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Dysphagia
Published in: Dysphagia 3/2021

01-06-2021 | Dysphagia | Original Article

Reliability and Validity of the Eating and Drinking Ability Classification System in Adults with Cerebral Palsy

Authors: Sung Eun Hyun, You Gyoung Yi, Hyung-Ik Shin

Published in: Dysphagia | Issue 3/2021

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Abstract

The Eating and Drinking Ability Classification System (EDACS) was developed to evaluate dysphagia in children with cerebral palsy (CP). This study aimed to investigate the interrater reliability and validity of the EDACS in adults with CP. This cross-sectional study included 117 community-dwelling adults (mean age, 37.9 ± 12.5 years) with a confirmed CP diagnosis. A swallowing occupational therapist (SwOT) conducted detailed interviews with participants and/or caregivers to classify the EDACS. Another SwOT and participants/caregivers evaluated the EDACS. Correlations were evaluated between the EDACS and Functional Oral Intake Scale (FOIS), Swallowing Quality of Life (SWAL-QOL), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification System (MACS). Interrater reliabilities between SwOTs (κ = 0.866, intraclass correlation coefficient (ICC) = 0.867), and between SwOT and participant/caregiver (κ = 0.884, ICC = 0.717) were reported. The EDACS correlated with the FOIS, SWAL-QOL, and MACS, although no significant correlation was found with the GMFCS. The EDACS of spastic-type showed better correlation than that of dyskinetic-type with the FOIS, MACS, and GMFCS. There was a significant correlation between the EDACS and the GMFCS in those aged ≤ 30 years, whereas there was no correlation in those aged ≥ 30 years. The EDACS is a reliable and valid tool for classifying eating and drinking ability in adults with CP. The correlation between the EDACS with gait or hand function was more prominent in individuals with spastic CP and in younger individuals. The EDACS is a valuable adjunct to comprehensive functional classification in adults with CP.
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Literature
1.
Michael-Asalu A, Taylor G, Campbell H, Lelea L-L, Kirby RS. Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update. Adv Pediatr. 2019;66:189.PubMedCrossRef
2.
Rosenbaum P, Eliasson A-C, Hidecker MJC, Palisano RJ. Classification in childhood disability: focusing on function in the 21st century. J Child Neurol. 2014;29:1036–45.PubMedCrossRef
3.
Hidecker MJC, Ho NT, Dodge N, Hurvitz EA, Slaughter J, Workinger MS, et al. Inter-relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol. 2012;54:737–42.PubMedPubMedCentralCrossRef
4.
5.
Sellers D, Mandy A, Pennington L, Hankins M, Morris C. Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy. Dev Med Child Neurol. 2014;56:245–51.PubMedCrossRef
6.
Delbecq AL, Van de Ven AH, Gustafson DH. Group techniques for program planning: a guide to nominal group and Delphi processes. Glenview: Scott, Foresman; 1975.
7.
Schiariti V, Fowler E, Brandenburg JE, Levey E, Mcintyre S, Sukal-Moulton T, et al. A common data language for clinical research studies: the National Institute of Neurological Disorders and Stroke and American Academy for Cerebral Palsy and Developmental Medicine cerebral palsy common data elements version 1.0 recommendations. Dev Med Child Neurol. 2018;60:976–86.PubMedCrossRef
8.
Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. The Eating and Drinking Ability Classification System in a population-based sample of preschool children with cerebral palsy. Dev Med Child Neurol. 2017;59:647–54.PubMedCrossRef
9.
Tschirren L, Bauer S, Hanser C, Marsico P, Sellers D, Hedel HJA. The Eating and Drinking Ability Classification System: concurrent validity and reliability in children with cerebral palsy. Dev Med Child Neurol. 2018;60:611–7.PubMedCrossRef
10.
Goh YR, Choi JY, Kim SA, Park J, Park ES. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: relations with other functional profiles. Res Dev Disabil. 2018;72:248–56.PubMedCrossRef
11.
Monbaliu E, De La Peña MG, Ortibus E, Molenaers G, Deklerck J, Feys H. Functional outcomes in children and young people with dyskinetic cerebral palsy. Dev Med Child Neurol. 2017;59:634–40.PubMedCrossRef
12.
Van Hulst K, Snik DAC, Jongerius PH, Sellers D, Erasmus CE, Geurts ACH. Reliability, construct validity and usability of the Eating and Drinking Ability Classification System (EDACS) among Dutch children with Cerebral Palsy. J Pediatr Rehabil Med. 2018;11:115–24.PubMedCrossRef
13.
Blair E, Langdon K, McIntyre S, Lawrence D, Watson L. Survival and mortality in cerebral palsy: observations to the sixth decade from a data linkage study of a total population register and National Death Index. BMC Neurol. 2019;19:111.PubMedPubMedCentralCrossRef
14.
Himmelmann K, Sundh V. Survival with cerebral palsy over five decades in western S weden. Dev Med Child Neurol. 2015;57:762–7.PubMedCrossRef
15.
