There is no denying that disordered, unhealthy eating habits of any kind present a significant problem and distressing situation to one’s family and to the individual themselves. Such is the case with pica eating disorder.
This disorder is motivated by a desire to consume ingredients or items that are of a non-nutritive, sometimes non-food, nature. The cause of this is sometimes unknown and hard to pinpoint, but has been linked to those with autism spectrum disorder (ASD).
Are pica and autism connected?
Pica is an eating disorder characterized by the persistent consumption of non-nutritive substances, such as dirt, paper, chalk, starch or hair, for a period of at least one month. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties with social interaction, communication, and restricted, repetitive patterns of behavior or interests.
While these two conditions are distinct, research and clinical observations have highlighted notable connections between the two. Understanding these connections can aid in the early identification and treatment for those who may be affected by both.
Individuals with autism are significantly more likely to exhibit pica behavior compared to the general population. Estimates suggest that around 23% of children with ASD and up to 60% of adults may experience pica at some point. This increased prevalence can be attributed to several overlapping behavioral characteristics and sensory processing differences common in autism.
Children with ASD often exhibit difficulty with sensory processing and pica may be an expression of this. For instance, the tactile or oral stimulation provided by certain substances might be sought after by those with sensory-seeking behaviors. The act of eating non-food substances can also be a form of self-soothing or self-regulation in response to environmental stressors that individuals with autism might find overwhelming.
Additionally, difficulties with communicating can keep children with ASD from expressing their needs or discomforts, such as hunger or nutritional deficiencies, leading them to seek out non-nutritive substances as a way to care for themselves. Or, it might occur as part of a wider pattern of restricted and repetitive interests typical to autism, where a fascination with the texture or function of non-food items becomes intense enough to cause them to want to consume the item.
How is pica treated in someone with autism spectrum disorder?
One of the first steps in treating pica in individuals with autism is through a thorough medical evaluation to rule out any underlying medical or nutritional deficiencies that may be contributing to the behavior. For example, deficiencies in minerals like iron or zinc can sometimes manifest in pica-like behaviors. Correcting these deficiencies through dietary changes or supplements may reduce or eliminate the pica behavior. Thus, collaboration with healthcare providers, including pediatricians or dieticians and nutritionists, is essential in the beginning stages of treatment.
Once medical concerns have been addressed and/or ruled out, behavioral interventions are the next step. Applied Behavior Analysis (ABA) is a commonly used modality as ABA focuses on understanding the function of pica behavior within the context of the individual’s environment; it attempts to modify the behavior through reinforcement and other behavioral modification techniques. For instance, positive reinforcement might be used to encourage the individual to engage in alternative, appropriate behaviors. Additionally, functional communication training may be used to give individuals more adaptive ways to express their needs or sensory preferences.
Changing factors in the environment is also a crucial tool used in decreasing pica behavior. For example, it might mean removing harmful non-food items from any easily accessible spaces. Caregivers, teachers and family members should be educated and involved in maintaining this safe environment.
Additionally, providing sensory alternatives that cater to the individual’s needs, such as chewable jewelry or other safe items designed for oral stimulation, can satisfy the sensory needs without the associated risks of consumption.
In some cases, medication may be considered, particularly if pica is resistant to behavioral interventions or if there is a coexisting condition, such as obsessive-compulsive disorder. Medications such as selective serotonin reuptake inhibitors (SSRIs) have been explored for reducing compulsive behaviors, although their use should be carefully monitored by a healthcare professional due to potential side effects and varying individual responses.
Family and caregiver support is also vital in the treatment of pica in individuals with autism. Education and support for caregivers enables them to better understand the disorder and implement effective strategies that will benefit the individual’s recovery efforts. Support groups and resources can provide invaluable assistance and encouragement as all parties navigate these challenges.
Pica recovery programs
Managing a situation of pica is challenging, especially when you notice it occurring in the lives of one of your children. Thankfully, with the right treatment approaches and management strategies targeted at addressing both pica and any underlying concerns, recovery is possible.
To get in touch with a facility that can help, contact Seeds of Hope by calling (610) 679-8262 or fill out an online contact form on our website anytime.
