Reliability and validity of the Eating and Drinking Ability Classification System (EDACS) for children with cerebral palsy in Taiwan

Purpose: The study was to assess the inter- and intra-rater reliability, construct validity and utility of theEating and Drinking Ability Classification System (EDACS).

Methods: EDACS was translated into in Taiwan using an interactive process. Agreement between health profes-sionals 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 sixeducation institutions. The raters used EDACS independently to classify children’s eating and drinkingability and re-classified children’s eating and drinking abilities after one month. Pairs of raters showedsubstantial 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-raterreliability of EDACS level showed almost perfect agreement at rater 1 (k ¼ 0.87; absolute agreement ¼91%) 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 healthprofessionals and teachers to classify functional eating and drinking abilities in children with cerebral palsy