Eating and Drinking Ability Classification System for people with Cerebral Palsy (EDACS)

Richard_Scope

Since 2023, Sussex NHS Trust and Scope have worked together on an Eating and Drinking Classification System for people with cerebral palsy (CP).

EDACS describes how people with cerebral palsy eat, drink and swallow using five distinct levels. EDACS is now used internationally.

People with cerebral palsy cannot use the range of physical movement available to most of us. We developed the Eating and Drinking Ability Classification System (EDACS) for people with Cerebral Palsy by consulting with people with Cerebral Palsy, as well as parents and experts around the world.

https://youtu.be/G535Jybm-fM

Difficulties may occur in the development of walking, speech, and hand function. The movements involved in biting, chewing, and swallowing are frequently affected. Children and young people with cerebral palsy may have problems eating enough food to grow and to stay healthy because it is challenging to move their mouths to eat and drink efficiently. Some of them will have problems with frequent chest infections because particles of food or drink enter their lungs when they swallow. These difficulties continue throughout their lives.

We developed the Eating and Drinking Ability Classification System (EDACS) for people with Cerebral Palsy. EDACS describes five distinct levels of ability using the key features of safety and efficiency:

• Level I - Eats and drink safely and efficiently
• Level II - Eats and drinks safely but with some limitations to efficiency
• Level III - Eats and drinks with some limitations to safety; there may be limitations to efficiency
• Level VI - Eats and drinks with significant limitations to safety
• Level V - Unable to eat or drink safely - tube feeding may be considered to provide nutrition

forgoodnesssake

Presumably this will dovetail with the SALT food texture scale? When I think about my family member with CP I don't think that the levels above are informative enough however in combination with the SALT scale of food textures it goes a good way to being a sort of brief overview that at least gives an idea. There is also of course the issue of posture, head control etc etc to take into account. The above also does not give any indication of whether this is self feeding or being fed by someone else (as in my son's case) which i think is a bit of an oversight…but maybe I am missing something?

Richard_Scope

Hi @forgoodnesssake, good questions and feedback which I asked for a response from the researchers at Sussex NHS Foundation Trust. Here is their response:

The video is a brief summary of the scale, which includes a separate description of whether someone is independent, requires assistance or is totally dependent upon another at mealtimes. It dovetails with the IDDSI (International Dysphagia Diet Standardisation Initiative), which describes food textures for everyone who has dysphagia. This tool is specifically for people with CP and provides a summary description of eating and drinking. As your family member quite rightly says, there are issues of posture, head control, etc. The more detailed descriptions in the larger EDACS document covers these. See www.edacs.org. It is likely that more detail is needed to really support someone at mealtimes that might be written in a mealtime guidance document.

 

The EDACS levels are being used in international research to create clinical guidance to inform health professionals and families. This is the way that the GMFCS is used in the CPIPS programme, as well as other research, to predict clinical outcomes and needs. EDACS is a good predictor of someone’s respiratory health, oral health and nutritional needs/growth.

 

EDACS in Eating and drinking ability and nutritional status in adults with cerebral palsy -      https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.15196

 

EDACS in Eating and drinking abilities and respiratory and oral health in children and young adults with cerebral palsy -   https://onlinelibrary.wiley.com/doi/10.1111/dmcn.16262

 

EDACS in Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement - https://pmc.ncbi.nlm.nih.gov/articles/PMC7818421/

 

I hope that helps. Let me know if more information is needed. I am happy to communicate directly.

forgoodnesssake

Thanks for that