Pica and Autism: Mouthing of Things in Children

Many kids with autism exhibit pica behavior, which means they mouth, chew on, or ingest things that aren’t edible. This can be extremely dangerous as kids often eat or mouth things that are either unsanitary or unhealthy in some way, or even objects that are sharp that could potentially lead to internal injuries. Today I’m sharing a small excerpt from a recent live Q&A session discussing pica and autism.

How to Get a Child to Stop Putting Things in His Mouth

One of our members asked, “I just completed Module 2 of your course and I’m a little confused. My son has a problem behavior of putting things in his mouth, but I can’t understand how to use positive reinforcement to prevent it. Should I stop him from going to the playground? How do you use positive reinforcement?

This little boy, who is 2 ½, is eating dirt and mulch from the playground. That is a big problem. There is a term we use called pica, and that means ingesting, eating, and chewing on inedible things. It can be a life-threatening problem and it is usually classified as self-injurious behavior. It’s a big problem because some kids swallow things like nails or glass or even mulch and dirt. Even if a child inadvertently swallows things, they could be putting things in their mouths that are really dangerous and could perforate their bowels or do even more harm. It’s not something we can treat lightly at all.

I ethically would recommend that parents and professionals not work through this on their own. Find a behavior analyst locally who can help you assess the situation. Or work with a physician, a psychiatrist, neurologist or even the child’s general pediatrician to come up with a plan medically and behaviorally to treat pica.

Stop Pica Behaviors in Autism

I will say that chewing behaviors, like just chewing your shirt, pencils, or toys, was a problem that Lucas had. It also was a problem that several of my clients had. Medically, we need to rule out vitamin and mineral deficiencies as well as lead levels. I would not just treat it behaviorally because there is some research to show that kids on the spectrum sometimes have an incorrect ratio of zinc to copper inside their body. I have read that zinc deficiency can cause chewing problems. Definitely do a zinc blood test. Talk with your child or client’s doctor about what testing they might need and what medications might help. I did a video blog specifically on the topic of medications and the zinc to copper ratio.

Copper in kids with autism can be a problem. If the copper level gets high and the zinc level is already low, it can cause aggression and irritability. I was giving Lucas multivitamins because he was such a poor eater, and he started having irritability within 30 minutes of giving him a multivitamin. I figured out his multivitamin had copper in it and as soon as I stopped giving it to him the irritability went away. Make sure if you are giving multivitamins, that there’s no copper in the multivitamin.

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Pica and Autism Assessment

We also need to assess when the chewing behavior occurs. To answer the member’s question about the playground, if the child only eats stuff when he’s at this playground, whether its mulch or something else, then I would stop taking him to that playground – at least until you learn how to get him to attend to materials and how to not chew on stuff within the home. Because once you get out in the community, now you’ve got a bunch of other variables. And if somehow this specific mulch or this specific environment is triggering this chewing and it doesn’t occur anywhere else, then yes, I would stop going at least temporarily until you figure out what’s going on.

To recap, assess when the chewing happens, what materials a child chews and then also why he chews. Is it when he’s not engaged? Is it, when he’s hungry? What does his feeding look like normally? I remember somebody asking me for my opinion about a boy who was eating dangerous things and had to have surgery for the removal of some object that he ate and he couldn’t pass on his own. One of the first things that an expert in pica and autism said was, what is his diet normally? What does he normally eat and normally drink?

Help for Pica and Autism

Module four of the toddler course on eating and drinking should be very helpful for pica and autism questions. You want to treat pica behavior like it’s a problem behavior.

Once you assess, then you make a plan. That could be to stop going to that playground, or carrying something to the playground like an iPad where the child would have his hands full so he won’t be tempted to chew on the mulch. He’d have a nice reinforcement as you pair up not eating things with the iPad or some other game. I wouldn’t try to get him to play on the equipment at the playground unless he loves it. If he loves it, then I would try to catch him when he comes down the slide. Keep him moving and don’t let him loiter around and start grabbing things.

For more information about pica and autism, you can attend a free online workshop by going to marybarbera.com/workshop. Whether you are a parent or a professional, there is help for you out there.

Interested in learning more about Pica and how it relates to Autism?
Take a free course

Transcript

Many kids with autism exhibit Pica behavior, which means they mouth, chew on, or ingest things that aren’t edible. This can be extremely dangerous as kids often eat or mouth things that are either unsanitary, unhealthy in some way or even objects that are sharp that could potentially lead to internal injuries. Hi, I’m Dr. Mary Barbera, autism mom, Board Certified Behavior Analyst, online course creator, and bestselling author of The Verbal Behavior Approach. Each week I provide you with some of my ideas about turning autism around so if you haven’t subscribed to my YouTube channel, you can do that now. Today I’m sharing a small excerpt from a recent live Q and A session discussing mouthing and eating things that are not edible. Um, I just completed the module two. Um, I’m a little confused. My son has a problem behavior of putting things in his mouth, but I can’t understand how to use positive reinforcement to prevent it.

