Identifying empirically supported treatments for pica in individuals with intellectual disabilities.

The team pulled every study they could find on pica in people with intellectual disabilities. They kept only the 34 that met strict scientific rules. Then they asked: which treatments have enough proof to be called well-established?

Packages that mix reinforcement for good behavior with ways to block or reduce pica rose to the top. These combos now count as well-established, the highest stamp of approval in behavior analysis.

Ganz et al. (2004) told the same story in 2004, but with a looser narrative review of 26 studies. The new work tightens the screws by using systematic rules and adding eight more studies.

Boudreau et al. (2015) later showed the payoff in real life: all 11 kids in their clinic got big drops in pica after staff used the same combo packages.

Allan et al. (1994) is one of the 34 studies pooled here. Their tiny three-child test of custom reinforcers and punishers now sits inside a much larger evidence base.

You no longer have to guess what works for pica. Pick interventions that both reward alternate behavior and stop the pica response. If you already use DRO, NCR, or brief restraint, keep going—the science backs you up. Start new cases with a two-part plan: reinforce mouth-appropriate play while blocking or redirecting every pica attempt.