What is pica?
Pica is generally defined as the compulsive eating of non-nutritive substances. This behavior is manifested for a period of at least one month at an age when this behavior is developmentally inappropriate (after eighteen to twenty-four months), and is not a culturally sanctioned practice. The term pica comes from the Latin word for magpie. This bird is known for eating habits that are indiscriminate between food and non-food substances.
Who is most likely to exhibit pica behavior?
This eating disorder is most often seen in children but it is also the most common eating disorder seen in individuals with developmental disabilities. Pregnant women may experience pica which generally disappears at the end of the pregnancy.
What causes pica behavior?
The exact cause for pica behavior is generally undetermined. We know that persons with developmental disabilities are at higher risk for this behavior and pica tends to be more severe in persons with more severe developmental disabilities. In some cases there may be nutritional deficiencies in iron and zinc but addition of these substances does not always result in the cessation of the behavior. Some research findings suggest that individuals report enjoying the sensory aspects of the substance such as the texture, taste or smell. Other researchers feel that there may be an underlying biochemical disorder or that it may be a part of the spectrum of obsessive-compulsive disorder (OCD) in which relief from tension or anxiety is obtained through this practice.
What sort of things may be ingested?
Some substances reportedly ingested are: clay or dirt, stones, hair, feces, laundry starch, vinyl gloves, pieces of plastic, pop-top rings, plaster, chalk, wood, burnt matches and cigarette butts, including filters. Ingesting anything that has no food value is considered pica behavior.
What are the risks of this behavior?
Pica is an extremely serious problem due to the potential for harm to the person following ingestion of substances that may be toxic or lethal. Risks include the potential for parasites, bowel obstructions, perforations caused by sharp objects, and accidental poisoning. Poisoning may occur when lead or other heavy metals are ingested. Eating certain plants or berries that are inedible can cause poisoning. Drinking chemicals or household cleaners, for instance, can cause burns and even death. Surgical intervention may be necessary to correct problems caused by pica and places the person at risk for surgical complications.
How do you treat pica in persons with developmental disabilities?
First, the person must be kept safe which may mean careful monitoring of the environment to remove toxic or lethal substances. Adequate supervision must be provided. A functional analysis is critical to assist in making a determination of the function of this behavior and suggesting behavioral strategies that may be successful. Some positive behavior practices that have shown promise include discrimination training between edible and non-edible items, antecedent manipulation, and differential reinforcement of other or incompatible behaviors. Other behavioral strategies may be successful in treatment of pica and frequent review of published research is warranted.
For more information about poisoning, visit www.aapcc.org web site.
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