Mini-EDACS: Eating and Drinking Ability Classification System for young children with cerebral palsy

Introduction: The Eating and Drinking Ability Classification System (EDACS) was developed to classify function of people with cerebral palsy (CP) in 5 levels from 3 years. This study aimed to develop and test Mini-EDACS to describe developing eating and drinking abilities of children with CP between 18 and 36 months. Patients and Methods: EDACS was applied to existing longitudinal videoed standardised feeding evaluations of children with CP aged 18 to 36 months (n=130). EDACS content was modified to describe distinct levels of ability and mealtime performance for younger children with CP from video assessments. The content validity of Mini-EDACS was established through an international Delphi survey; consensus was defined as >80% agreement. Mini-EDACS classifications were made by parents using personal knowledge of their children, and speech and language therapists (SLT) from video recordings (n=50). Inter-observer reliability was assessed by comparing levels assigned by expert observers. Results: Mini-EDACS contains age-appropriate descriptions of eating and drinking ability for children 18 to 36 months with CP, including suitable drinking methods, and descriptions indicating learning of biting, chewing, swallowing, and drinking skills. 89 stakeholders including parents, health professionals, and care staff participated in the Delphi survey. Levels of agreement for 21 out of 22 questions were between 95% and 100%. One question received 92% agreement. Reliability data will be reported for SLTs vs SLTs and SLTs vs parents. Conclusion: Mini-EDACS describes 5 distinct levels of eating and drinking ability for children with CP age 18 to 36 months. Use of Mini-EDACS by parents and professional enables systematic sharing of information about children’s abilities. EDACS, with expanded descriptions of function in Mini-EDACS, can facilitate working in partnership with families across the lifespan. Mini-EDACS will broaden the focus of population-based research.