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

Figures & data

Table 1. Characteristics of participants (n = 53).

Age (yr), mean (SD)	6.7 (4.1)
Sex, n females (%)	19 (36)
Type of cerebral palsy, n (%)
Diplegia	14 (26)
Hemiplegia	5 (10)
Quadriplegia	34 (64)
GMFCS, n (%)
Level I	1 (2)
Level II	10 (19)
Level III	5 (9)
Level IV	19 (36)
Level V	18 (34)
MACS, n (%)
Level I	1 (2)
Level II	6 (11)
Level III	9 (17)
Level IV	13 (16)
Level V	15 (18)
CFCS, n (%)
Level I	3 (6)
Level II	7 (13)
Level III	6 (11)
Level IV	19 (23)
Level V	15 (28)

GMFCS: Gross Motor Function Classification System; MACS: Manual Ability Classification System; CFCS: Communication Function Classification System.

Table 2. Characteristics of raters (n = 30).

Experience (yr), mean (SD)	5.3 (6.3)
Sex, n females (%)	30 (100)
Education status, n (%)
Tertiary	27 (90)
Master	3 (10)
Profession, n (%)
Regular teacher	26 (87)
Speech therapist	3 (10)
Occupational therapist	1 (3)
Acquaintance of participants (yr)	Rater 1 n (%)	Rater 2 n (%)
<1	27 (51)	26 (49)
1 ∼ 2	8 (15)	24 (45)
2 ∼ 3	16 (30)	3 (6)
>3	2 (4)	0 (0)

Table 3. EDACS Inter-rater agreement and disagreements.

	Rater 2
Rater 1	I	II	III	IV	V	Total
First assessment
I	5	0	1	0	0	6
II	0	9	1	0	0	10
III	0	4	16	0	0	20
IV	0	0	1	11	3	15
V	0	0	0	0	2	2
Total	5	13	19	11	5	53
Second assessment
I	5	0	0	0	0	5
II	2	9	2	0	0	13
III	0	1	14	4	0	19
IV	0	0	2	11	1	14
V	0	0	0	0	2	2
Total	7	10	18	15	3	53
	Rater 2
Rater 1	Independent	Required assistance	Dependence	Total
First assessment
Independent	4	1	1	6
Required assistance	0	17	3	21
Dependence	1	4	22	26
Total	5	22	26	53
Second assessment
Independent	7	1	0	8
Required assistance	0	14	1	15
Dependence	1	0	29	30
Total	8	15	30	53

Table 4. EDACS intra-rater reliability.

	Second assessment
First assessment	I	II	III	IV	V	Total
Rater 1
I	5	0	1	0	0	6
II	0	10	0	0	0	10
III	0	3	17	0	0	20
IV	0	0	1	14	0	15
V	0	0	0	0	2	2
Total	5	13	19	14	2	53
Rater 2
I	5	0	0	0	0	5
II	2	7	4	0	0	13
III	0	3	12	4	0	19
IV	0	0	2	9	0	11
V	0	0	0	2	3	5
Total	7	10	18	15	3	53
	Second assessment
First assessment	Independent	Required assistance	Dependence	Total
Rater 1
Independent	5	0	1	6
Required assistance	3	14	4	21
Dependence	0	1	25	26
Total	8	15	30	53
Rater 2
Independent	5	0	0	5
Required assistance	2	15	5	22
Dependence	1	0	25	26
Total	8	15	30	53

Table 5. Distribution of EDACS level compared with other classification scales.

	EDACS level
Rater 1	I	II	III	IV	V	Total
GMFCS
I	1	0	0	0	0	1
II	2	5	1	2	0	10
III	1	0	3	1	0	5
IV	2	0	7	0	0	9
V	0	5	9	12	2	28
Total	6	10	20	15	2	53
MACS
I	1	0	0	0	0	1
II	2	3	1	0	0	6
III	3	2	1	3	0	9
IV	0	5	12	2	0	19
V	0	0	6	10	2	18
Total	6	10	20	15	2	53
CFCS
I	1	1	1	0	0	3
II	2	1	3	1	0	7
III	2	0	1	3	0	6
IV	0	6	9	6	1	22
V	1	2	6	5	1	15
Total	6	10	20	15	2	53
	EDACS level of assistance
Rater 1	Independent	Required assistance	Dependence	Total
GMFCS
I	1	0	0	1
II	3	7	0	10
III	1	2	2	5
IV	1	4	4	9
V	0	7	21	28
Total	6	20	27	53
MACS
I	1	0	0	1
II	3	3	0	6
III	2	5	2	9
IV	0	10	9	19
V	0	2	16	18
Total	6	20	27	53
CFCS
I	1	2	0	3
II	1	4	2	7
III	1	2	3	6
IV	1	10	11	22
V	1	3	11	15
Total	5	21	27	53