Autism: Understand Pica Behavior Before You Regret

p-pica-enhd-ar1What is Pica? You might ask. I didn’t know what it was either until my child began eating very strange, nonfood items. I was shocked and didn’t know what to do about this behavior. It’s not exactly something a Mom is told to be prepared for. It defined a large part of Tyler’s growing up years.

“Pica is a term that refers to cravings for substances that are not foods. Materials consumed by patients with pica include dirt, ice, clay, glue, sand, chalk, beeswax, chewing gum, laundry starch, and hair.”
Online Encycolpedia of Mental Disorders/Ob-Ps
http://www.minddisorders.com/Ob-Ps/Pica.htmlDefinition

When Tyler was a baby he quickly learned how to climb out of his crib. So, we put him on his brother’s bottom bunk with a side rail. He wouldn’t stay in his bed. We had to lock the door to keep him in. One day, I went in the room to check on him during nap time. He was sitting in the floor with his diaper torn off, eating the silicone beads (he had peed in) from the diaper. I was shocked! I quickly wiped it out of his mouth and reality of that was a shock. I didn’t know about Pica behavior.

About the same time, we were invited to go to the beach with some extended family members. The whole day he ate beach sand. and the whole day, I embarrassingly shoveled the sand out of this tiny mouth. I didn’t know why it was happening. I couldn’t explain it to my mother-in-law who appeared to be appalled. We chose not to take him to the beach anymore for a while.

After we moved to Georgia these behaviors increased. He started eating the bark off the trees and ate sticks. He would line them up on the picnic table and eat them like they were jerky. We tried to stop him but that would be impossible – he did it every time he went outside.

But soon his love for wood in his diet moved inside. He had a very expensive Thomas the Tank Engine wooden train set. One day I was in his room reassembling the train set. I noticed the notches that fit the track pieces together were missing on some of them. A few days later I found teeth marks on the trains. All I could think was “This beloved toy is now food, apparently.” We had to remove the train from his room.

Soon after that, I was vacuuming the stairs in our home and saw that he had been gnawing on the wooden stair case banister in the foyer. There were child teeth marks all in the top rail. We had a dog, but this was not the dog.

I was very concerned and talked to the pediatrician. That’s when I first heard the word “Pica”…there was nothing that we could do about it. I was on my own as to how to stop this behavior. I thought that Maybe I could keep it down to a minimum if I watched him even closer.

Not so much – his love for wood turned to his shirts. He began eating the fibers of his shirts fronts around the collar and sleeves. I would send him to school with a shirt on and he would get off the bus with it half gone. What do I do with THAT?! He must wear shirts!! I was informed by one of his teachers that another student had that problem and they put a bandanna on him. The material is more difficult to shred. I went to a store that sold many different colors of them. I bought ALL the bandanna’s – designer too! I had purchased every color so I could coordinate them with his outfits. I’m OCD about stuff like that. He looked good sportin’ the bandannas and matching shirts. He chewed on the bandannas but he couldn’t tear or shred them. They would come home soaked with spit, but fully intact . AH Ha! I won!

I found ways to handle the shirt eating. But not the wood and dirt eating. I just couldn’t stop it. Then, a new behavior arose. He was eating his mattress. Imagine walking in your child’s room after he left for school and finding what WAS the mattress, torn to pieces, as if a pack of hounds and been in there feasting all night. Yes, he had attempted to eat everything but the springs. So, we quickly took what was left of the bed out of his room. He didn’t sleep on it anyway.

One Christmas we decided since he liked to jump so much that we would get him a small trampoline for his room. Soon he stopped jumping on it and started eating the side padding and foam. OK, really?! So out went the eaten trampoline. The pica behaviors had reared their ugly head over and over, despite all of our efforts.  It was winning again.

He continued to eat his diapers for many years. He ate sticks, bark, dirt…all in his belly. He ate chalk and crayons.  We would jokingly say, “He must have a digestive system of steel!!”

