What is Pica in Children with Autism?

Children with autism are at increased risk for eating non-food items, which can cause harm. An expert from Henry Ford Health shares what you need to know about pica in children with autism.

Children, especially babies and toddlers, explore the world with their mouths. Experts believe that grasping an object and bringing it to their mouth is a baby’s way of demonstrating coordinated movement. It also meets their need to explore. But when children eat items that are not considered food — and do it repeatedly — this is called pica.

While any child can develop pica, it’s more common in children with autism or other intellectual disabilities, says Allegra Picano, MS, RD, a registered dietitian-nutritionist with Henry Ford Health’s Pediatric Center for Nutrition.

What is pica in children with autism?

“Pica is an eating disorder in which a person repeatedly eats things that are not food and have no nutritional value,” Picano says. “It’s estimated that about 2-26% of kids with autism also have pica.”

What are some of the items that tend to get eaten?

It is common to see children eat non-food items such as clay, paint chips, ice and dirt, says Picano.

What causes pica?

The exact cause is not known, says Picano, but pica is commonly a result of nutrient deficiency. “Kids who have pica will commonly have mineral deficiencies, such as calcium, iron or zinc deficiency,” she says.

Pica may also be a coping mechanism to manage stress or anxiety, she says, adding that pica is also associated with childhood trauma such as abuse or neglect.

“Pica is also seen more commonly in children living in low socioeconomic situations, although it is unknown why this is the case,” Picano says.

How much does pica exist across different levels of autism?

More research is needed to understand what groups of children are most at risk for pica, but Picano shares these facts from what has been studied:

  • We do know there is a pattern of atypical eating behaviors and hypersensitivity to food textures among children with autism.
  • These sensory processing difficulties may result in both atypical eating and pica behavior.
  • There is likely an association between children with higher levels of sensory processing difficulty and increased risk in pica development — but the research does not yet exist to prove it.

What can parents do to stop pica in their child with autism?

Because pica is related to nutrient deficiencies or stress, “parents can prioritize a well-balanced diet to prevent nutrient deficiencies and utilize resources that may help prevent food insecurity or manage stress,” Picano suggests. She also says that feeding and behavioral therapy may also help children with autism.

Reach out to your health care provider to discuss treatments, such as applied behavior analysis (ABA) therapy and functional analysis. “These therapies can help identify triggers for pica and determine if pica is secondary to sensory-seeking behavior, automatic reinforcement or social factors, such as seeking attention from caregivers,” Picano says.

What are some ways to make a child’s environment safe?

Close monitoring is important to safeguard a child with pica. Picano also suggests these methods to ensure safety for your child:

  • Keep items out of reach
  • Use childproof locks
  • Distract your child with activities that occupy their attention
  • Make sure all caregivers are aware of the dangers
  • Repair any chipped paint that may exist in the home

Be sure to keep the Poison Help Line number in a central location where all caregivers can access it. The number for a local poison center is 800-222-1222.

“If they think their child has been poisoned but he or she is awake and alert, they can reach the poison center 24/7,” says Picano. “Parents should call 911 if it is an emergency situation and their child has collapsed or is not breathing.”

Expertise from Henry Ford Health Center for Autism and Developmental Disabilities. Learn more at henryford.com. Find more articles like this at Metro Parent’s Your Top Kids Health Questions Answered!

Claire Charlton
Claire Charlton
An enthusiastic storyteller, Claire Charlton focuses on delivering top client service as a content editor for Metro Parent. In her 20+ years of experience, she has written extensively on a variety of topics and is keen on new tech and podcast hosting. Claire has two grown kids and loves to read, run, camp, cycle and travel.


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