Identifying feeding problems in mentally retarded persons: development and reliability of the screening tool of feeding problems (STEP).

The team built a five-minute carer checklist called STEP. It flags five feeding-risk zones: choking risk, food refusal, poor chewing, picky eating, and low weight.

They tested the form with adults who have intellectual disability. Factor analysis and reliability checks showed the tool hangs together and carers agree on scores.

STEP gave clear factors that match real-life problems. Inter-rater reliability was high enough for clinic use.

No feeding treatment was tried; the paper only shows the scale works as a quick screen.

Meral et al. (2014) later kept the same 23 items but ran them in Turkish with kids on the spectrum. Their positive results extend STEP beyond English-speaking adults.

Sauna-Aho et al. (2025) scanned 31 ways to check swallowing in adults with ID and found only four tools with solid proof. STEP was not among the four, yet it still fills a gap: it is shorter and carers can give it free while the proven tools need special gear or clinics.

Farrant et al. (1998) and Baker et al. (2005) used the same build-and-test plan for epilepsy scales in the same population. Their pattern shows brief carer reports can be trusted for medical red flags, backing STEP’s approach.

You now have a five-minute screen you can hand to staff or parents during intake. If STEP flags aspiration risk or severe selectivity, you have data to fast-track the client to a swallow study or feeding team. Use it before you write goals so you target the right domain first.