear weighted Kappa (κW). Associations with other functional classification systems including the Dysphagia Management Staging Scale (DMSS) were investigated to determine construct validity by Kendall’s tau-b. RESULTS: Thirty-one SLTs classified 149 children (67 girls; mean 10 y, SD 4 y, range 3–21 y) with EDACS. Pairs of SLTs showed good agreement ([ICC] = 0.84; 95% confidence interval [CI] 0.79–0.88; [κW] = 0.71). Eighty-one parents showed good agreement with SLTs (n= 31) as well (ICC = 0.80; 95% CI 0.71–0.87; κW= 0.61). There was a significant and strong positive correlation of EDACS with DMSS (Kendall’s tau-b 0.81) supporting its construct validity. Usability of EDACS was generally good. CONCLUSION: The Dutch version of EDACS is reliable and valid, and can be used easily by (familiar and unfamiliar) SLTs and parents of children with CP. Parents and professionals showed a high level of consistency when classifying eating and drinking abilities. EDACS enables uniform and efficient communication about safety and efficiency of functional eating and drinking ability in clinical and research contexts.
