course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restric-
tive food intake disorder (Criterion C). If the symptoms occur in the context of another
mental disorder (e.g., intellectual disability [intellectual developmen tal disorder], neuro-
developmental disorder), they must be suffici ently severe to warrant additional clinical
attention (Criterion D) and should represent a primary aspect of the individual’s presen-
tation requiring intervention. The disorder may be diagnosed across the life span, par-
ticularly in individuals who also have in tellectual disability. Many individuals with
rumination disorder can be dire ctly observed engaging in the behavior by the clinician. In
other instances diagnosis can be made on the basis of self-report or  corroborative informa-
tion from parents or caregivers. Individuals may describe the behavior as habitual or out-
side of their control.
Associated Features Supporting Diagnosis
Infants with rumination disorder display a characteristic position of straining and arching
the back with the head held back, making  sucking movements with their tongue. They
may give the impression of gaining satisfaction from the ac tivity. They ma y be irritable
and hungry between episodes of regurgitation.  Weight loss and failu re to make expected
weight gains are common features in infants with rumination disorder. Malnutrition may
occur despite the infant’s appa rent hunger and the ingestion of relatively large amounts of
food, particularly in severe cases, when regurgitation imme diately follows each feeding
episode and regurgitated food is expelled. Malnutrition might also occur in older children
and adults, particularly when the regurgitation is accompanied by restriction of intake.
Adolescents and adults may attempt to disgui se the regurgitation behavior by placing a