Reducing pica by teaching children to exchange inedible items for edibles.

Two children with developmental disabilities kept eating non-food items. The team taught a simple swap. Hand over the rock or paper; get a bite of cookie in return.

Sessions ran in a clinic room. Trainers waited for pica attempts, then cued the exchange. They praised each trade and gave a small edible.

Pica dropped fast when the kids could trade. The swap kept working weeks later. One child needed extra practice to use the skill in new rooms.

Frank‐Crawford et al. (2025) later tested a fuller package with 33 clients. Their 90 % drop in pica supersedes this tiny 2006 study and shows the exchange idea scales up.

Ruckle et al. (2023) ran a conceptual replication. Instead of trading for food, kids tossed pica items into a trash can and got praise. Pica still fell, proving the magic is the replacement response, not the cookie itself.

Ledford et al. (2019) extended the swap idea to a preschool playground. Teachers gave attention, not food, for handing over items. Pica stayed low, showing the reinforcer can change as long as the response stays easy.

You can start tiny. Teach one clear trade: item in hand, edible in mouth. Watch the data; if pica dips, keep the swap and fade the food later. If it spreads, add extra settings or people. The 2025 case series gives you a roadmap when you are ready to build a full program.