# Cross-Cultural Adaptation and Validation of the Mini-Eating and Drinking Ability Classification System for Korean Children with Cerebral Palsy Aged 18–36 Months

## TL;DR

The Korean version of the Mini-EDACS is a reliable and valid tool for assessing feeding and swallowing abilities in young children with cerebral palsy.

## Contribution

The study provides a culturally adapted and validated version of the Mini-EDACS for Korean children with cerebral palsy aged 18–36 months.

## Key findings

- The Korean Mini-EDACS showed excellent inter-rater reliability between caregivers and clinicians.
- Strong correlations were found between Mini-EDACS levels and other functional classification systems.
- The tool supports standardized communication and early identification of children needing feeding support.

## Abstract

What are the main findings?
The Korean version of the Mini-Eating and Drinking Ability Classification System (Mini-EDACS) demonstrated excellent inter-rater reliability between caregivers and clinicians.Construct validity was supported by significant correlations between Mini-EDACS levels and other functional classification systems (GMFCS, Mini-MACS, CFCS, VFCS, and FOIS-C).

The Korean version of the Mini-Eating and Drinking Ability Classification System (Mini-EDACS) demonstrated excellent inter-rater reliability between caregivers and clinicians.

Construct validity was supported by significant correlations between Mini-EDACS levels and other functional classification systems (GMFCS, Mini-MACS, CFCS, VFCS, and FOIS-C).

What is the implication of the main finding?
The Korean Mini-EDACS provides a reliable and valid framework to classify feeding and swallowing abilities in children with cerebral palsy aged 18–36 months.This tool enables standardized communication between clinicians and caregivers and may guide early identification of children needing feeding support.

The Korean Mini-EDACS provides a reliable and valid framework to classify feeding and swallowing abilities in children with cerebral palsy aged 18–36 months.

This tool enables standardized communication between clinicians and caregivers and may guide early identification of children needing feeding support.

Background/Objectives: Feeding and swallowing difficulties are common in young children with cerebral palsy (CP), yet no validated tool has been available in Korea for those under 3 years. The Mini-Eating and Drinking Ability Classification System (Mini-EDACS) was designed for children aged 18–36 months. This study aimed to translate the Mini-EDACS into Korean and evaluate its reliability and validity. Methods: Translation followed international guidelines, including forward–backward translation and Delphi consensus with experts in pediatric dysphagia. Forty-eight children with CP (mean age 27.1 ± 5.0 months) were assessed. Caregivers and speech–language pathologists (SLPs) independently rated Mini-EDACS and assistance levels. Inter-rater reliability was examined using Cohen’s κ. Construct validity was tested by Spearman’s correlations with the Gross Motor Function Classification System (GMFCS), Mini-MACS, the Communication Function Classification System (CFCS), the Visual Function Classification System (VFCS), and the Functional Oral Intake Scale for Children (FOIS-C). Results: Agreement between caregivers and SLPs was excellent (κ = 0.90; weighted κ = 0.98). Assistance-level ratings also showed almost perfect concordance (κ = 0.97). Mini-EDACS correlated strongly with FOIS-C (ρ = −0.86, p < 0.001) and with assistance levels (ρ = 0.81, p < 0.001). Moderate-to-strong positive correlations were observed with GMFCS (ρ = 0.56), Mini-MACS (ρ = 0.64), CFCS (ρ = 0.61), and VFCS (ρ = 0.61), supporting construct validity. Conclusions: The Korean Mini-EDACS is a reliable and valid tool for classifying eating and drinking abilities in children with CP under 3 years. It enables standardized communication between caregivers and clinicians, complements existing functional classification systems, and may facilitate earlier identification and intervention for feeding difficulties.