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Pica Disorder in Children with Autism

Pica is a Latin term that refers to a raven that eats everything voraciously. This disorder is characterized by a tendency to consume non-food items. Pica is often associated with developmental and intellectual disorders, such as autism, and children with autism may eat unusual or unhygienic items such as walls, dirt, clay, clay modeling materials, paper, wood, wax, and chalk, which can pose serious health risks.

 

 

Causes of Pica

Several factors may contribute to this behavior:

  1. Sensory-Taste Disorders:
    Children with autism may have either heightened or reduced taste sensitivity. Those with low taste sensitivity may not perceive the harmfulness of certain items, making them more likely to lick or eat non-food objects.
  2. Organic Causes:
    Nutritional deficiencies, such as low levels of iron, zinc, calcium, and vitamins B1, B2, B3, C, as well as anemia or malnutrition, may trigger Pica.
  3. Psychological and Social Causes:
    Emotional deprivation or lack of parental care and attention can contribute to the development of Pica behaviors.
  4. Enzyme or Appetite Regulation Issues:
    Malfunctioning enzymes in the brain that regulate appetite may cause the child to consume inappropriate items or substances that their body lacks, such as iron.
  5. Digestive Problems:
    Some children may have gastrointestinal discomforts, such as colic, which may lead them to chew or ingest unusual items as a coping mechanism.

 

Prevalence

Studies show that Pica affects 16% to 32% of children aged 1 to 6 years, with a significant decrease in older children, reaching about 10% in children over 10 years old. Pica is very rare among typically developing children or adolescents. Among children with developmental, intellectual, or autism-related disorders, the prevalence can reach 25%, with roughly equal rates in boys and girls.

 

Potential Harm from Pica

  1. Poisoning: Consuming materials such as lead paint chips can cause stomach disorders, neurological damage, hyperactivity, and distractibility.
  2. Infections: Eating clay or dirt may lead to parasitic or bacterial infections.
  3. Bacterial and Parasitic Diseases: Contaminated items can cause severe illnesses affecting the liver and kidneys.
  4. Gastrointestinal Damage: Eating indigestible objects like stones may result in intestinal blockage, ulcers, wounds, or damage to the esophagus and stomach.

 

Treatment

1. Medical Treatment

  • Children with Pica often have anemia, iron deficiency, vitamin D deficiency, calcium and zinc deficiency, and sometimes fungal infections in the mouth or tongue.
  • Comprehensive medical examinations are necessary to correct nutritional deficiencies.
  • There is currently no specific medication for Pica, but some studies suggest that medications that improve dopamine function may help reduce the behavior.

2. Psychological and Behavioral Treatment

  • For children with low taste sensitivity, it is beneficial to redirect their attention to other sensory channels, such as touch and sight, and encourage safe exploration of objects.
  • Continuous emotional support from the family is essential to reduce psychological stress and reinforce positive behaviors.
  • Behavioral and educational training: Teach the child to distinguish between edible and non-edible items. Pair correct behavior with reinforcement and incorrect behavior with verbal cues and facial expressions.
  • Professional guidance is essential due to the potential health risks associated with Pica.