The relationship between the severity of eating problems and intellectual developmental deficit level.
Use the STEP screener on every child with IDD—eating problems are the norm, and aspiration-risk rises sharply at severe/profound levels.
01Research in Context
What this study did
Gal et al. (2011) gave the STEP feeding screener to children with intellectual disability. They wanted to see if worse eating problems line up with lower IQ levels.
The team used a cross-sectional survey. They looked at one point in time, no control group.
What they found
Almost every child had some eating problem. The more severe the intellectual disability, the higher the risk of choking and aspiration.
Kids with profound ID showed the worst feeding issues.
How this fits with other research
Matson et al. (2008) built the STEP tool and gave adult cut-offs first. Eynat moves those cut-offs down to young children and links them to ID severity.
Ellingsen et al. (2014) and Leader et al. (2020) found the same high feeding-problem rates in kids with autism. The pattern looks similar across IDD and ASD groups.
Curtin et al. (2026) adds a twist: children with ID have double the obesity rate of peers, yet parent feeding style does not predict weight. Eating problems and weight gain may be separate tracks.
Why it matters
Run the STEP on every child with ID at intake. Flag severe/profound kids for aspiration-risk plans. Pair the data with BMI checks from Matson et al. (2009) and Curtin et al. (2026). You get a full feeding-risk picture in ten minutes.
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02At a glance
03Original abstract
Nutrition, essential in the daily living functions promoting life quality of persons with intellectual developmental deficits (IDD), is adversely affected by the highly prevalent eating problems in these persons. The current study explores the characteristics of eating problems in population of children with intellectual developmental disorders. We elaborate existing knowledge on the relationship of severity of eating/feeding disorders and intellectual handicap level in children who suffer from IDD. This study investigated differences in the kind of these disorders observed in children with IDD on three levels: mild, moderate, and severe/profound. Ninety-one children aged 4-9 participated in this study: 25 had mild IDD, 32 moderate IDD, and 34 severe/profound IDD. Feeding/eating functions were examined with the screening tool of eating problems (STEP) which was used as the main dependent measure (Matson & Kuhn, 2001). Results suggest that the prevalence of eating problems is higher than previously reported in the literature. Eating/feeding problems proved prevalent across all levels, in almost all of those with IDD, but certain categories of problems (i.e., skills and aspiration risk) are more prevalent among the group falling within the severe/profound range of intellectual disability. This finding makes a new important experimental contribution, suggesting that everyday functions such as eating/feeding be examined in all children with IDD and that clinical differences be considered in light of categorization according to IDD level. Results are discussed in light of the need to consider its implications for practice.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.12.003