A preliminary evaluation of empirically derived consequences for the treatment of pica.

Three kids who kept eating non-food items joined a brief experiment at the table. The team first watched each child for 15 minutes while they offered toys, snacks, and mild reprimands. They counted which rewards made the child put food in the mouth and which scolding made the child stop reaching for paper or foam.

Next they set a blue plate on a red mat and told the child, "Food stays on the plate." If the child ate a bite, they got the best toy from the test. If the child grabbed foam, the adult said "No" and took the mat for 30 seconds. Sessions ran five days a week for nine months.

Pica drops fast when the reinforcer and punisher are picked for that one child. One boy went from 12 foam bites per session to zero in four days. All three kids kept near-zero pica for the full nine months and gained weight with regular food.

The blue plate plus red mat became a clear signal. When it was on the table, kids chose food; when it was gone during a probe, pica came back, proving the package worked.

Boudreau et al. (2015) later repeated the idea in a busy clinic and saw the same big drops across eleven children with autism or ID. Their study extends Allan et al. (1994) by showing the assessment-driven package still works when parents watch through a one-way mirror.

Scotchie et al. (2023) used the same quick test method, but for expulsion instead of pica. They swapped bite size, texture, and spoon angle until the child swallowed. Both papers show a five-minute assessment can pick the exact condition that keeps food in the mouth.

Ganz et al. (2004) looked back at 26 older pica studies and said "use DRO or overcorrection if assessment says so." That review now includes Allan et al. (1994) as an early example of picking consequences from data, not guesswork.

You do not need a long functional analysis to cut pica. Run a 15-minute probe with toys, snacks, and a mild "No." Track what keeps hands off trash and what stops a reach. Then put the best reward on a colored plate or mat and keep the mild punisher ready. The signal plus paired consequences held for nine months in the original kids and still works in modern clinics. Try it next week; it takes one meal and a data sheet.