Pica

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Does anyone else's child struggle with this?

My son was recently diagnosed with this. He's had the symptoms for a while, but they've definitely gotten worse since he's started kindergarten.

He'll eat grass, dirt, glue, crayons, and whatever else he can get his hands on. His teacher tells me that he does it the most when he is nervous - especially during one-on-one conversations with the teacher, the nurse, or another grown-up.

He has mild autism and (not so mild) ADHD which he takes a stimulant for. I'm taking him to the doctor today for a checkup and probably some blood work to see if he's deficient in anything.

I did it as a child and continued right through until I was around sixteen. I ate a wide variety of supposedly inedible items, such as coins, crayons, chalk, pebbles, soil, sand, flowers, leaves, plasticine, paper, buttons, small plastic toys, glass marbles and probably many more other things. I also used to carry a matchbox filled with table salt, which I used to lick. Why I did any of it I have non idea. I've read that supposedly Pica can be caused by mineral or vitamin deficiencies but I personally don't buy into that, how would a coin or a glass marble provide any trace minerals when it passes rigth trhough the digestive system uneffected? I have no idea why I stopped either but I obviously stop did eventually because I don't do it any more. As far as I know it hasn't done me any physical harm.

Have you tried sensory chew toys? Give him something safe to put in his mouth and chew on?

Another thing that you really need to investigate is if his stimulant medication is causing this. Sorry, but its not the cure-all that we would want it to be. When I was on that stuff, I pulled out all of my hair. My homework was better, my room was clean, and I was going bald. There are many reports of people doing weird things while on these medications. PICA is a known, but very rare, side affect of ritalin. So, I would try a trial of him off the medication with the cooperation of the school. I would request that the school start to track the frequency of this PICA behavior and take him off the medication, without warning them on which day you are doing so, for about a week, and then put him back on the medication, all while having the school monitor his PICA. When you are done, get together with the school and compare notes.

Of course, I don't know your son and all of this would have to be done with the help/support of his psychiatrist and his interventionist at school. But what I'm saying is pretty standard. There is a chance that his stimulant medication is helping the hyperactivity but causing PICA. It needs to be investigated and sadly, it is not likely to be a great couple of weeks for him at school while you do so.

*OK. i didn't pull out ALL of my hair. Just some of it. Enough to be noticable but not enough to look like I was on Chemotherapy.

He has severe ADHD, so taking him completely off meds is not an option. He's been on Concerta for awhile and this is a more recent thing. His doctor doesn't see a connection there.

I've tried sensory chew toys and he doesn't like them.

You still need to know if the medication is causing him harm. At the very least, his psychiatrist needs to be involved. I'm assuming he already has a qualified child psychologist and he isn't being treated by his pediatrician if his ADHD is severe. It doesn't matter that he's been on it for a while. He's a little kid. They change over time. Its just really concerning that he's picking this up now. The more likely answer is that kindergarten is stressing him out, considering the timing, but I personally hold a very high standard of safety with psych meds and children. Because I've personally experienced how much they can mess with your head and autistic kids don't have the words to describe it when we experience bad side effects.

I'm talking from the perspective of someone who is on the very talkative, vocabulary 3 years ahead of grade level, type of autism - I didn't have the words. The same could be said for school stress, actually. I didn't know how to tell grown-ups that I was getting bullied in kindergarten. I knew that they were calling me fa***t and pulling my hair, but I didn't know that those things were wrong.

As a teacher, I saw first hand how medications can turn a kid's world into a better place. I'm not totally against them. I'm just saying, investigate.

I'm following the advice of his pediatrician.

Typically when pica is diagnosed, doctors do testing for the following:
• hemoglobin/hematocrit.
• Iron (ferritin, TIBC, serum iron).
• Serum zinc level
• Test for parasites if there is reason for concern (i.e., worms or larvae in the stool or other clinical
symptoms)

Depending on the situation and results, some treatments suggested might be supplementation with iron/zinc, evaluation by dietian/GI doctor is gastrointestinal issues are suspected and a dental checkup . Asking about a referral to a behavioral specialist is common too.

All things to consider and possible ask about in the appointment!

We are getting the blood work done today. Also, my son has a behavioral therapist and a specialist that he works with.

I'm anxious about how the blood work is going to go.

As a child, I used to eat the cloth of my shirt collars, and paper (the little flaps left over when you tear paper out of a spiral notebook), also chew pen caps.

I read that it's not all that uncommon in children with an ASD.