01/02/2026
Pica in Autistic Children
Pica is a condition where a child repeatedly eats non-food items. It is more common in autistic children and children with other developmental needs.
Common items children with pica may eat
Paper, books, cardboard
Chalk, sand, soil, stones
Soap, sponge, foam
Hair, cloth, threads
Paint, crayons, pencil tips
Why pica happens in autistic children
Pica is not bad behaviour. It often happens because of one or more of these reasons:
1. Sensory needs
Many autistic children explore the world through their mouths.
They may like certain textures (hard, crunchy, soft)
They may seek oral stimulation
2. Communication difficulties
Some children cannot express:
Hunger
Discomfort
Anxiety So they use behaviour instead.
3. Nutritional deficiencies
Low levels of:
Iron
Zinc
can increase cravings for non-food items.
4. Stress, anxiety or boredom
Changes in routine, lack of structure, or emotional distress can trigger pica.
5. Developmental delay
Younger developmental age increases the likelihood of mouthing behaviours.
Why pica is a concern
Pica can be dangerous if not managed:
Choking
Intestinal blockage
Poisoning (paint, chemicals)
Infections (soil, dirty objects)
Dental damage
How pica is managed (best practice)
Medical support
Check iron and zinc levels
Treat underlying deficiencies
Regular medical monitoring
Occupational Therapy (OT)
Sensory integration therapy
Safe oral alternatives (chewable toys, sensory tools)
Reduce sensory-seeking through structured activities
Behavioural support
Identify why the behaviour happens (ABC: Antecedent-Behaviour-Consequence)
Teach safer replacement behaviours
Positive reinforcement
Environmental strategies
Keep unsafe items out of reach
Increase supervision
Provide safe chewable items
Home & school consistency
Same strategies used at home and school
Clear routines
Visual supports
What parents and teachers should remember
✔ Pica is a need, not stubbornness
✔ Punishment does not stop pica
✔ Early intervention reduces risks
✔ Multidisciplinary support works best
