Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles.
EDACS is a valid single measure for grading swallowing severity and correlates tightly with motor and communication function in kids with CP.
01Research in Context
What this study did
Yu-Ra and team tested the Eating and Drinking Ability Classification System (EDACS) in 151 Korean children with cerebral palsy. They wanted to see if EDACS levels line up with other swallowing, motor, and communication tests already in use.
Kids were scored on EDACS (levels I-V) plus six other scales like the Functional Oral Intake Scale and the Gross Motor Function Classification System. The team then ran correlations to check how well the numbers matched.
What they found
EDACS levels showed strong to very strong correlations (r = 0.70-0.90) with every other measure. Higher EDACS level (more severe dysphagia) tracked closely with worse motor and communication scores.
The link was strongest between EDACS and swallowing tests, but even non-feeding measures like walking and talking lined up well. EDACS appears to capture overall disability severity, not just eating issues.
How this fits with other research
Phillips et al. (2014) compared two IQ tests in deaf/hard-of-hearing preschoolers and found big individual score gaps even when group means matched. Yu-Ra’s team did not report those person-by-person swings, so we cannot tell if EDACS also misses outliers who defy the trend.
Kahng et al. (1999) compared dementia rating scales in adults with Down syndrome and picked observer-rated tools over the MMSE. Like Yu-Ra, they showed that choosing the right classification system matters, but they focused on diagnostic accuracy while Yu-Ra focused on convergent validity.
Oliver et al. (2002) refined the five-factor Developmental Behavior Checklist for kids with intellectual disability. Both studies trim a clinical checklist into a cleaner, stronger tool, yet C et al. used factor analysis and Yu-Ra used correlation, so the math differs while the goal matches.
Why it matters
If you serve kids with CP, EDACS gives you one quick number that lines up with swallowing, motor, and language scores. You can use it at intake to flag who needs a full swallow study and at reassessment to show parents clear progress or decline. Add EDACS to your toolkit today—it takes five minutes and speaks the same language as the rest of your data.
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02At a glance
03Original abstract
This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2017.12.002