PICA Awareness: A debilitating condition, common with autism

What’s PICA?

Pica is a mental health condition where people compulsively swallow non-food items. For my son, Charlie, who has profound autism, a “PICA item” is… everything. Wrappers, toys, dirt, plants, paint from the wall, anything on the floor, rubber bands, nails, coins, dollar bills… You name it. Charlie compulsively swallows everything he sees.

What causes PICA if not anemia?

Sometimes, PICA is caused by a deficiency like anemia. In those cases, the fix is easy: Iron. But in many cases, like Charlie’s, there are no found causes and no solutions…

When I hear people make blanket statements such as “autism is a gift,” it angers me. Is it? Because my child doesn’t even grasp the danger of swallowing screws.

PICA and autism

Charlie is 10 years old and diagnosed with Level 3 Autism—severe autism.
My biggest worry used to be whether Charlie was going to have a happy, independent life, but for the past few months, my primary struggle has been to keep him safe.

Charlie has PICA, which means he is constantly swallowing non-food items. It’s compulsive.I’ve stripped his room of anything that he could possibly chew off and swallow overnight, but he’s creative.

One thing I hadn’t thought about was the beautiful decals on his bedroom walls, and recently a screw from his dresser.

The surgeon just found a screw (and rubber bands) inside his colon.

Where does it happen?

Everywhere. PICA happens everywhere and with everybody–when he’s alone and when he’s surrounded by people. It’s compulsive. Everyone on his care team has witnessed it: his developmental pediatrician, his general practitioner, and of course, his teacher and ABA therapists that he spends so much time with. Yet, no one knows the root cause or how to stop it. No one. His labs were perfect. I just took him to the doctor again last week, but there’s just no help. I’m desperate for help.

What I want people to know about PICA and autism

I want greater PICA awareness and more solutions. Anemia and deficiencies are clearly not the only cause for PICA.

– Charlie doesn’t have any known deficiencies or parasites.

– His condition isn’t linked to inflammation or malabsorption.

– He doesn’t eat non-edible objects for attention and does it even when he’s alone.

– A functional assessment was done. The function of the behavior is “automatic”

– He doesn’t like chewy toys

The lack of explanation has left me feeling defeated.

Do me a favor, the next time someone insists that “everyone is equally autistic” and “severe autism isn’t real” due to the non-linear nature of struggles, remind them of this: even on their most difficult day, they wouldn’t choose to swallow a screw. In contrast, even on Charlie’s best day, he wouldn’t understand the danger of ingesting non-edible items.

Had you heard of PICA before you started following me? If so, was it linked to a deficiency or was it a mystery case like Charlie?

Our previous ABA therapy center reported us to CPS after Charlie ate some non-edible items. I’m still mad about it and very thankful for our current center, who has been consulting with PICA experts instead.