Pica refers to eating or mouthing non-edible items, such as stones, dirt, metal, faeces.
The reason a person on the autism spectrum might experience pica could be medical, dietary, sensory or behavioural and include:
- not understanding which items are edible and inedible
- seeking out sensory input – the texture or the taste of the item
- relieving anxiety or stress
- relieving pain or discomfort
- displaying a symptom of iron deficiency
- a continuing of infant mouthing behaviour, or a later occurrence of the mouthing phase
- seeking attention
- avoiding a demand
You could try to:
- set up a sorting activity for the person to sort edible and inedible items
- use PECS (Picture Exchange Communication System) to encourage the person to put appropriate items in their mouth and reward them
- replace the inappropriate item with an appropriate alternative of a similar texture, eg a crunchy carrot stick, a chewy tube, popcorn, chewing gum
- visit the GP or dentist to rule out any medical problems, oral pain or nutritional deficiencies, or to seek referral to an occupational therapist
- increase the amount of structured activities in the person's day
- respond as neutrally as possible when the behaviour occurs, giving a firm 'no' with little eye contact, reinforcing it with a symbol
- reduce demands placed on the person
- distract and divert their attention.
You could try to use a social story to reinforce the idea about not eating faeces. Social stories are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why.
The National Autistic Society website has some useful information: http://www.autism.org.uk/about/strategies/social-stories-comic-strips.aspx
You could add pictures too if you feel this may help.
For example a social story about not eating faeces may include:
- Don't eat the poo
- Poo is dirty and smells bad
- Don't touch the poo with my hands
- Poo goes in the toilet
- I sit on the toilet and poo into the toilet
- If I want something to eat I ask for something that I can eat
If you are reading this information from a print-out, you can visit the web page and find out more at www.autism.org.uk/challengingbehaviour