Should He be Eating That?

Expert Name: Amanda Fishley, MA, BCBA, COBA
Expert Title: MA, BCBA, COBA
Company Name:  Special Learning, Inc.
Company URL: www.special-learning.com
Short Bio: Amanda Fishley, MA, BCBA, COBA is a Board Certified Behavior Analyst and Certified Ohio Behavior Analyst. She has experience working with children,

adolescents and adults in variety of settings including school, home and mental health facilities. In each of these environments, she worked closely with parents, teachers, and paraprofessionals to develop and oversee implementation of behavior intervention plans. She has extensive experience mentoring and providing supervision to RBTs, BCBA candidates and behavior analysts. As an Associate Director of Clinical Solutions for Special Learning, she is responsible for creating and presenting educational materials and promoting Special Learning’s mission to positively impact the special needs community. She received her Master’s degree in Special Education/ABA from The Ohio State University. She has been working with in the field of ABA for over ten years.

Should He be Eating That?
What is Pica?
Pica is the ingestion of nonedible substances, such as sand, cigarettes, wood, dirt, cotton, etc. As one can imagine, this can be a significant problem and is relatively common among individuals with developmental disabilities. Potential risks associated with pica include, but not limited to, intestinal blockage, poisoning, parasites, surgery to remove objects, and even death. 
 
So, what do we do?
First, consult with a physician about the problem and a behavior analyst if possible. There are options and research has demonstrated effective interventions that decrease and even eliminate this behavior long term. 
 
In the most recent literature review conducted by Hagopian, Rooker, and Rolider (2011), they concluded that behavorial intervention is a well-established treatment for pica.  Utilizing reinforcement and response reduction procedures exceeded their criteria as well-established treatment. 
 
Contemporary behavior treatment aims to:
  • Bring eating under more appropriate stimulus control
  • Provide alternative and competing sources of stimulation (access to food)
  • Establishing alternative responses one the individuals contact non-edible items
Again, with the potential severity of the problem, it’s important to contact your physician for the health and safety of the child/adult. I also encourage you to not give up hope on finding an effective intervention. A behavior analyst can help you to discover why your child is engaging in this behavior and write a plan accordingly.  
 
What you can do immediately:
Modify the environment. Remove/hide the items that the individual tends to consume. Inform all significant others, teachers, therapists, and family members of the problem so they can also modify the environment and monitor the behavior.  Offer choices of preferred edible items and allow those to be available as much as possible or you see fit. 
 
Reference:
Hagopian, L. P., Rooker, G. W., & Rolider, N. U. (2011). Identifying empirically supported treatments for pica in individuals with intellectual disabilities. Research in Developmental Disabilities, 32, 2114-2120.
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Being an RBT for me was extremely fun because where were you going to find a place where you can be completely silly without having to worry what people thought about you? This was the only job that made me feel like I could make a dramatic difference while being myself.

I also liked to be surrounded by people that had the same goals of wanting to help kids and the teamwork made the job much easier and more enjoyable.

Change and progress was the ultimate goal for our kiddos. The early intervention program was seriously only a miracle because I saw changes in the kiddos that from day one, you wouldn’t even recognize who they were.

Changes from being able to utter 3-4 words where they can only make a syllable from when they started, the behavior decreases in which kiddo that used to engage in 30-40 0 self-harm to only half, learning how to wait during games, table work where they use to swipe and drop to the floor if they had to.

My favorite was when the parents would tell us what amazing progress they were making at home. I used to tear up and felt for these parents so much because it was already difficult for them and now, they can trust and rely on ABA and the therapists knowing their goal was ours.

By Emma Rogers, BA, RBT

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