Writing in Autism Parenting Magazine, Claire Delano described potential problems with individuals mouthing or eating non-food objects and what can be done about this behavior. Ms. Delano's article—"Pica and Autism: What Should You Do?"—provided a good starting place for understanding and treating pica.
Pica is a dangerous, potentially life-threatening behavior for anyone. Depending on what objects are ingested, young children may face nutritional deficiencies, choking, poisoning, parasites, blood infections, intestinal blockages or perforations, etc. These problems can require hospital visits, surgery, and may even cause death.
In this article, we’ll explore what exactly pica is, what may cause it, and how you can help your child with autism if it’s something he/she struggles with.
In her description of how to help individuals with autism who have problems with putting inedible items in their mouths, Ms. Delano described four studies that used differential reinforcement to treat pica. Her descriptions of the studies are largely accurate and clear, making them accessible for lay readers.
Many research teams have reported methods for treating pica. As early as 1975 (see Foxx & Martin), behavior analysts addressed this problem, and they have continued to examine it much more recently (see Ledford et al., 2019). Some teams such as the one associated with Cathleen Piazza, Tiffany Kodak, and their colleagues have conducted multiple studies of pica as a part of broader work on eating (e.g., food refusal, mealtime misbehavior, and more). Also see studies reported by F. Charles ("Bud") Mace and his colleagues. Readers interested in these topics can search for work by any of these authors and find helpful articles.
I have listed a few of these various studies in the references. Note that not all of them examined pica among individuals with autism—no surprise, as other people may also mouth or eat non-food items.
Many of these studies employed functional analyses or functional behavior analysis. Understanding the functions of behaviors is a very important procedure for explaining and treating behavior problems. However, it is a topic for another post (or, perhaps, a series of posts).
Meanwhile, read Ms. Delano’s article!
Foxx, R. M., & Martin, E. D. (1975). Treatment of scavenging behavior (coprophagy and pica) by overcorrection. Behaviour Research and Therapy, 13(2-3), 153-162. https://doi.org/10.1016/0005-7967(75)90009-1
Kodak, T., & Piazza, C. C. (2008). Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North America, 17(4), 887-905. https://doi.org/10.1016/j.chc.2008.06.005
Ledford, J. R., Barton, E. E., Rigor, M. N., Stankiewicz, K. C., Chazin, K. T., Harbin, E. R., & Taylor, A. L. (2019). Functional analysis and treatment of pica on a preschool playground. Behavior Analysis in Practice, 12(1), 176-181. https://doi.org/10.1007/s40617-018-00283-9
Mace, F. C., & Knight, D. (1986). Functional analysis and treatment of severe pica. Journal of Applied Behavior Analysis, 19(4), 411-416. https://doi.org/10.1901/jaba.1986.19-411
Piazza, C. C., Fisher, W. W., Hanley, G. P., Leblanc, L. A., Worsdell, A. S., Lindauer, S. E., & Keeney, K. M. (1998), Treatment of pica through multiple analyses of its reinforcing functions. Journal of Applied Behavior Analysis, 31 (2): 165-189. https://doi.org/10.1901/jaba.1998.31-165