Pica

Treatments

Overcorrection Procedure        

Treatment Summary: Overcorrection procedures are applied to teach correct behavior through exaggerated practices which includes oral hygiene, personal hygiene and tidying. Oral hygiene, personal hygiene and tidying are used in an alternating form. Individuals are requested to brush their teeth with a toothbrush soaked in a slightly distasteful solution, such as lemon juice or hot sauce. Individuals are made to wash their hands, face and anus, along with being asked to pick up their living area and empty their trash. A damp washcloth soaked in unpleasant solutions was also used to wash their lips and mouth for the overcorrecting process. 

• Reference: Bell, K. E., & Stein, D. M. (1992). Behavioral treatment for Pica: a review of empirical studies. International Journal of Eating Disorders, 11 (4), 377-389 

• Submitter: Valerie Parker 

Response Blocking, Redirection, and Differential Reinforcement 

Treatment Summary: After determining the non-nutritive item that is being consumed, the same item is then placed on the floor in a room along with nutritive foods, games, and various activities. The child is instructed not to eat the non-nutritive items and instead eat the food, play the games and engage in the activities. If the child reaches for the Pica item (the process of eating a non-nutritive substance like cigarette butts), they are given a verbal reprimand not to do so and be physically aided to prevent the Pica event. Within the room a colored card is emplaced to associate the card with the correct behaviors. After conditioning, the colored card is given to the child without response blocking reprimands. 

• Reference: Stiegler, Lillian N., (2005). Understanding pica behavior: a review for clinical and education professionals. Focus on Autism and Other Developmental Disabilities, 20(1), 33. 

• Submitter: Michael McDonald 

Reducing Pica by Teaching Children to Exchange Inedible Items for Edibles 

Summary of Treatment: The resource noted below discusses the use of reinforced behavior modification to decrease the frequency of pica. The subjects that participated in this treatment study suffered from severe levels of mental retardation and, in some cases, had comorbid conditions. After baseline assessments were conducted to determine each participants preferred edible items. The participants then underwent a teaching session where the process of exchanging inedible items for their preferred edible items was explained (the teaching ended once each participant made 10 successful exchanges without being prompted).  When the participants entered the intervention phase of this process, they were instructed to hand the therapist inedible items for a chip or whatever their preferred item was. When pica would occur, the therapist would reteach the participant. It was found that, over the course of time, the frequency of exchanges would increase, while the incidence of pica decreased.  

• Reference: Kern, L., Starosta, K., & Adelman, B. (2006). Reducing pica by teaching children to exchange inedible items for edibles. Behavior Modification, 30(2), 135-158. doi: 10.1177/0145445505283414 

• Submitted By: Ashley Pruszinski