Assessment & Research

The social and recreational characteristics of adults with intellectual disability and pica living in institutions.

Ashworth et al. (2009) · Research in developmental disabilities 2009
★ The Verdict

Adults with ID and pica in institutions are lonelier and less active—treat social needs as a medical priority.

✓ Read this if BCBAs writing discharge or day-program plans for institutionalized adults with pica.
✗ Skip if Clinicians who only work with children or out-patient brief consultations.

01Research in Context

01

What this study did

Ashworth et al. (2009) looked at adults with intellectual disability who live in large institutions.

They compared two groups: residents who eat non-food items (pica) and residents who do not.

Staff records gave data on friendships, group activities, and free-time choices.

02

What they found

The pica group had fewer friends and joined fewer games or outings.

They also spent more free time alone or doing simple, solitary tasks.

Overall, pica went hand-in-hand with clear social isolation.

03

How this fits with other research

K-Alanay et al. (2007) found that institutional life itself raises rates of infection and mental health issues. Melody’s work adds social isolation to that list of risks.

Rose et al. (2000) showed poor diet and little exercise among UK residents. Together with Melody, these papers paint a full picture: body and social life both suffer inside institutions.

Peters et al. (2013) mapped daily-living skill gaps in the same setting. Their data help explain why residents with pica struggle: weaker community skills leave fewer chances to join safe, fun activities.

04

Why it matters

If you serve adults with ID and pica, plan rich social and recreational supports before any move to community living. Build small-group meals, peer buddies, and structured hobbies into the behavior plan. These steps can cut isolation and may reduce pica itself.

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Add one peer-accompanied lunch or game period to the weekly schedule for each client with pica.

02At a glance

Intervention
not applicable
Design
other
Sample size
1008
Population
intellectual disability
Finding
negative

03Original abstract

This paper reports on the social life of adults with intellectual disability (ID) who engage in pica behaviour (i.e., ingestion of non-food items). Secondary analyses were conducted on the population of adults residing in Ontario's three remaining specialized institutions for persons with ID (N=1008); 220 individuals (21.8%) had pica. All persons were assessed using the interRAI Intellectual Disability assessment, a comprehensive and standardized instrument that supports person-centered service planning. A series of logistic regression models were used to evaluate the relationship between pica and various indicators of social relationships and activities, while controlling for a set of covariates. Pica was significantly associated with increased likelihood of not having a strong and supportive relationship with family, lack of social contact, absence of participation in activities of long-standing interest, absence of involvement in a day program, as well as lack of involvement in recreational activities; though it was not related to interpersonal conflict. Attention should be equally paid to the social correlates of pica rather than solely concentrate on its health risks. Implications for the community supports needed to ensure the successful transition of persons with pica from institutional to community settings is also discussed.

Research in developmental disabilities, 2009 · doi:10.1016/j.ridd.2008.07.010