The eating and drinking ability classification system in a population-based sample of preschool children with cerebral palsy

Benfer, Katherine A., Weir, Kelly A., Bell, Kristie L., Ware, Robert S., Davies, Peter S. W. and Boyd, Roslyn N. (2017) The eating and drinking ability classification system in a population-based sample of preschool children with cerebral palsy. Developmental Medicine and Child Neurology, 59 6: 647-654. doi:10.1111/dmcn.13403


Author Benfer, Katherine A.
Weir, Kelly A.
Bell, Kristie L.
Ware, Robert S.
Davies, Peter S. W.
Boyd, Roslyn N.
Title The eating and drinking ability classification system in a population-based sample of preschool children with cerebral palsy
Journal name Developmental Medicine and Child Neurology   Check publisher's open access policy
ISSN 1469-8749
0012-1622
Publication date 2017-03-09
Year available 2017
Sub-type Article (original research)
DOI 10.1111/dmcn.13403
Open Access Status Not yet assessed
Volume 59
Issue 6
Start page 647
End page 654
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
2806 Developmental Neuroscience
2728 Clinical Neurology
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.
Formatted 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.
Keyword Clinical Neurology
Pediatrics
Neurosciences & Neurology
Pediatrics
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1018264 - KAB
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Admin only - CHRC
Child Health Research Centre Publications
 
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