Pica is an eating disorder that involves consuming items not normally eaten by people, such as sand, garbage, and glue. Pica is a fairly common eating disorder among children and the developmentally challenged, and it can have serious repercussions. Pica is sometimes caused by nutrient deficiencies.
Usually in children, the disorder will go away with time, but when it continues, treatment for Pica usually involves behavior modification strategies, and can be a very difficult habit to break.
Symptoms of Pica Eating Disorder
The symptoms of Pica are the consumption of non-food items. Sufferers of Pica will eat different items depending on their compulsion. According to the National Institute of Health (NIH), common examples are
- Dirt
- Paper
- Feces
- Garbage
- Clay
- Ice
- Hair
During his work with the developmentally challenged population, the author has worked with several Pica sufferers, including one who once swallowed a razor blade, several who would eat feces, and another who caught and ate a live small bird.
In those who have Pica due to nutritional deficiencies, the sufferer may eat items that do not contain the minerals lacking in the person’s diet (“Pica” kidshealth.org/). This is counterintuitive to what one might expect, and makes it difficult to diagnose the deficiency without specific testing.
In order to be diagnosed as Pica, “This pattern of eating should last at least one month (“Pica” nlm.nih.gov).” It should be noted that Pica is different from the normal exploring of its environment that a child does. In a child, the eating pattern must be considered inappropriate for the child’s age (“Pica” kidshealth.org).
Causes of the Pica Eating Disorder
There are several possible causes of Pica Disorder, as its symptoms fit several maladies. Some potential causes are:
- Nutrient Deficiency, usually iron or zinc deficiency
- Parasites causing a nutrient deficiency
- Obsessive Compulsive Disorder
- Stimming related to Autism
- Mental Illness such as Schizophrenia
- Developmental Challenges or Traumatic Brain Injury (TBI)
In some cases, this eating disorder is caused by cultural factors, especially the eating of soil or clay. “Clay eating and starch eating are seen in the United States in some southern, rural, African American communities, primarily among women and children (Ellis, Dr. Cynthia R. “Pica” emedicine.medscape.com).” In some cultures, eating starch is also common to treat morning sickness (Ellis).
Pica Eating Disorder Treatment
Treatment for Pica varies depending on what has caused the disorder. For those found to have a nutrient deficiency, treatment for the deficiency should make the Pica behavior disappear (nih.gov). In cases where the nutrient deficiency is caused by a parasite, that parasite must be addressed first.
When Pica is caused by mental illness or developmental challenges, treatment becomes more complex.
According to Dr. Ellis, “Currently, behavioral strategies have been most effective in treating pica (Ellis).” The four basic strategies for behavior modification are (LeBow, Dr. Robert. Lecture. 11/17/08):
- Positive reinforcement (the addition of something enjoyed) for good behavior, such as a token economy
- Negative reinforcement (the removal of something aversive) for good behavior, such as removal of something phobic.
- Positive punishment (the addition of something aversive) for poor behavior, such as a water mist spray.
- Negative punishment (the removal of something enjoyed) for poor behavior, such as planned ignoring.
Note that some of these strategies are only used in severe cases. The most common strategies are Positive Reinforcement for good behavior and Positive Punishment for poor behavior. The specific steps are contingent on the Pica sufferer.
There have been some studies that show that the use of medication have been effective in treating Pica (nih.gov).
In his work with those with Pica, the author has often used a token economy to great effect.
Pica can be a very serious and dangerous disorder. Lead poisoning from eating paint chips is possible, along with poisoning from household cleaners and the like. Other potential problems are bowel obstructions, malnutrition, and bezoar-- a ball of foreign material in the stomach (“Bezoar” nih.gov). Treatment of Pica is not easy, but it can be done. The key is using appropriate behavior strategies for the sufferers of this eating disorder.
 |
