Fact Sheet

What is Pica Disorder?

Pica (Disorder) is the craving to eat non-food items, such as dirt, paint chips, and clay. Some children, especially preschool children, exhibit Pica. Pica is prevalent among individuals having developmental disorders including autism, individuals with an intellectual disability, and among young children age two to three years.

Very young children are not able to look at an object and determine if it is edible, so they give things they are interested in the “taste test.” Eventually, through their own development and trial and error, most children begin to discriminate between food and inedible objects and find other ways to explore and satisfy their curiosity.

Children younger than age two, especially those who are teething, will chew on non-food items and may try to eat them. This is considered developmentally appropriate for their age. Although it varies, most children generally lose the desire to put things in their mouths around age two.

The word “pica” is derived from the Latin word for magpie, a species of bird that feeds on whatever it encounters.

How is it manifested?

The mental health professionals’ handbook, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (2013), which is abbreviated as DSM-5, classifies Pica under the heading of “Feeding and Eating Disorders of Infancy or Early Childhood.” A diagnosis of Pica Disorder requires that the individual must persist in eating non-food substances for at least one month. This behaviour must be inappropriate for the child’s stage of development. Further, it must not be approved or encouraged by the child’s culture.

Who is affected?

Some research indicates that 25-33 percent of young children have Pica Disorder at some point. Young children with Pica are most likely to eat paint, plaster, string, hair, and cloth, while older children are more likely to consume animal droppings, sand, insects, leaves, rocks, and cigarette butts.

Individuals with developmental disabilities have an increased chance of the condition. People with mental health issues such as Obsessive-Compulsive Disorder and Schizophrenia and nutritional deficiencies also are at increased risk. Other at-risk groups include pregnant women, dieters, individuals who are malnourished, people who have epilepsy, and children who experience neglect, lack of supervision, and insufficient food and nutrition.

Children who have had a brain injury also may develop the condition. Pica becomes less prevalent as children grow older, and most adult cases are found in individuals with an intellectual disability.

How is it diagnosed or detected?

There is no diagnostic test for Pica. Typically, a person with Pica is referred to a physician for some other condition that is linked to Pica, like iron deficiency, anemia, lead poisoning, or malnutrition. Pica is then discovered during diagnosis and treatment. To receive a diagnosis of Pica Disorder the individual must have a primary diagnosis.

The child’s family doctor or paediatrician will play an important role in helping parents manage and prevent pica-related behaviours and in educating parents to teach children about acceptable and unacceptable food substances. The doctor will also work with you to find ways to restrict the non-food items your child craves (e.g., using child-safety locks, high shelving, and keeping medications out of reach). Some children require behavioural intervention and families may need to work with a psychologist or other mental health professional.

Prevalence:

(United States): Prevalence of Pica is limited because the disorder often is unrecognized and underreported. Although prevalence rates vary depending on the definition of Pica, the characteristics of the population sampled, and the methods used for data collection, Pica is reported most commonly in children and in individuals with mental and developmental delays. Children with an intellectual disability and autism are affected more frequently than children without these conditions. Among individuals with intellectual disability, Pica is the most common eating disorder, where the risk and severity of Pica increases with the severity of the delay. In some cultures, Pica is a sanctioned practice and is not considered pathologic.

Additional Resources

Kids Health – http://kidshealth.org
Kids Health is a website and source of information about health, behaviour, and development from before birth through the teen years.

Books

Consuming the Inedible: Neglected Dimensions of Food Choice (Anthropology of Food and Nutrition)
by Jeremy MacClancy, C. Jeya Henry, and Helen Macbeth
Throughout the world, everyday, millions of people eat earth, clay, nasal mucus, and similar substances. Yet food practices like these are strikingly understudied in a sustained, interdisciplinary manner. This book aims to correct this neglect. Contributors, utilizing anthropological, nutritional, biochemical, psychological and health-related perspectives, examine in a rigorously comparative manner the consumption of foods conventionally regarded as inedible by most Westerners.

Handbook of Preschool Mental Health: Development, Disorders, and Treatment
by: Joan L. Luby, MD
This important volume comprehensively explores the development of psychiatric disorders in 2- to 6-year-olds, detailing how the growing empirical knowledge base may lead to improved interventions for young children and their families. Leading contributors examine advances in the conceptualization and diagnosis of early-onset disruptive disorders, mood and anxiety disorders, eating and sleeping disorders, autism, and other clinical problems.

The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.