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Cross-Cultural Adaptation and Validation of the Mini-Eating and Drinking Ability Classification System for Korean

You Gyoung Yi1, Seoyon Yang1, Jeong-Yi Kwon2

  • 1Department of Rehabilitation Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea.

Children (Basel, Switzerland)
|October 29, 2025
PubMed

Insights

The Korean Mini-Eating and Drinking Ability Classification System (Mini-EDACS) is reliable for assessing feeding in young children with cerebral palsy (CP). This tool aids early intervention for pediatric feeding difficulties.

Area of Science:

  • Pediatric Rehabilitation
  • Clinical Assessment Tools
  • Child Neurology

Background:

  • Feeding and swallowing difficulties are prevalent in young children with cerebral palsy (CP).
  • No validated tool existed in Korea for assessing eating and drinking abilities in children under 3 years with CP.
  • The Mini-Eating and Drinking Ability Classification System (Mini-EDACS) was developed for children aged 18-36 months.

Purpose of the Study:

  • To translate the Mini-EDACS into Korean.
  • To evaluate the reliability and validity of the Korean version of Mini-EDACS.
  • To provide a standardized tool for assessing pediatric feeding in Korea.

Main Methods:

  • The Mini-EDACS was translated into Korean following international guidelines, including expert Delphi consensus.
  • Forty-eight children with CP (mean age 27.1 months) were assessed by caregivers and speech-language pathologists (SLPs).
  • Inter-rater reliability was assessed using Cohen's kappa, and construct validity was evaluated against other classification systems (GMFCS, Mini-MACS, CFCS, VFCS, FOIS-C).

Main Results:

  • Excellent inter-rater reliability was found between caregivers and SLPs (κ = 0.90; weighted κ = 0.98).
  • Mini-EDACS showed strong correlations with the Functional Oral Intake Scale for Children (FOIS-C) (ρ = -0.86) and assistance levels (ρ = 0.81).
  • Moderate-to-strong correlations were observed with GMFCS, Mini-MACS, CFCS, and VFCS, supporting construct validity.

Conclusions:

  • The Korean Mini-EDACS is a reliable and valid tool for classifying eating and drinking abilities in children under 3 years with CP.
  • This tool facilitates standardized communication between caregivers and clinicians.
  • It supports earlier identification and intervention for pediatric feeding difficulties in Korea.
Abstract

Keywords:
Mini-EDACScerebral palsydysphagiaeating and drinking abilityfeeding difficultiesfunctional classificationreliabilityvalidity

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