Pica and Autism/Pica in Developmental Disability – Ports of Entry
Research Article
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DOI:
https://doi.org/10.58372/2835-6276.1184Keywords:
autism, dopamine, microbiome, neurodivergent, picaAbstract
Introduction: GI symptoms and disease in neurodivergent individuals who engage in pica are consistently higher than in comparable groups who do not ingest non-food substances. Such statistics serve as a red flag, not only for immediate medical consideration, but also as a baseline against which the impact of long-term interventions for pica and correlated GI issues can be measured. Organic treatment approaches offer effective alternatives to common behavior modification approaches.
Objective: Literature draws a sensory-based through line from a hypothesized etiology to the motivation and subsequent treatment of this often life-long aberrant behavior. This paper integrates disciplines to identify key components and research directions for pica and autism/pica.
Method: Large field studies, parent reports, and a smaller study based on chart review serve to document prevalence of GI symptoms and disease for individuals with autism with and without comorbid pica, and similarly for individuals with developmental disability, but not autism, with and without comorbid pica. Strengths and limitations of environmental (behavioral) and organic (nutritional, homeopathic) approaches to mitigating pica and identifying research are delineated.
Results: Two reports, each with more than 2,000 clients with autism and with and without pica, indicate that GI symptoms are between one and three times higher in those with comorbid pica. In a chart review study of 64 adults ages 24-58 at a developmental center, the disparity between autism groups with and without pica was even greater for a range of gastrointestinal (GI) symptoms, and alarmingly so, for all ten of the most frequently occurring GI diseases.
Conclusion: While behavior intervention based on reinforcement principles has been touted as first line treatment, it has significant limitations. Functional analysis of behavior most often points to sensory variables maintaining pica, a finding compatible with organic explanations. A sensory hypothesis is supported by medication efficacy consistent with an addiction model. Thus, an internal (organic) rather than an external (behavior modification) approach is more likely to be successful (durable across settings) in long-term treatment. That said, there is also opportunity for tiered or combined approaches to protect and ensure both the immediate and future health of persons with pica disorder.
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