Sensory Explorations: Understanding Pica
What is Pica?
Pica is an eating disorder based on psychological, nutritional, and sensory factors in which individuals consume nonfood items (e.g., dirt, rocks, paper, crayons, and chalk) (Durani, 2023; Wu, 2023). In general cases, young children tend to put non-food items in their mouth (e.g., toys or grass) to explore the world around them; however, individuals with pica are ingesting the non-food items (Durani, 2023). This type of eating disorder can lead to many different complications, such as intestinal blockage, suffocation, dental injury, parasite infection, and a decreased ability of the digestive system to absorb nutrients from foods (Williams et al., 2022). If your child shows an indication of pica, there are various supports and strategies to ensure your child is safe and healthy. Read below to learn more and talk with your healthcare provider about any questions or concerns!
Populations with Pica
This eating disorder commonly impacts children between the ages 2-3; about 25% of individuals with intellectual disabilities experience PICA (Williams et al. et al, 2022).
Iron deficiencies are correlated with pica, and some individuals have been able to resolve their eating disorders by consuming iron supplements (Hill & Harrington, 2023; Williams et al., 2022). Here are some mental/developmental disorders that have been linked with pica:
Autism spectrum disorder (ASD)
Fetal alcohol syndrome (FAS)
Depression
Anorexia nervosa
Attention deficit hyperactivity disorder (ADHD)
Obsessive-compulsive disorder (OCD)
Brain injury
Sensory processing difficulties
(Williams et. al., 2022)
Some individuals have pica based on their social status/environment. Factors that may impact the presence of/individuals acting upon pica cravings include:
Lack of support
Little to no social contact
Decrease in participation and engagement with meaningful activities
Decrease in going out in the community
Environments that create a lot of stress on the body
(Williams et. al., 2022)
Correlation between Pica and Sensory Seeking
Oral-seeking individuals experience hyposensitivity or a lack of response to sensory stimulation (Wu, 2023). Individuals tend to seek strong textures, tastes, and pressure when chewing or biting on something (Wu, 2023).
Strategies for Pica
Foods with strong flavors: Foods with bold flavors or textures can help stimulate oral sensory input. Different foods for kids with pica include apples, crackers, nuts, berries, and sour candy.
Implement heavy and big movements: This can help add proprioceptive input as it links with oral seeking by receiving deep pressure on the body.
Create an obstacle course at home: This provides different sensory inputs, such as proprioceptive and vestibular input, to help individuals self-regulate when they need to move their bodies.
Use visual cues: This can help identify the items in the home that are not safe to eat and provide snacks or water so they have access to something to eat.
Social stories: Talking through a story can help educate kids on what is safe to eat and what is not. They can also show visual pictures of what they can eat and practice role-playing.
Positive reinforcement: This can help encourage desirable behavior when children pick up an edible food item to eat.
(Hill & Harrington, 2023 ;Wu, 2023)
References
Durani, Y. (2023). Pica. KidsHealth. https://kidshealth.org/en/parents/pica.html#:~:text=Pica%20is%20an%20eating%20disorder,can%20lead%20to%20health%20problems
Hill, J. & Harrington, R. (Hosts). (2023). Pica or oral seeking? Sensory strategies for both! (No. 263) [Audio podcast episode]. Harkla. https://harkla.co/blogs/podcast/263-pica-or-oral-seeking-sensory-strategies-for-both
Williams, F., Gibbs, S., & Ama S. (2022). The assessment and management of pica in people with intellectual disability. Cambridge University Press. https://www-cambridge-org.pearl.stkate.edu/core/journals/bjpsych-advances/article/assessment-and-management-of-pica-in-people-with-intellectual-disability/CCE4F8AFE3216EB4534D4E211F829862
Wu, E. (2023). How to manage pica with sensory therapy?. OT Ella Bella. https://otellabella.wordpress.com/2023/07/25/how-to-manage-pica-with-sensory-therapy/