Intellectual and Developmental Disabilities (IDD) and Food Neophobia

By Sigrid Wang

Intellectual and Developmental Disabilities (IDD) refer to a group of conditions characterized by limitations in both intellectual functioning and adaptive behavior. These limitations typically appear during the developmental period and affect learning, communication, social interaction, and daily living skills. 

Among the many challenges faced by individuals with IDD, feeding difficulties are particularly common. One notable type of feeding difficulty is food neophobia. Food neophobia is characterized by the child’s rejection of foods that are new or unfamiliar for them, both visually and in terms of taste [7]. One in every tenth child was diagnosed with high levels of food neophobia, among which the age group of 5–6 years has the highest percentage. It also confirmed that the occurrence of food neophobia is independent of gender [6].

Factors influence food neophobia

Food neophobia, especially in children with IDD, is rarely caused by a single factor. Instead, it is the result of a complex interaction between genetic and environmental influences and the strength of which changes throughout life [5].

Research has suggested that certain feeding behaviors like neophobia, may run in families due to a potential hereditary component. Some children are born with heightened sensitivity to taste, smell, texture or even the appearance of food. Sensory characteristics have been regarded as one of the most influential determinants of eating behavior, and textures are the main reason for food rejection in children [3]. For instance, a child might refuse green vegetables because the texture feels overwhelming instead of its taste. Some children may also become distressed when presented with certain food combinations or consistencies. 

Feeding behavior is also determined by many factors including anthropological, economic, psychological and home-related factors. Their influences interact with each other and are shaped by the individual situation of the family [4]. The way a child is introduced to food and the experiences they have during mealtimes play a crucial role. Several environmental factors can reinforce food neophobia. For example, negative early experiences, such as choking, vomiting, or allergic reactions can lead to strong associations between unfamiliar foods and discomfort.

Parental pressure to insist a child eat something can increase anxiety when eating,  which will be worse over time. Lack of variety in the child’s diet or infrequent exposure to new foods can also limit their willingness to try unfamiliar items. Children with IDD are especially vulnerable to these influences because they often rely more heavily on routine. Changes in food color, shape or even the type of plate used can cause distress. 

The importance of overcoming food neophobia

Addressing food neophobia in children with IDD is not just about encouraging them to eat more variety, but because of long-term health development and life quality for both themselves and the whole family.

Firstly, limited food intake can lead to deficiencies in essential nutrients. Children with neophobia may avoid entire food groups like fruits, vegetables or proteins, which results in unbalanced diets and lacking key vitamins and minerals. These deficiencies can have irreversible consequences during critical periods of growth for children. For example, iron deficiency in early childhood can impact cognitive function and learning ability. 

The act of eating is also a developmental process. During mealtimes, children learn important skills such as chewing, using utensils and realizing hunger or fullness. If a child consistently avoids new food, they may miss the opportunity to develop these skills, which will lead to further delays in social interaction.

Additionally, for children who have chronic conditions that require special diets, food neophobia can seriously influence treatment. These children may refuse the necessary substitute foods, making it difficult for caregivers to manage the condition effectively. In such cases, neophobia can directly impact the treatment of the disease and further increase the risk of complications [7]. Moreover, mealtime struggles can place emotional strain on families. Repeated conflicts or anxiety around feeding can disrupt family harmony and lead to caregivers' stress.

Strategies to address food neophobia

While food neophobia in children with IDD can be a complex and lasting challenge, there are several practical strategies that caregivers and professionals can use to help children build a more positive relationship with food.

The first one is gaining dietary care and professional support from a feeding specialist to develop a personalized eating plan. Considering both the child’s preferences and their medical or developmental needs matters a lot for overcoming food neophobia. A specialist can also monitor for nutrient deficiencies and suggest gradual strategies for food introduction.

Children are more likely to engage with food when mealtime feels safe and enjoyable. Small changes in presentation can make a big difference. Animal-shaped spoons or plates featuring cartoon characters can be used to spark curiosity and reduce anxiety. Serving meals in small portions and offering them at consistent times each day can also build predictability for them.

The emotional tone during meals matters. Caregivers should try to maintain a calm and positive atmosphere and avoid forcing children to eat. Always celebrating small successes in trying new foods can build trust and reduce fear [2].

Finally, children should be actively invited to help prepare meals like choosing items at the grocery store or washing vegetables can build excitement and ownership for them. It also increases the chances they’ll be willing to try the foods they helped create [1].

References

[1] Allirot, X., da Quinta, N., Chokupermal, K., & Urdaneta, E. (2021). Involving children in food preparation: A way to promote healthy eating and reduce food neophobia? Appetite, 166, 105475. doi: 10.1016/j.appet.2016.04.031

[2] Dovey, T. M., Staples, P. A., Gibson, E. L., & Halford, J. C. G. (2008). Food neophobia and ‘picky/fussy’ eating in children: A review. Appetite, 50(2–3), 181–193. https://doi.org/10.1016/j.appet.2007.09.009

[3] Drewnowski A. Taste preferences and food intake. Annu. Rev. Nutr. (1997). 17:237–253. doi: 10.1146/annurev.nutr.17.1.237.

[4] Guzek D., Nguyen D., Głąbska D. Food Neophobia and Consumer Choices within Vietnamese Menu in a Polish Cohort Study. Int. J. Environ. Res. Public Health. (2021). 18:2925. doi: 10.3390/ijerph18062925.

[5] Howard A.J., Mallan K., Byrne R., Magarey A., Daniels L. Toddlers’ food preferences. The impact of novel food exposure, maternal preferences and food neophobia. Appetite. (2012).59:818–825. doi: 10.1016/j.appet.2012.08.022.

[6] Kozioł-Kozakowska A., Piórecka B. Food neophobia its determinants and health consequences. Stand. Med. Pediatr. (2013). 1–6.

[7] Patel M.D., Donovan S.M., Lee S.-Y. Considering Nature and Nurture in the Etiology and Prevention of Picky Eating: A Narrative Review. Nutrients. (2020). 12:3409. doi: 10.3390/nu12113409.