In this chapter the term "feeding problem" describes a range of ingestive behaviors in persons with intellectual disabilities (ID). The chapter focuses on evidence-based practice (EBP) for food refusal, pica, and rumination. The prevalence of food refusal in children with ID is unclear. To date, there are no consensus panel reports or controlled group studies which provide evidence for effective interventions for food refusal. There are, however, a growing number of treatment studies which use single-subject designs. Medical problems commonly associated with food refusal may require the involvement of medical providers, while changes in diet or tube feedings may require consultation from a nutrition specialist. Pica is common among persons with ID. Both behavioral and nutritional interventions have been used in the treatment of pica. Rumination may lead to significant medical problems including dehydration, weight loss, malnutrition, and aspiration. Other feeding issues discussed here include rapid eating and adipsia.
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