When he was 9 years old, we moved into a new home.  Shortly after moving in, I found red and pink stains on the stairs. I cleaned them up, but in the next few days, more appeared. Then, I caught him in the act. He would drink lots of red or pink crystal lite or Kool aid and proceed to throw it up and play in it…draw in it. My stairs were apparently his canvas. If he noticed that I was watching him do this, he would swallow the puke.

But my mind went to Tyler’s esophagus. What would this do to him? I called the pediatrician. I told him what was happening. No, long term this COULD be damaging but nothing could be done to stop him. I was a mother of four kids. There were many activities going on at my house and all my time and attention could not go to Tyler alone. Watching Tyler’s every move 24/7. NOT POSSIBLE.

I spent many hours cleaning all the spots,watching him as closely as possible, and praying for him to not have any physical damage.

During his school days, Tyler had a nervous habit of chewing on his thumb and making it bleed.  I would put a band-aid on it every morning before the bus came.  Several months into this routine I had an IEP meeting with his teachers.  They mentioned that every morning they had to medicate his thumb because it bled.  I said,”that’s why I always put a band-aid on his thumb before I put him on the bus,”  they responded, “he gets off the bus at school in the morning with no band-aid and it’s bleeding.”  We asked the bus driver were there band-aids left on the bus?” The answer,”no,and I clean it every afternoon.”

I was puzzled.  I gave the teachers a box of band-aids to apply at school when needed.  One morning his thumb was bleeding and Tyler was ready early, so I put a band-aid on his thumb with the idea that I would take it off before he got on the bus.  I got distracted with the dog.  I left the room for a few minutes.  I came back in the room and found Tyler chewing vigorously on something.  I made him spit it out.  It was the band-aid I had put on his thumb.  He was happily chewing it like bubblegum.

That’s when it became clear to me.  The mystery of the missing band-aids was solved.  They had all been digesting in his stomach.

Years of Pica persisted.  But the frequency of this behavior seemed to dwindle down when he became an adolescent.  As time when by, we began to let our guards down.

Then, out of the blue, one day we heard Tyler gagging and coughing in the kitchen.  We ran in there to see what the problem was.  He had an open bottle of rubbing alcohol in his hand and alcohol was dripping from his mouth.  He had tried to ingest it.  The expression on his face made us think that it disgusted him.  However, he did this over and over. We hid the rubbing alcohol, but he would find it anyway.  We had to find creative places to hide it from then on.  So creative that WE almost couldn’t find it when we needed it.

What did we learn?!  NEVER let your guard down.  Pica will rear it’s ugly head when we least expect it.

I didn’t have any guidelines.  Doctors didn’t seem to have a solution.  It was up to us, once more, to prevent Tyler from ingesting these things.

If your child has shown signs of eating nonfoods, take time to learn more. I found some up to date articles written about Pica and what a parent can do about it.  AutismSpeaks.org has a practical guide for parents:

1) Keep a list of the items your child eats or mouths. Share this list
with your child’s doctors, teachers or other caregivers.
2) Keep track of how often your child displays pica behavior in a
notebook.
3) Keep a list of the places and situations where your child puts
things in his/her mouth.
4) Keep non-food items your child frequently attempts to eat out
of his or her sight. Move items to a safe location such as the
basement.
5) Put locks on cabinets, closets or doors that contain possible
pica objects.
6) Vacuum or sweep floors daily to reduce items on the floor that
your child might eat.
7) Enrich your child’s environment. During down times, provide
access to things your child likes to do that do not include pica
items.
8) Teach danger awareness skills. Have your child practice
identifying things that are non-edible or dangerous.

My experiences with Pica involving my son were so upsetting as they emerged.  I was horrified to think he was hurting himself and I couldn’t stop him. I felt that somehow I could have prevented it.  I was often ashamed to even mention it.  If you are a parent coping with this behavior, I hope that you will seek help.  Share the list, ask for help, don’t let your guard down, and keep being the best parent you know how to be.

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