Background: Disorders of movement and posture associated with cerebral palsy (CP) often lead to childhood difficulties with feeding, eating, drinking and swallowing which extend into adulthood. The consequences of compromised eating and drinking skills include respiratory disease, due to food and fluid entering the lungs, and malnutrition, leading to poor growth and health. There is no agreement in clinical and research contexts about the classification of eating and drinking abilities of people with CP to reflect severity of limitations to function. The study aim was to develop a valid and reliable system to classify eating and drinking performance of people with CP, using a pragmatic Mixed Methods approach. Method: The first draft of the Eating and Drinking Ability Classification System (EDACS) was developed from my clinical experience, the research literature and clinical assessments. A series of groups were held, using a Nominal Group Process (NGP), inviting experts to closely examine the content and wording of EDACS. After each group, EDACS was modified and presented to the following group until no new ideas or comments were made. A Delphi Survey (DS) was conducted with a wider group of international experts to further examine and modify the content of EDACS; the DS was repeated until 80% of panellists agreed with the content. In the final stage, EDACS was used by speech and language therapists (SaLTs) and parents to classify the eating and drinking abilities of children with CP; the agreement and reliability between classifications was tested. Findings: Fifty six UK experts participated in 7 nominal groups. The revised EDACS draft was examined by 95 expert panellists in an international DS; more than 80% of panellists agreed with the content of EDACS, after two rounds of the DS. Experts included people with CP, parents, health professionals and researchers. When SaLTs used EDACS to classify 100 children, absolute agreement was 78%, kappa=0.72; ICC=0.93 (95% CI 0.90 to 0.95). Any disagreement was only by one level, with one exception. When SaLTs and parents classified 48 children, absolute agreement was 58%, kappa=0.45, ICC=0.86 (95% CI 0.76 to 0.92). Parents either agreed with SaLTs, or rated their children as more able by one level. The new Eating and Drinking Ability Classification System provides a valid and reliable system for classifying eating and drinking performance of people with CP. EDACS describes the whole range of ability from age 3 years, providing a context for parents to consider their own child’s eating and drinking.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:608301 |
| Date | January 2014 |
| Creators | Sellers, Diane |
| Publisher | University of Brighton |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://research.brighton.ac.uk/en/studentTheses/104fbc32-1d32-4aec-8b28-b9bec6e19ef5 |
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