Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy

Abstract

Aim: The aim of this study was to develop a valid classification system to describe eating and drinking ability in people with cerebral palsy (CP), and to test its reliability. Method: The Eating and Drinking Ability Classification System (EDACS) was developed in four stages in consultation with individuals with CP, parents, and health professionals: Stage 1, drafting informed by literature and clinical experience; Stage 2, modification by nominal groups; Stage 3, refinement in an international D elphi survey; and Stage 4, testing of agreement and reliability between classifications made by speech and language therapists (Sa LT s), and between Sa LT s and parents. Results: Seven nominal groups involved 56 participants; 95 people participated in two rounds of the Delphi survey. Using the version of EDACS produced from this process, Sa LT s in pairs classified 100 children. The rate of absolute agreement was 78% (kappa=0.72; intraclass correlation coefficient [ICC]=0.93; 95% confidence interval [CI] 0.90–0.95). Any disagreement was only by one level, with one exception. Sa LT s and parents classified 48 children. The rate of absolute agreement was 58% (kappa=0.45, ICC=0.86; 95% CI 0.76–0.92). Parents either agreed with Sa LT s or rated their children as more able by one level. Interpretation: The EDACS provides a valid and reliable system for classifying eating and drinking performance of people with CP, for use in both clinical and research contexts.