Aim: The aim of this study was to develop a valid classification system to describe eating and drinking ability in people with cerebral palsy (CP), and to test its reliability.Method: The Eating and Drinking Ability Classification System (EDACS) was developed in four stages in consultation with individuals with CP, parents, and health professionals: Stage 1, drafting informed by literature and clinical experience; Stage 2, modification by nominal groups; Stage 3, refinement in an international Delphi survey; and Stage 4, testing of agreement and reliability between classifications made by speech and language therapists (SaLTs), and between SaLTs and parents.Results: Seven nominal groups involved 56 participants; 95 people participated in two rounds of the Delphi survey. Using the version of EDACS produced from this process, SaLTs in pairs classified 100 children. The rate of absolute agreement was 78% (kappa=0.72; intraclass correlation coefficient [ICC]=0.93; 95% confidence interval [CI] 0.90–0.95). Any disagreement was only by one level, with one exception. SaLTs and parents classified 48 children. The rate of absolute agreement was 58% (kappa=0.45, ICC=0.86; 95% CI 0.76–0.92). Parents either agreed with SaLTs or rated their children as more able by one level.Interpretation: The EDACS provides a valid and reliable system for classifying eating and drinking performance of people with CP, for use in both clinical and research contexts.

Surveillance registers monitor the prevalence of cerebral palsy and the severity of resulting impairments across time and place. The motor disorders of cerebral palsy can affect children's speech production and limit their intelligibility. We describe the development of a scale to classify children's speech performance for use in cerebral palsy surveillance registers, and its reliability across raters and across time. Speech and language therapists, other healthcare professionals and parents classified the speech of 139 children with cerebral palsy (85 boys, 54 girls; mean age 6.03 years, SD 1.09) from observation and previous knowledge of the children. Another group of health professionals rated children's speech from information in their medical notes. With the exception of parents, raters reclassified children's speech at least four weeks after their initial classification. Raters were asked to rate how easy the scale was to use and how well the scale described the child's speech production using Likert scales. Inter-rater reliability was moderate to substantial (k>.58 for all comparisons). Test-retest reliability was substantial to almost perfect for all groups (k>.68). Over 74% of raters found the scale easy or very easy to use; 66% of parents and over 70% of health care professionals judged the scale to describe children's speech well or very well. We conclude that the Viking Speech Scale is a reliable tool to describe the speech performance of children with cerebral palsy, which can be applied through direct observation of children or through case note review.

Activities and participation of children with cerebral palsy: parent perspectives. . ???aop.label???.

Aim: The aim of this study was to investigate if intervention targeting breath support, phonation, and speech rate increases speech intelligibility and participation in the conversational interactions of younger children with dysarthria and cerebral palsy (CP).Method: Fifteen children with dysarthria andCP(nine males, six females; age range 5–11y, mean age 8y,SD2y;CPtype: eight spastic, four dyskinetic, one ataxia, twoWorsterDrought syndrome;GrossMotorFunctionClassificationSystem levelsII–IV, median levelII) participated in this study. Children received three sessions of individual therapy per week for 6 weeks. Intelligibility of single words and connected speech was compared across five points: 1 and 6 weeks before therapy and 1, 6, and 12 weeks after therapy. Three familiar listeners and three unfamiliar listeners scored each recording. Participation in communicative interactions was measured using theFocus on theOutcomes ofCommunicationUnderSix (FOCUS) tool. Analyses of variance and pairedt‐tests were used to investigate change.Results: Mean speech intelligibility increased after therapy to familiar listeners (single words 10.8%, 95% confidence interval [CI] 7.2–14.4; connected speech 9.4%, 95%CI4.8–14.1) and unfamiliar listeners (single words 9.3%, 95%CI6.8–11.8; connected speech 10.5%, 95%CI7.3–13.8).FOCUSscores increased following therapy for parents (mean increase 30.3, 95%CI10.2–50.4) and for teachers (28.25, 95%CI14.4–42.1), but changes did not correlate with intelligibility. A wide variation was seen in individual responses to therapy.Interpretation: Brief intensive therapy is associated with gains in intelligibility and communicative interactions for some younger children with dysarthria.