Rumination Disorder 333
hand over the mouth or coughing. Some will a void eating with others because of the ac-
knowledged social undesirability of the behavi or. This may extend to an avoidance of eat-
ing prior to social situations, such as work or school (e.g., avoidi ng breakfast because it
may be followed by regurgitation).
Prevalence
Prevalence data for rumination disorder ar e inconclusive, but the disorder is commonly
reported to be higher in certain groups, such as individuals with intellectual disability.
Development and Course
Onset of rumination disorder can occur in in fancy, childhood, adolescence, or adulthood.
The age at onset in infants is usually between ag es 3 and 12 months. In infants, the disorder
frequently remits spontaneously, but its course can be protract ed and can result in medical
emergencies (e.g., severe malnutrition). It can potentially be fatal, particularly in infancy.
Rumination disorder can have an episodic course or occur continuously until treated. In
infants, as well as in older individuals with intellectual disability (intellectual developmen-
tal disorder) or other neurodevelopmental diso rders, the regurgitation and rumination be-
havior appears to have a self-soothing or self-stimulating func tion, similar to that of other
repetitive motor behaviors such as head banging. 
Risk and Prognostic Factors 
Environmental. Psychosocial problems such as lack of stimulation, neglect, stressful life
situations, and problems in the parent-child relationship may be predisposing factors in
infants and young children.
Functional Consequences of Rumination Disorder
Malnutrition secondary to repeated regurgit ation may be associated with growth delay
and have a negative effect on development an d learning potential. Some older individuals