Should I stop him from going to the playground? Uh, how do you use positive reinforcement? And in, in this situation, this little boy is eating dirt and mulch from the playground and he’s two and a half years old. That is a big problem. And there is a term we use called Pica, P I C A and that means ingesting, eating, chewing on, um, inedible things. And it is a can be a life threatening, uh, problem and it is usually classified as self injurious behavior, but it is a big problem because some kids swallow things like nails or glass or even mulch and dirt. Um, and even if they inadvertently swallow things, if they are putting things in their mouths that are really dangerous, can perforate your bowels for instance, and that sort of thing. So, uh, it’s not something we have, we can treat lightly at all and it’s something that ethically I need to recommend and I totally would recommend that this not just be like, Oh, I’ll just figure it out as I go. Like, if you can find a behavior analyst locally who can help you, come in, assess the situation, uh, work with, uh, a physician or a psychiatrist or neurologist or even your general pediatrician to come up with a plan medically and behaviorally to treat Pica. I will say that chewing behaviors, like just chewing your shirt and chewing on pencils and chewing on, uh, toys. Um, that was a problem that Lucas had. And it also was a problem that several of my clients have. And I will say that medically we need to rule out, uh, vitamin, mineral deficiencies, lead levels. Um, I would not just treat it behaviorally because there is some research to show that kids on the spectrum and probably kids that aren’t even diagnosed, although I don’t know that for sure, but kids on the autism spectrum, um, sometimes have a, uh, the ratio of zinc to copper is not correct inside their body.

And I have read a little bit about this and I have read that zinc deficiency, for instance, um, can cause chewing problems like chewing on, on stuff. So I would do a zinc, uh, blood test. I would have, you know, talk to your doctor, Google Mary Barbera zinc. And I did do a video blog specifically on the topic of medications and I talk about zinc to copper ratio. So in Lucas’s case, giving him zinc supplementation, which is an over the counter supplement. But again, you want to know that your child needs that and what the dosage should be. And I don’t know that for, you know, your child depending on their size. The other thing you want to watch with the zinc to copper ratio is copper in kids with autism can be a problem. So if the copper gets high and the zincs already low, it can cause aggression.

Um, it can cause irritability. And I noticed that and I, again, it’s in this blog where I talk about zinc to copper ratio. Um, Lucas, I was giving him multivitamins cause he was such a poor eater and he, um, started having irritability within 30 minutes of giving him a multivitamin. And what I found out, that’s when I learned about the zinc copper ratio. And I found out that this multivitamin, uh, had copper in it. So I stopped that and the irritability went away. So make sure if you are giving multivitamins, uh, that there’s no copper in the multivitamin. So that is something to consider. Okay. So medical issues are a problem with, especially with chewing behavior. Um, and then the other thing we want to assess is, okay, so, um, assessing when the chewing behavior occurs. Like if you said, my son only eats stuff when he’s at this playground with this mulch or whatever, then yeah, I would stop taking him to that playground at least until you can learn what to do, how to prevent things, till you learn how to get him to attend to materials and how to not chew on stuff within the home.

Because once you get out in the community, now you’ve got a bunch of other variables. And if somehow this specific mulch or this specific environment is triggering this chewing and it doesn’t occur anywhere else, then yes, I would stop going at least temporarily until you can get somebody to help you until you figure out what’s going on. So assess when chewing happens, what materials a child chews, um, and then also why he chews. So is it when he’s not engaged? Um, is it, when he’s hungry? What does his feeding look like? Like normal. Like I remember I had this one client, I don’t even think he wasn’t a client of mine, but somebody was asking me my opinion about a boy who was eating dangerous things had, had to have surgery for some kind of removal of some object that he ate that he couldn’t pass.

And, and one of the first things that an expert in Pica said was, well, what is his diet normally? What does he normally eat and normally drink? And so, um, in this case, module four of the toddler course on eating and drinking should be very helpful too. So don’t treat chewing behavior in a vacuum. Treat it like it’s part of the problem. Okay. So once you assess, then you make a plan, whether that be stop going to that playground, whether that be um, you know, carrying something to the playground that like an iPad where he would have his hands full and he’d have a nice reinforcement as you pair up not eating things. So I wouldn’t try to get him to play on the equipment unless he loves it. If he loves it, then I would just try to like catch him when he comes down the slide.

Okay, let’s run, run, run, let’s go back up. I wouldn’t let him loiter around and start grabbing things and I would definitely block that and, and prevent the, uh, the eating of anything that’s not edible because it is a real safety issue. Even if they’re just eating dirt. That’s e coli. That’s dangerous, um, medically. Wherever you’re watching this, I’d love it if you would leave me a comment, give me a thumbs up, share this video with others who may benefit. And for more information, you can attend a free online workshop at marybarbera.com/workshop. And I’ll see you right here next week.

 

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