The validation of Spanish and Portuguese versions was given high priority from the inception. Complete data from Portuguese language were available, and the EFAS Score Committee decided to publish this without delay without waiting for completed data from other languages. Following the results of the present study, it can be concluded that the EFAS Score was successfully cross culturally validated in Portuguese. As 221 million people speak Portuguese as mother tongue worldwide, the validation of the Portuguese score version is an important break- through for the EFAS Score. The eleven currently validated EFAS Score versions allow for validated assessment of almost 1 billion people worldwide in mother tongue.