Eating items that are not food...

• What is Pica?
• Research
• What they used to do about it?
• What to do about it now?
• Functional Analysis
• Preference

What is Pica?
Pica is basically the consumption of non-edible items.  Some children like to place certain object in their mouth, because they like the texture which is a brain stimulation for them that excites their senses.
 
Research
Piazza et al. (1998)  was a research article about Pica exploring the reasons for Pica, to find out what it was controlled by, and possible treatment for it.

What they used to do about it?
In the past, treatment for this was by using DRO, as mentioned previously in my blog, it's when attention is  presented to other appropriate behaviors (not necessarily related or in the same category as the behavior) that is not the problem behavior.  You can look at the glossary for further definition.  So when a child would place a rock in her mouth, would be blocked, but no other attention was given towards that, such as giving her something else to eat or play with or shows gestures of approval or disapproval.  Instead, every time she/he showed desirable behavior the parent would give all the attention towards that behavior.

What to do about it now?
Now, after the function of the behavior is analyzed.  The parent, which is informed by the behavior analysis would block them and then replace the stimulation with a more appropriate object (like food, chew tube, etc.). (1) to supply the oral stimulation the child wants and (2) to teach them an alternative appropriate behavior.  But the parent will not only provide the new stimulation only after the inappropriate behavior.  They have to be continuously be introduced to it, to teach them that they use "this" instead of "that". 

Functional Analysis
But as the study has suggested, you can't just give the child anything, a functional analysis must be done by a professional BCBA to find out why they are doing it, what causes them to do it, and what reaction that we provide keeps it going.  Because if you want the job done, you have to do with right.  You have to understand the reason for the behavior. Plus, some of the children use pica not only as a stimulus but to get something else they want.  Such as attention or another substance.  This can be done through you giving them attention immediately after the undesired behavior occurs, and you give your child a drink after you tell them to expel what's in their mouth.  So, they have learned to do this to get a "drink".   All behaviors happen for a reason.

Preference
In addition, you can't just replace the behavior with just anything, becasue not all kids like the same thing, and you must find items that strongly have a power over them compared to others that don't.  And of this a professional BCBA would do a preference assessment to determine what works best.  These steps help insure a treatment plan with less trails and errors to effectively take care of the problem behavior.

There is another option...

• Punishment = Last Choice
• What is DRO?
• Ok, So What Do I Do with the Inappropriate Behaviors Then?
• Patience
• Consistency & Immediacy

Punishment = Last Choice
In my previous post, you noticed that I talked a lot about punishment, and how it's the least effective form of long term results.  Meaning, no timeouts, spanking, yelling extremely loud, grounding your child for a month, etc.  And with all the frustration that I had with this (because I used to do it), what other option do I have?  The thing that frustrate some parents is that they were raised to use such teaching methods for their kids, and most of them are labeled under punishment.  And if you can't use these "punishments", it might feel like you've been doing things all wrong and now you have to start all over.  Change is hard, but of course if we look at the big picture we will learn it's for the better.  So instead of punishment we use reinforcement. And a great way to do this is with DRO.

What is DRO?
DRO stands for Differential Reinforcement of Other Behaviors.   Which basically means you will immediately pay more attention in a positive manner to appropriate behaviors that your child will present.  For example: your child puts their shoes on, throws something in the garbage, says "pleases" and "thank you", you get visually excited about it.  You are showing them which behavior are accepted and which ones that are not by showing obvious visual differences.  You can have them keep track of these accepted behaviors through the use of charts and tangibles (items they can have physically).

Ok, So What Do I Do with the Inappropriate Behaviors Then?
A great way to handle these unacceptable behaviors is through a learning technique.  Generally you would be blocking the behavior through interrupting it and redirecting the behavior to something more acceptable.  For example, she/he has  a tantrum.  They begin to yell, cry and scream.  Immediately show them the appropriate behavior during this inappropriate behavior (interrupting them) and say (redirecting) "If you feel mad...say you are mad.  If you want something...say what you want" or if they are too young to understand that, say "Say 'I'm sad'" to try to have them repeat "I'm sad".  Then have them say "I want my toy".  The point of this is to have them replace that problem behavior with something that is socially more acceptable.  So that when they are in school or playing with other children, their interaction with others will be in a more acceptable manner. At the end causing less chaos and less phone calls of your child hitting someone else, bitting, etc.

Patience
Just like in my previous post, remember the importance of patience.  Some children learn fast, while for others it may take some time.  Every child is different and that is ok.  You know your child.

Consistency & Immediacy
And the most important thing with all this is: Consistency and immediacy.  Always providing the same consequence after the behavior and right away.