Have you noticed your child with autism reaching for unusual objects and putting them in their mouth? This behavior might be pica, a condition characterized by the persistent eating or mouthing of non-food items. While pica can occur in children with or without autism, it’s significantly more common in those on the spectrum.
What Is Pica?
Pica is a feeding disorder characterized by the persistent consumption of non-nutritive substances for at least one month. These substances can vary greatly, ranging from seemingly harmless items found in nature like dirt, leaves, and grass, to potentially dangerous and even lethal objects such as rubber gloves, clothing tags, screws, or cigarette butts.
There’s a spectrum of severity when it comes to pica. Some children may primarily ingest relatively harmless materials, while others may gravitate towards more concerning objects that can cause choking hazards, intestinal blockages, or even lead poisoning.
The reasons behind pica behavior in autistic individuals are complex and not fully understood. It’s believed that sensory seeking can be a significant factor. The texture or mouthfeel of certain non-food items might be appealing to someone with autism. Additionally, pica may serve as a way to self-soothe or cope with anxiety or pain, particularly pain related to dental issues.
Is Pica Common in Autism?
Pica is significantly more prevalent in individuals with autism compared to the general population. Studies suggest that around 23.2% of autistic children and a staggering 60% of autistic adults exhibit pica behavior. This stark contrast highlights the strong association between pica and autism spectrum disorder (ASD).
The link between pica and autism may be further supported by research examining gastrointestinal (GI) issues. Children with autism and pica appear to have a higher prevalence of GI signs, symptoms, and diseases compared to those without pica.
Additionally, autistic children with pica are more likely to experience food cravings and specific GI conditions like irritable bowel syndrome (IBS) and gastroesophageal reflux (GERD) than autistic children without pica.
Research on adults with autism and pica paints a similarly concerning picture. A study analyzing ten years of medical records found that individuals with pica, particularly those with co-occurring autism, had significantly higher rates of various health conditions compared to control groups.
These findings suggest that pica takes a toll on the body over time, potentially leading to shorter lifespans and higher mortality rates for individuals with autism. Experts believe autistic individuals with pica may represent a distinct subgroup characterized by unique GI symptoms and requiring specialized treatment approaches.
While the exact reasons behind pica in autism remain under investigation, some potential explanations exist. Sensory-seeking behavior is a common factor, where the individual finds the texture or mouthfeel of non-food items pleasurable.
Another possibility is difficulty distinguishing between food and non-food items, leading the autistic child to believe the inedible object is something they can eat. Finally, pica can sometimes be a sign of a nutritional deficiency.
How to Treat Pica in Autistic Children?
Getting a diagnosis of pica is a crucial first step towards effective management. Early intervention can prevent harm and the need for more complex treatments later. Pediatricians, gastroenterologists, psychiatrists, and clinical psychologists can diagnose pica and may recommend additional tests to rule out underlying nutritional deficiencies or medical conditions that might contribute to pica behavior.
Medical Evaluation and Management
A doctor will likely run blood tests to check for iron and zinc deficiencies, common contributors to pica. Based on the results, dietary changes or supplements may be recommended. Additionally, pica can lead to health complications like lead poisoning, which can also be detected through blood tests. Regular monitoring is crucial to identify and address any pica-related health issues like dental problems, nutrient absorption difficulties, or blockages in the digestive system.
Collaboration with Caregivers
Inform teachers, childcare providers, and anyone else involved in your child’s care about the pica diagnosis. Sharing details about the types of non-food items your child tends to eat and situations that might trigger pica helps them keep your child safe. Teachers may need to adjust routines or store certain materials out of reach.
Environmental Modifications
“Pica-proofing” your home environment is essential. Identify and remove objects your child commonly eats. This might involve keeping tempting items out of sight, locked away, or placed high on shelves. Frequent vacuuming and sweeping are important, but remember to be patient – creating a completely pica-proof environment can be challenging.
Remember, pica can impact the entire family. Offer support and understanding to siblings who might be affected by their brother’s or sister’s pica. For example, a sibling might feel frustrated if their toys are damaged due to pica behavior.
Sensory Enrichment
If your child’s pica is linked to sensory seeking, enriching their environment with stimulating activities can be helpful. Provide a variety of engaging activities that keep their hands busy, reducing the urge to put non-food items in their mouth. This could include playing with sensory bins, building with blocks, or creative art projects.
Teaching Food vs. Non-Food Differentiation
Help your child develop the ability to distinguish between safe, edible food and non-food items. Use games or activities to practice identification, sorting, and labeling safe and unsafe objects for consumption.
Behavioral Intervention
Consider working with a Board Certified Behavior Analyst (BCBA) or other qualified behavior specialist. They can help develop a personalized treatment plan using techniques like skill building, redirection, and providing alternative behaviors that meet your child’s sensory needs in a safe way. These strategies can significantly reduce pica behavior and improve your child’s overall safety and well-being.
Your Partner in Helping Children with Autism
At Rainbow ABA, we have a team of experienced and compassionate ABA therapists serving children with autism in New Jersey, Georgia, and Texas. Our therapists can create a personalized treatment plan to address pica behavior and help your child develop healthy eating habits.
Contact us today to schedule a free consultation and learn more about how Rainbow ABA can support your child’s journey!
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