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Tackling Pica

Caring for a child with special needs is difficult and challenging to manage on its own. As a parent of children with disabilities, the primary focus we seek to provide our children is quality of their life, achieving moments of independence, socialization with others and their overall well-being. What do you do however, when a condition is paired with another debilitating disorder - in this case Pica?What is Pica exactly? 


Pica is classified as an eating disorder often present in children who suffer from Autism and other developmental and intellectual disabilities. I recall how strange this disorder seemed when we were first introduced to it in our youngest son. I remember searching the internet and finding Webster’s definition of Pica: “an abnormal desire to eat substances not normally eaten”. It was described so matter of fact, however as a parent, I found it immensely overwhelming as we attempted to comprehend why my son would ingest random objects in his environment. It is one thing reading about this behavior and quite another watching your son eat things like clothing, paper or screws. We had to constantly observe him and ensure we swept his environment for potentially harmful things that he may target. 


Juggling his non-verbal Autism along with Pica seemed nearly impossible in that moment.Pica can range in severity and typically exposes the child to dangers such as choking, ingestion of harmful or toxic substances and damaging of teeth. To the parents and caretakers however, it’s a dangerous and continuous struggle of daily safety management. Not to mention extremely stressful and emotionally draining. 


• Why is my child seeking out these non-edible items to eat? 

• How can I ensure every preferred non-edible item is always out of reach and avoidable? 

• What are the available options to help my child with this condition? 


These are all valid questions to ask yourself and it’s also very important to seek out a formal diagnosis as the first step in helping to heal your child.  Pica, unlike many other mental health disorders, is easily diagnosed as its only major symptom is immediately detectable. Our son was constantly chewing on things, drooling, and eventually choking or vomiting from attempting to swallow non-edible objects. It was absolutely horrifying.  Seeking medical assistance from the nearest research hospital, was the first action we took in our journey.Doctors began the arduous diagnosis process with standard blood tests to extract nutrient deficiencies – zinc or iron -- which can sometimes provoke the urge to chew and ingest non-edible items. 


Medical and diet deficiencies, sensory stimulation, anxiety and behavior-related issues are typical root causes for Pica that the doctors will investigate. Diet deficiency was ruled out as a root cause for our son and we began discussing next steps with our developmental specialist. 


How is Pica Treated? 


Once the root cause has been established by a specialist, the next step is figuring out what works to manage your concerns and ensure your child’s safety. In our son’s case, the exact root cause has still not been determined. We have received multiple opinions - sensory stimulation and anxiety release. Unfortunately, when you have a low functioning child, many questions go unanswered – especially the whys. 


There are multiple recommended avenues to explore once you receive a Pica diagnosis. I suggest giving each a try. 


• Occupational therapy — this typically focuses on treating the sensory imbalances present in many developmental and intellectual disorders. This would address Pica if the basis of the child’s eating disorder is derived from sensory or anxiety related issues. The child may seek out certain textures, smells, or simply enjoy the feeling of the item in their mouth or throat.In this therapy, alternative methods are offered for obtaining the sensory stimulation that your child may be seeking or can assist in releasing anxiety. Jaw and facial massages, electronic toothbrushes or therapeutic baby brushes are some examples. Introduction of chews designed specifically for the purpose of assisting oral stimulation also can really be a great help in the treatment plan for this population. 


• Applied Behavioral Analysis or “ABA” therapy — a system that focuses on using data driven techniques to modify behaviors present in individuals who suffer from behavioral disorders. ABA is applied over time and does not typically offer an immediate resolution to Pica. Instead, therapists focus on teaching the child what is an appropriate edible vs non-edible. ABA encourages the parents/caretakers to continue the approaches outside of sessions. The repetition of this strategy would theoretically teach the child to eventually cease the behavior. 


• Non-harmful chewable replacements — items made from non-harmful and non-toxic materials that a child can chew on to address sensory and anxiety issues, teeth grinding, divert the need to eat non-edible items, establish focus, etc. This method can show faster results in some individuals and has been our family’s preferred method.Utilizing chewing replacements can be implemented at home and for a reasonable cost which was a relief as a special needs parent. “Chews”  are available in a variety of shapes, textures and densities to offer an alternative to the child's preferred non-edible. 


There are numerous resources online for exploring the various replacement options, but I found that Chubuddy helps to determine your child’s “Chew Factor” and offers a comprehensive guide to finding the right type of chew for your child. We were ecstatic to discover our son’s daily need to chew or eat non-edible objects was drastically reduced when we introduced the Springz bracelet! We also saw a reduction in self-injurious biting behavior with the introduction of the chew, which was a big sigh of relief. Seeing your child bite the skin off their hands and fingers to the point of bleeding is very unsettling to say the least. 


Once you have found that desired chew, ensure you have multiples handy and that they are always readily available to your child. Many chews can be clipped directly to your child’s clothing or if tolerated, or worn as jewelry around the neck or wrist. Our family utilizes jewelry that we clip to our son’s clothing to avoid losing them.  He prefers the stretchiness, softness and length of the Springz bracelets and Spiralz necklaces, and after trial and error, this has become his favorite! 


There will always be disappointment, confusion, sadness, grief and even despair, but after all the hard times, there is also hope, strength and the unconditional love that special needs parents provide their little ones (and often receive back too!).Nothing has been proven to be 100% effective yet, and as parents, we can only try our best and find what works for our child. It’s like a puzzle that requires many helping hands to put together. So rest assured that you are not alone on this journey. We are a community of those helping hands, ready to reach out and share our stories and experiences together.        Allesandra B

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