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Eating and drinking abilities and nutritional status in children with cerebral palsy: A population-based study

Anna Nyman1,2, Anita McAllister1, Elisabet Rodby-Bousquet3,4,5

  • 1Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology-CLINTEC, Karolinska Institutet, Stockholm, Sweden.

Developmental Medicine and Child Neurology
|December 10, 2025
PubMed

Insights

Almost one-third of children with cerebral palsy (CP) experience eating and drinking difficulties (dysphagia), impacting their growth. Undernutrition is linked to these challenges, with growth affected from early stages.

Area of Science:

  • Pediatric Neurology
  • Clinical Nutrition
  • Rehabilitation Medicine

Background:

  • Cerebral palsy (CP) affects motor function, often leading to challenges in eating and drinking.
  • The Eating and Drinking Ability Classification System (EDACS) categorizes these difficulties.
  • Understanding the prevalence and impact of dysphagia in CP is crucial for nutritional management.

Purpose of the Study:

  • To determine the prevalence of eating and drinking difficulties using the EDACS in a large cohort of children with CP.
  • To examine the relationship between EDACS classifications and undernutrition in this population.
  • To assess how EDACS levels influence growth parameters, considering motor function and CP subtype.

Main Methods:

  • Cross-sectional study utilizing data from the Swedish CP follow-up program for children aged 19 years and younger.
  • EDACS ratings were correlated with z-scores for weight-for-age and height-for-age.
  • Regression models analyzed the impact of EDACS levels on height-for-age, controlling for gross motor function and CP subtype.

Main Results:

  • Included 2280 children with CP; 30.6% had safety concerns (EDACS levels III-V).
  • 19.9% of children experienced undernutrition, with a significant association between EDACS level and nutritional status (p < 0.001).
  • Height-for-age decreased from EDACS level II, even after controlling for motor function and CP subtype.

Conclusions:

  • Nearly one in three children with CP exhibit dysphagia.
  • Growth is negatively impacted in children with CP starting from EDACS level II, highlighting the importance of early intervention.
Abstract

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