Eating What You Should Not: Pica in Autistic Individuals

Pica Pica

Pica is a deadly disorder, one which is both standalone but appears also in individuals diagnosed with autism. One of the comorbid disorders related to those on the spectrum, it is a strange behavioural problem that is also defined as an eating disorder which has failed to subside in children older than 36 months. Many children on the spectrum are also diagnosed with pica, one which might be the result of an excessive need for sensory stimulation. This peculiar phenomenon dates back to the Greco-Roman civilization. Rather interesting, as deadly as it can be.

Pica Facts
Certain facts concerning the prevalence of Pica have been presented in the November 2012 issue of Psychiatric Annals. Certain intriguing points include:

  • Pica is the recurring ingestion of nonnutritive substances. these can include anything from soil to freezer frost to carpets and paint.
  • The substances eaten may vary with age and what is available at the moment.
  • Within younger population or those with neurological disorders, clinicians see pica as a form of self-soothing behavior that occurs when arousal reaches a certain level.
  • Prevalence seems to be higher among certain populations, including pregnant women, children, adults with iron deficiency, and institutionalized individuals.
  • A referenced study presents that 33.9% of Detroit children in treatment for sickle cell anemia were diagnosed with pica.
  • Pregnant women around the world show different prevalence rates of pica, ranging from 5% to 56%.
  • Pica comorbid disorders include: intellectual development disorder, autism spectrum disorder, schizophrenia, avoidant/restrictive food intake disorder (ARFID), and obsessive-compulsive disorder.

Pica's Gender Discrimination
In one particular study, 13 non-nutritive food items were determined to be consumed with the prevalence of geophagy, amylophagy, and of other pica substances such as charcoal and chalk being 53.4%, 85.2% and 19.0% respectively. Furthermore, pica was not found to be higher during pregnancy, contrary to what other studies have suggested. Also, where once it was believed that the prevalence was higher in females, it has been found that one should not discriminate, with males just as likely to be diagnosed with the possibly deadly disorder.

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Pica and ASD
Pica, combined with autism spectrum disorder and an intellectual disability, was found to show the least amount of pro-social behavior and the most amount of negative behavior when compared to any of the groupings with single disorders. This conclusion was reached by researchers looking at adults and the degree to which autism and intellectual disabilities combined with pica can contribute to a lack of social skills. The study was published in the October 2012 issue of the Journal of Developmental and Physical Disorders, and claimed that adults with intellectual disabilities and/or with autism spectrum disorders are often at risk for developing additional forms of psychopathology and/or challenging behaviors, including pica.

Pica Treatment
Over the last few decades, a number of interventions have been devised. These conclude behavioral methods (e.g., aversive stimuli, overcorrection, timeout, reinforcement) and biological interventions (e.g., pharmacotherapy, nutritional supplements). The most effective method of treatment discovered was the use of applied behavior analysis (ABA). Clinicians are now focusing on more positive procedures to guide their individual treatment plans. The article outlining this information does not fail to also mention the need for surgery and the fact that this form of addiction to eating material that is not nutritional could be life-threatening.

One Strange Addiction... to Sofas
The DailyMail newspaper had published a story about a woman with a strange addiction. Her comfort food was eating sofas! Adele Edwards, of Bradenton, Florida, had been eating the foam inside couch cushions for 21 years in 2011. She had sought help at this time, which has me wondering if she still has this problem, and, if so, to what degree. According to her, she has eaten couch cushions everyday of her life since she was 10 and her cousin tried it out for fun. With her parents divorcing and stress becoming commonplace in her life, her pica addiction had her consuming the equivalent of a throw pillow per week. According to the doctors, if she continued on this path she would die. Her major problem? Iron deficiency.

If you want to read a touching story about the adoption of a child with pica and the reasons for his disabilities, click here.



Oh for crying out loud!!! Zinc and/or iron deficiency!!! Run fast and far from those who think it's all in your head, especially if they concoct some aversive "solutions"!
VJ, your comment confuses me. Why would a nutrient deficiency not be an answer for eating non-foods? Also, what are you suggesting is all in your head?
I absolutely agree with VJ- There are plenty of studies that also agree as well saying that having a deficiency such as iron and/or Zinc or B, etc... You can easily crave things that are more primal and instinctive by scent and by nature (i.e. Dirt, paint, ice chips, etc...) Having experienced this with my own daighter who is highly functioning autistic - I absolutely agree (and in my own opinion, conclude) that this is a way to treat Pica. When your body needs protein it'll crave meat even if you don't eat meat- there is absolutely no difference here. My daughter is 5 and began eating dirt last year - to the point she would sneak away during play time or out of the dog door to get it. It was petrifying! ABA said it was a "punishable act" so we needed to make sure that we always had the Same "punishment" for it. I didn't necessarily agree with this as it wasn't a behavior she could control. After research and talking with doctors - we did blood work and found out she was anemic. About three weeks after starting her on a children's Multi vitamin and morning drops of iron in her juice - she perked up and her cravings stopped completely. I truly suggest researching this if PICA is something you or someone you know Is suffering from.
Ohhh, You mean don't buy into the fact that is is a need for sensory stimulation. I'm sorry. I have always learned too that it is from nutritional deficiency.