What is pica?

June 2005

What is pica?

Pica is an eating disorder characterized by a persistent craving for and ingestion of nonfood substances (e.g. clay, dirt, feces, laundry, cornstarch, cigarette butts, ashes, plaster, toothpaste, and soap.) While it is often a part of normal developmental exploration for infants and toddlers to put any and everything into their mouths, youth with pica continue this pattern well beyond the age of 2. According to Stefanie Dugan (2002, Gale Encyclopedia of Medicine), there is no known specific cause for pica but it is often associated with “nutritional deficiencies; dieting; malnutrition; cultural factors; parental neglect; developmental problems; mental health conditions- autism, mental retardation, obsessive compulsive disorders, schizophrenia, stress; and pregnancy. Pica can lead to lead poisoning, bowel problems, intestinal obstruction or perforation, dental injury and parasitic infections.”

The DSM-IV diagnostic criteria for Pica (1994, the American Psychiatric Association) includes:

A. Persistent eating of nonnutritive substances for a period of at least one month.

B. The eating of nonnutritive substances is inappropriate to the developmental level.

C. The eating behavior is not part of a culturally sanctioned practice.

D. If the eating behavior occurs exclusively during the course of another mental Disorder (e.g., Mental Retardation, Pervasive Developmental Disorder, Schizophrenia) is sufficiently severe to warrant independent clinical attention.

WHAT CAN PARENTS/GUARDIANS DO?

Educate young children about appropriate and non-appropriate substances.
Request a comprehensive assessment for the youth—physical, emotional and educational.
Remove and or secure inappropriate or dangerous substances.
Keep physical and mental health providers informed of your child's eating pattern.
Develop a treatment plan with your provider and youth (if possible) that works for your family.

WHAT CAN MENTAL HEALTH PROVIDERS DO?

Help families obtain a comprehensive assessment— physical, emotional and educational—for their youth.
Provide families and youth with educational information about pica.
Provide families and youth with information about various treatment options including family guidance, mild aversion therapy, positive reinforcement, and cognitive behavioral therapy.
Develop with families, youth, and physical health providers a comprehensive treatment plan.

Technical Assistance Partnership for Child and Family Mental Health

Mental Health and Systems of Care Frequently Asked Questions

Home About Us About Systems of Care Contact Us Events & Presentations Newsletter Consultant Pool Special Topics Column Grantee Locator Webinars Resource Specialties Child Welfare Education Family Involvement Juvenile Justice Mental Health Primary Care Substance Abuse Sustainability Youth Involvement Regional Technical Assistance Region I Region II Region III Region IV Region V Region VI Communities of Practice Cultural and Linguistic Competence Early Childhood Transition-Aged Youth	Mental Health and Systems of Care Frequently Asked Questions
	June 2005 What is pica? Pica is an eating disorder characterized by a persistent craving for and ingestion of nonfood substances (e.g. clay, dirt, feces, laundry, cornstarch, cigarette butts, ashes, plaster, toothpaste, and soap.) While it is often a part of normal developmental exploration for infants and toddlers to put any and everything into their mouths, youth with pica continue this pattern well beyond the age of 2. According to Stefanie Dugan (2002, Gale Encyclopedia of Medicine), there is no known specific cause for pica but it is often associated with “nutritional deficiencies; dieting; malnutrition; cultural factors; parental neglect; developmental problems; mental health conditions- autism, mental retardation, obsessive compulsive disorders, schizophrenia, stress; and pregnancy. Pica can lead to lead poisoning, bowel problems, intestinal obstruction or perforation, dental injury and parasitic infections.” The DSM-IV diagnostic criteria for Pica (1994, the American Psychiatric Association) includes: A. Persistent eating of nonnutritive substances for a period of at least one month. B. The eating of nonnutritive substances is inappropriate to the developmental level. C. The eating behavior is not part of a culturally sanctioned practice. D. If the eating behavior occurs exclusively during the course of another mental Disorder (e.g., Mental Retardation, Pervasive Developmental Disorder, Schizophrenia) is sufficiently severe to warrant independent clinical attention. WHAT CAN PARENTS/GUARDIANS DO? Educate young children about appropriate and non-appropriate substances. Request a comprehensive assessment for the youth—physical, emotional and educational. Remove and or secure inappropriate or dangerous substances. Keep physical and mental health providers informed of your child's eating pattern. Develop a treatment plan with your provider and youth (if possible) that works for your family. WHAT CAN MENTAL HEALTH PROVIDERS DO? Help families obtain a comprehensive assessment— physical, emotional and educational—for their youth. Provide families and youth with educational information about pica. Provide families and youth with information about various treatment options including family guidance, mild aversion therapy, positive reinforcement, and cognitive behavioral therapy. Develop with families, youth, and physical health providers a comprehensive treatment plan.