Speyer R, Cordier R, Kim JH, Cocks N, Michou E, Wilkes-Gillan S. Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta-analyses. Dev Med Child Neurol. 2019;61:1249–58.PubMedCrossRef
16.
Sheppard JJ. Swallowing and feeding in older people with lifelong disability. Adv Speech Lang Pathol. 2002;4:119–21.CrossRef
17.
Balandin S, Hemsley B, Hanley L, Sheppard JJ. Understanding mealtime changes for adults with cerebral palsy and the implications for support services. J Intellect Dev Disabil. 2009;34:197–206.PubMedCrossRef
18.
Seo HG, Yi YG, Choi YA, Leigh JH, Yi Y, Kim K, et al. Oropharyngeal dysphagia in adults with dyskinetic cerebral palsy and cervical dystonia: a preliminary study. Arch Phys Med Rehabil. 2019;100:495e1–500e1.CrossRef
19.
Su C-L, Chen S-L, Tsai S-W, Tseng F-F, Chang S-C, Huang Y-H, et al. Efficacy of predicting videofluoroscopic results in dysphagic patients with severe cerebral palsy using the Mann assessment of swallowing ability. Am J Phys Med. 2016;95:270–6.CrossRef
20.
Rogers BT, Stratton P, Msall M, Andres M, Champlain M, Koerner P, et al. Long-term morbidity and management strategies of tracheal aspiration in adults with severe developmental disabilities. Am J Ment Retard. 1994;98(4):490–8.PubMed
21.
McCormick A, Brien M, Plourde J, Wood E, Rosenbaum P, McLean J. Stability of the Gross Motor Function Classification System in adults with cerebral palsy. Dev Med Child Neurol. 2007;49:265–9.PubMedCrossRef
22.
Jahnsen R, Aamodt G, Rosenbaum P. Gross Motor Function Classification System used in adults with cerebral palsy: agreement of self-reported versus professional rating. Dev Med Child Neurol. 2006;48:734–8.PubMedCrossRef
23.
van Meeteren J, Nieuwenhuijsen C, de Grund A, Stam HJ, Roebroeck ME. Using the manual ability classification system in young adults with cerebral palsy and normal intelligence. Disabil Rehabil. 2010;32:1885–933.PubMedCrossRef
24.
25.
Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39:214–23.PubMedCrossRef
26.
Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall AM, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48:549–54.PubMedCrossRef
27.
Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children. 2017;4:30.PubMedCentralCrossRef
28.
Cans C. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000;42:816–24.CrossRef
29.
Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.PubMedCrossRef
30.
McMicken BL, Muzzy CL, Calahan S. Retrospective ratings of 100 first time-documented stroke patients on the Functional Oral Intake Scale. Disabil Rehabil. 2010;32:1163–72.PubMedCrossRef
31.
Kim JY, Kim DY, Kim H, Cho S-R. A validation study of the Korean Version of the Swallowing-Quality of Life Scale. Commun Sci Disorder. 2013;18(3):341–7.CrossRef
32.
Youssof S, Romero-Clark C, Warner T, Plowman E. Dysphagia-related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL-QOL instrument. Muscle Nerve. 2017;56:28–35.PubMedPubMedCentralCrossRef
33.
Fitzpatrick P. Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess. 1998;2:14.
34.
Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr. 2003;11:S681–S684684.CrossRef
35.
Pamela S, Van H, Kathy EG, Monica M. Survey response rates and survey administration in counseling and clinical psychology: a meta-analysis. Educ Psychol Meas. 2008;69(3):389–403.
36.
Jarl J, Alriksson-Schmidt A, Rodby-Bousquet E. Health-related quality of life in adults with cerebral palsy living in Sweden and relation to demographic and disability-specific factors. Disabil Health J. 2019;12(3):460–6.PubMedCrossRef
37.
Remijn L, van den Engel-Hoek L, Satink T, de Swart BJM, Nijhuis-van der Sanden MWG. Everyone sees you sitting there struggling with your food”: experiences of adolescents and young adults with cerebral palsy. Disabil Rehabil. 2019;41(16):1898–905.PubMedCrossRef
38.
Overeynder JC, Turk MA. Cerebral palsy and aging: a framework for promoting the health of older persons with cerebral palsy. Top Geriatr Rehabil. 1998;13:19–24.CrossRef
39.
McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, et al. The SWAL–QOL and SWAL–CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17(2):97–114.PubMedCrossRef
40.
McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins J, Chignell KA, et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysaphagia. 2000;15(3):122–33.CrossRef
41.
McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins J, Chignell KA, et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia. 2000;15(3):115–21.PubMedCrossRef
42.
Keage M, Delatycki M, Corben L, Vogel A. A systematic review of self-reported swallowing assessments in progressive neurological disorders. Dysphagia. 2015;30(1):27–34.PubMedCrossRef
Metadata
Title
Reliability and Validity of the Eating and Drinking Ability Classification System in Adults with Cerebral Palsy
Authors
Sung Eun Hyun
You Gyoung Yi
Hyung-Ik Shin
Publication date
01-06-2021
Publisher
Springer US
Published in
Dysphagia / Issue 3/2021
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-020-10141-y

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