[Dysphagia] PICA

[scott-dailey at uiowa.edu (Dailey, Scott)]

With PICA it is also important to rule out any nutrient deficiencies
(iron, magnesium, selenium etc). Some individuals who have deficiencies
will exhibit PICA, presumably in an effort to remediate the deficiency.


As well as the medical and sensory factors in pica, there may also be
social issues, in that anytime they try to put something in their
mouths, they receive attention, and may avoid a particular task
presented to them.  An approach like "We will take it away if you put it
in your mouth" when presented with tasks within their developmental
programming that they do not like. The individual may learn if I put
items in my mouth, the task goes away.   In addition, if the individual
has very limited skills for interacting with the environment and/or
limited independent leisure skills, pica may be the way they interact
with the environment when left alone even for a second.  Pica is not an
easy thing to treat, especially in the developmentally disabled
population.  

Scott

Scott Dailey, M.A., CCC-SLP
Speech-Language Pathologist II
University of Iowa Hospitals & Clinics
200 Hawkins Dr
Iowa City, IA 52242
(319)356-7030

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-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On
Behalf Of hillivie423@adelphia.net
Sent: Tuesday, November 01, 2005 12:16 PM
To: pressmah@sjhmc.org
Cc: dysphagia@b9.com
Subject: RE: [Dysphagia] PICA

 P.S., I believe that nearly everyone here has reflux, so that is also
an issue.  I  just don't see the deliberate seeking out and eating
inedibles except in 2 people out of 24 in this building.
---- pressmah@sjhmc.org wrote: 
> It would seem to me that if they are developmentally between the ages
of
> 18-24 months, that it would be an acceptable behavior, however, they
would
> require careful monitoring so that they do not swallow non edibles.
There
> is also some indication that excess mouthing may be secondary to
reflux i.e.
> if I have heartburn and I chew on something I make more saliva to
neutralize
> the acid.  Hilda Pressman
> 
> -----Original Message-----
> From: hillivie423@adelphia.net [mailto:hillivie423@adelphia.net]
> Sent: Monday, October 31, 2005 11:05 AM
> To: Dysphagia list
> Subject: [Dysphagia] PICA
> 
> 
> "Pica is an eating disorder typically defined as the persistent eating
of
> nonnutritive substances for a period of at least 1 month at an age in
which
> this behavior is developmentally inappropriate (eg, >18-24 mo). The
> definition occasionally is broadened to include the mouthing of
nonnutritive
> substances. Individuals presenting with pica have been reported to
mouth
> and/or ingest a wide variety of nonfood substances, including, but not
> limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead,
laundry
> starch, vinyl gloves, plastic, pencil erasers, ice, fingernails,
paper,
> paint chips, coal, chalk, wood, plaster, light bulbs, needles, string,
and
> burnt matches." 
> 
> The above quote was sent to me this morning.  It appears that anyone
who
> explores with his mouth, as do many of the profoundly mentally
retarded
> people with whom I work, should be considered to have PICA.  Is it
possible
> that people should not be diagnosed as having PICA if they mouth
objects to
> explore them, and then once the object is in the mouth, it gets
> automatically swallowed?
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