Discrimination training in the treatment of pica and food scavenging.

Two teens with intellectual disability lived on an inpatient unit. They kept eating non-food items.

Staff taught a simple rule. Food must sit on a bright placemat before it goes in the mouth. If you want more, ask by touching the mat.

A mild punisher followed any pica. The team tracked pica across three settings on the ward.

Pica dropped in every setting once the placemat cue began. One teen still followed the rule weeks later in the cafeteria and on family visits.

The second teen needed extra teaching in new places. Still, the mat signal cut dangerous eating fast.

Frank-Crawford et al. (2025) later tested 33 clients and beat pica by 90%. Their larger case series now sets the stronger standard, but the 1994 placemat idea lives inside their package.

Kern et al. (2006) swapped the placemat for an exchange: give me the rock, get a cracker. That tweak works when kids eat trash for the taste.

Ruckle et al. (2023) dropped the mat and used DRA plus brief blocking. Pica still fell, showing the field has moved past one-cue methods.

You can still start with the placemat trick. It is cheap, fast, and visual. Pair it with a request response and you get an early win while you build a fuller plan. Then fold in newer tools like DRA discard or functional swaps to lock in the gain across people and places.