Most of us are aware that infants like putting small nonfood objects in their mouth. Some older children and even adults, however, continue the practice. Then, this activity becomes an eating disorder called pica. In fact, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines pica as the “persistent eating of non-nutritive, nonfood substances for a period of at least one month,” particularly when doing so is not appropriate to the developmental level of the individual. These substances can even include one’s own hair or finger nails. Pica is especially dangerous when the individual ingests hazardous or poisonous materials such as paint chips that may contain lead, unsanitary items, or objects rendered sharp when they are broken.
Pica often occurs in persons who have another mental disorder, such as anorexia, anxiety, or autism. Among the latter, autistic individuals may enjoy the sensory stimulation this activity may provide. It is not an effort to gain attention or the result of an inability to communicate needs. The DSM-5 states that when pica occurs with another condition or disorder, is severe enough to warrant clinical attention.
All people who care for the individual must also be alerted to take the necessary steps to keep him or her safe, including the following:
- Keep those items out of reach of the individual in the home and places in the community. At home, careful and frequent cleaning are critically important.
- Communicate what is food and what isn’t and reinforcing those lessons
- Enrich the individual’s sensory environment in ways that do not involve putting things into one’s mouth, such as activities that keep the hands busy
- Follow through with established behavior plans (e.g., with Applied Behavior Analysis). This may include a system of rewards or schedule of small snacks of actual food items.
As with any psychological condition, preventing undesirable behaviors with healthy ones takes a great deal of patience, understanding, and being alert.