![]() ![]() autistic spectrum disorder) or during a medical condition (e.g. If occurring in the presence of another mental disorder (e.g. The eating behaviour is not part of a culturally supported or socially normative practice. The eating of non-nutritive substances is inappropriate to the developmental level of the individual. Persistent eating of non-nutritive substances for a period of at least 1 month. The Diagnostic Criteria for Pica from DSM 5 (American Psychiatric Association, 2013) states that pica is: Health professionals who can diagnose pica include paediatricians, gastroenterologists, psychiatrists and/or clinical psychologists. Getting a diagnosis of pica can be the first step towards effective management, not least because early intervention may prevent harm and the need for more complex treatments further down the line. It is written again in collaboration with James’ family and aims to bring together evidence from research, clinical practice and strategies that families develop themselves.īy doing so, we hope to continue to highlight the dangers of pica behaviour and to provide support to those currently managing what is still a poorly understood, socially stigmatising and potentially lethal condition. In this second article we will concentrate on what is known about interventions or treatments for pica, particularly for autistic people. Such severe pica is relatively rare but the consequences for the person who engages in it and their family and friends can be devastating, as it was for James and his family, whose tragic story we told in our corresponding article on this subject. Very tragically, his pica behaviour was a factor in his untimely death at the age of 21. The reason for this was the huge variety of items he would eat, such as conifer leaves and other plant material, his long history of engaging in pica and his compulsion to obtain his preferred items. James’s pica was recognised as being severe. As a result, despite the best efforts of those around him, it proved impossible to completely stop James from engaging in pica. This was often when he would grab something and run off with it. His family went to great lengths to keep him safe, however he was very fast, fit and active and always appeared to know when his carers were distracted or had relaxed. In his family’s words, caring for James was a great privilege but also a challenge. James Frankish was autistic and had a learning disability and severe pica (the eating of non-foods). Dr Shea also offers some advice on supporting autistic people with pica. Gift Aid and making your donation go furtherĭr Liz Shea from the Birmingham Food Refusal Clinic discusses pica (the eating of non foods) and highlights the story of James Frankish who sadly died from issues related to the condition. Our patron, president and vice presidents doi:10.1016/j.jbct.2020.10.Adult residential and supported living service vacancies Journal of Behavioral and Cognitive Therapy. Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder. Thomas JJ, Becker KR, Breithaupt L, et al. Pica in persons with developmental disabilities: Approaches to treatment. Matson JL, Hattier MA, Belva B, Matson ML. Journal of Intellectual & Developmental Disability. Pica in people with intellectual disability: a literature review of aetiology, epidemiology and complications. Muller Journal of Medical Sciences and Research. Pica in children with tetralogy of Fallot: Report of two cases. Pica: an age-old eating disorder that's often missed. Hartmann AS, Becker AE, Hampton C, Bryant-Waugh R. International Journal of Eating Disorders. Development of the Pica, ARFID, and rumination disorder interview, a multi‐informant, semi‐structured interview of feeding disorders across the lifespan: A pilot study for ages 10–22. American Psychiatric Association 2013.Ĭall C, Walsh BT, Attia E. ![]() Diagnostic and Statistical Manual of Mental Disorders. Pica disorder among African American women: A call for action and further research. Epidemiology of eating disorders in Africa. Journal of Clinical Psychology in Medical Settings. A systematic review of the effectiveness of behavioural treatments for pica in youths. Moline, R, Hou, S, Chevrier, J, Thomassin, K. Handbook of Childhood Psychopathology and Developmental Disabilities Treatment. Pica in individuals with developmental disabilities. Pica: A common condition that is commonly missed - an update review.
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