Reliability and validity of the Mini-Eating and Drinking Ability Classification System (Mini-EDACS) among Dutch preschoolers with cerebral palsy.
Floor van der Klift, Lynn B Orriëns, Bea Spek and 3 others
PMID 40170383WHAT IT FOUND
The Dutch Mini-EDACS reliably classifies eating and drinking abilities in children with cerebral palsy aged 18–36 months.
Speech therapists agreed almost perfectly with each other, but rated children as having more severe difficulties than parents did, who were more optimistic.
Key findings
01Inter-rater reliability between two speech therapists was almost perfect for Mini-EDACS levels (kappa 0.83) and substantial for assistance levels (kappa 0.70).
02Speech therapists tended to classify children as having greater eating and drinking challenges than parents did, a statistically significant difference.
03The Mini-EDACS showed moderate positive correlations with two parent-reported feeding questionnaires, supporting its construct validity.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size (48 children) was slightly below the recommended 50 for validation studies. The group had a predominance of children at lower Mini-EDACS levels (milder difficulties), which made it harder to achieve high inter-rater reliability. The PEDI-EAT-10 used for validity testing had not been previously validated in a Dutch population. Video-based classification meant therapists could not observe the child in person or see performance in other contexts, potentially affecting accuracy. The stability of the Mini-EDACS classification over time in this young, developing age group has not yet been established.
Declared interests
The authors received no financial support for the research and declared no potential conflicts of interest.
The easy way to misread this
Do not assume a parent's Mini-EDACS rating will match yours. Therapists in this study significantly rated children as having more severe eating and drinking difficulties than parents did. This reflects a difference in perspective on risk and daily performance, not necessarily an error by either party.