Assessment and treatment of pica: A consecutive controlled case series study

Frank-Crawford et al. (2025) treated 33 people who kept eating non-food items. They used one clear plan: find why pica happened, teach a safe swap, block the unsafe move, and practice in many places.

Each person got the same steps so the team could see if the full package worked for almost everyone.

Thirty of the thirty-three cases dropped pica by ninety percent or more. When new staff, rooms, and objects were added, twenty-six of twenty-nine clients kept the low level.

The plan worked without harsh steps or drugs.

Meier et al. (2012) first said we need multi-part plans and strong generalization checks. The new study answers that call with the largest run of cases to date.

Ruckle et al. (2023) tested the same three tools—DRA discard, RIRD, and competing items—in one child and saw big drops. Frank-Crawford et al. show the combo keeps winning across dozens of clients.

Ledford et al. (2019) proved a function-based plan can work on a preschool playground. The 2025 series widens the lens: it uses function-based tactics inside a broader package and proves it works for all ages and places.

You now have a full pica protocol that has already worked for thirty straight cases. Run the same steps: brief functional check, teach discard to trash, block and redirect every time, then practice with new people and settings. Track pica bites per hour; expect a ninety percent drop within weeks and durable safety across classrooms, homes, and community spots.