Eating behaviors and feeding problems among school-aged children with and without intellectual and developmental disabilities in Saudi Arabia

Children with intellectual and developmental disabilities (IDD) are at increased risk of nutritional challenges due to distinctive eating behaviors and feeding problems. Therefore, this study aimed to assess eating behaviors and feeding problems among school-aged children with and without IDD in Saudi Arabia and explore differences across diagnostic subgroups. This cross-sectional study was conducted in Riyadh, Saudi Arabia, between August and December 2024. A total of 168 school-aged children (68 with IDD and 100 without IDD) were recruited at the Child Development Center, University Hospital. Data on sociodemographic characteristics, eating behaviors, and feeding problems were collected using a structured, caregiver-administered questionnaire. Children with IDD exhibited a higher burden of eating behaviors and feeding problems compared to healthy peers. They were more likely to experience difficulties with sucking, chewing, and swallowing (37% vs 17%, P  = .001), gastrointestinal complaints such as nausea/vomiting (37% vs 15%, P  = .005) and constipation/diarrhea (43% vs 17%, P  = .001), and dental issues that interfered with swallowing (37% vs 18%, P  = .024). Overeating (41% vs 18%, P  = .002), unhealthy snacking (53% vs 32%, P  = .017), and pica (41% vs 15%, P  = .001) were also more common in IDD. Fruit and fruit juice intake differed significantly across subgroups ( P  = .033), with autism spectrum disorder children showing the lowest consumption. School-aged children with IDD in Saudi Arabia face significant nutrition-impacting eating behaviors and feeding difficulties compared to healthy peers. These findings highlight the need for routine, diagnosis-sensitive nutrition care and provide evidence to inform tailored interventions and policy strategies aimed at improving nutritional status and mealtime well-being in this population.