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  Feeding Problems - STEP  

Feeding and meal-time behavior problems are extremely common among individuals with Intellectual Disabilities. Feeding problems such as rumination, vomiting, pica, food refusal, and inadequate feeding skills are all behaviors that can contribute to severe health problems.

The Screening Tool of fEeding Problems (STEP) was developed as a means to identify feeding problems presented by persons with Intellectual Disability, and thus facilitate the process of identifying who would benefit from some type of behavioral or medical intervention. Items included in the STEP target feeding problems identified in the literature in the areas of risk of aspiration, food selectivity, feeding skills deficits, food refusal and associated behavior problems, and nutrition related behavior problems.


Kuhn, D. E., & Matson, J. L. (2002). A validity study of the Screening Tool of Feeding Problems (STEP). Journal of Intellectual & Developmental Disability, 27(3), 161-167.

Laud, R. B., & Matson, J. L. (2006). The relationship between manic symptoms on the DASH II and YMRS and feeding/mealtime behavior problems. Research in Developmental Disabilities, 27(5), 559-566.

Matson, J. L., Cooper, C. L., Mayville, S. B., & Gonzalez, M. L. (2006). The relationship between food refusal and social skills in persons with intellectual disabilities. Journal of Intellectual & Developmental Disability, 31(1), 47-52.

Matson, J. L., & Kuhn, D. E. (2001). Identifying feeding problems in mentally retarded persons: Development and reliability of the screening tool of feeding problems (STEP). Research in Developmental Disabilities, 22(2), 165-172.

Matson, J.L., & Kuhn, D.E. (2001) Screening Tool of fEeding Problems (STEP). Baton Rouge, LA: Disability Consultants, LLC.

Matson, J. L., Mayville, S. B., Kuhn, D. E., Sturmey, P., Laud, R., & Cooper, C. (2005). The behavioral function of feeding problems as assessed by the questions about behavioral function (QABF). Research in Developmental Disabilities, 26(4), 399-408.

Mayville, S. B., Matson, J. L., Laud, R. B., Cooper, C., & Kuhn, D. E. (2005). The Relationship Between Depression and Feeding Disorder Symptoms Among Persons with Severe and Profound Mental Retardation. Journal of Developmental and Physical Disabilities, 17(3), 213-224.