Pica in persons with developmental disabilities: approaches to treatment.
ABA packages that mix reinforcement with response-reduction still hold the strongest evidence for stopping pica in clients with autism or ID.
01Research in Context
What this study did
Matson et al. (2013) read every paper they could find on pica treatment. They looked at clients with autism or intellectual disability. The team wrote a narrative review to see which treatments had the best evidence.
What they found
ABA methods came out on top. Reinforcement plus response-reduction was the winning mix. No drug or sensory diet beat that combo.
How this fits with other research
Diz et al. (2011) said the same thing two years earlier. Their systematic review of 34 studies also crowned behavioral packages as "well-established."
Ganz et al. (2004) told the same story but with fewer studies. The 2013 paper adds newer data and keeps the same verdict.
Boudreau et al. (2015) went further. They treated 11 kids in a day clinic and saw big drops in pica. Their real-client numbers back up the 2013 review’s claim.
Why it matters
You can stop guessing. Start with ABA first. Pair reinforcement for toy play or food with gentle response blocking. If DRA alone fails, borrow Cox et al. (2015) and add a brief facial screen. Document bites per minute and you should see change within days.
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02At a glance
03Original abstract
Pica is a very serious problem in which an individual ingests substances without nutrition value, such as paper and paint. As this behavior is often life-threatening resulting in surgery, pica has received attention from researchers for several decades. During that time, a number of interventions have been devised, such as behavioral methods (e.g., aversive stimuli, overcorrection, time-out, reinforcement) and biological interventions (e.g., pharmacotherapy, nutritional supplements). This paper is a broad review of the research on treatment studies for this problem, with a focus on persons with autism and/or intellectual disability (ID), which constitutes almost all of the published treatment papers. In addition, strengths and weaknesses of different pica treatments are discussed. Upon review, applied behavior analysis (ABA) was found to have the most robust empirical support to treat this behavior. Most clinicians are drifting away from aversive techniques and relying on more positive procedures to guide their treatment plans. The implications of current status and future directions for research are also addressed.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.018