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What Are Options for Treating PICA?

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Pica is an eating disorder typically characterized by the continual eating of nonnutritive substances for a period of at least 4 weeks at an age in which this behavior is developmentally inappropriate (e.g., >18-24 mo). Today, the definition of PICA has been expanded to include eating of nonnutritive substances.

Individuals who are diagnosed with pica have been reported to mouth and/or gulp down a wide variety of nonfood materials, including, but not limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, cigarette butts, wire, and burnt matches.

In the majority of cases of children who have been diagnosed with PICA, natural recovery occurs with time. Most children who have no mental problems simply grow out of the disorder. However, some children may need a multidisciplinary approach involving psychologists or social workers. The role of physician in early treatment stage is that of reassurance.

When spontaneous recovery does not take place, some type of treatment must be offered. Expansion of management plan must take into relation symptoms of pica and causative factors, as well as treatment of potential complications of the disorder.

The variety of behavioral strategies that have been proven to be effective in treating PICA include

- Antecedent treatment
- Distinction guidance between edible and non-edible items
- Self-protection equipment that prevent insertion of objects in the mouth (mouth guards)
- Sensory strengthening of proper foods
- Differential strengthening of other or unrelated behaviors, such as screening (covering eyes briefly), or performing exercise (or watching TV) is encouraged
- Conditional aversive oral taste (silver acetate, lemon)
- Conditional aversive smell consciousness (sulfur or ammonia),
- Conditional aversive physical awareness (water spray, mild static shock therapy),
- Brief time out with physical restraint of arms
- Correction of the environment
- Administer appropriate responses to reinforce positive behavior.

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EmpowHER Guest

My question was, "is there a medical reason why I have been smelling and tasting burnt matches?" The answer was PICA. This is not anywhere close to the question. Please let me know what it is that might be going on, and what can be done about it. Thank you so much for your attention to this matter.

Marilyn Noel

January 19, 2012 - 10:32pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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