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Pica, Autism, and Other Disabilities
Victoria L Fields1, Gnakub N Soke2, Ann Reynolds3
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; ish7@cdc.gov.
Insights
Pica, the ingestion of nonfood items, is more common in children with autism spectrum disorder (ASD) and other developmental disabilities (DD). This study highlights the increased prevalence of pica in these children, informing specialized healthcare needs.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Neurodevelopmental Disorders
Background:
- Pica, the consumption of nonfood items, can pose serious health risks.
- While pica is noted in children with autism spectrum disorder (ASD) or intellectual disability (ID), systematic prevalence data is limited.
- This study addresses the gap in understanding pica prevalence in young children with and without ASD.
Purpose of the Study:
- To systematically assess the prevalence of pica in young children with autism spectrum disorder (ASD).
- To compare pica prevalence in children with ASD and other developmental disabilities (DD) against a general population control group.
- To investigate pica prevalence across subgroups of ASD and DD, considering intellectual disability and ASD characteristics.
Main Methods:
- A multisite case-control study, the Study to Explore Early Development (SEED), included children with ASD (n=1426), other DDs (n=1735), and population controls (n=1578).
- Children were categorized based on standardized developmental assessments and questionnaires to define ASD, ID, DD, and pica status.
- Adjusted prevalence ratios were calculated to compare pica rates between groups, controlling for sociodemographic factors.
Main Results:
- Pica prevalence was significantly higher in children with ASD (23.2%) and DD (8.4%) compared to population controls (3.5%).
- Elevated pica rates were observed in subgroups: ASD with ID (28.1%), ASD without ID (14.0%), DD with ID (9.7%), DD with ASD characteristics (12.0%), and DD with both ID and ASD characteristics (26.3%).
- Pica prevalence was not elevated in children with DD without ID or ASD characteristics (3.2%). Adjusted prevalence ratios ranged from 1.9 to 8.0 (P < .05).
Conclusions:
- Pica is notably common among young children diagnosed with ASD, exhibiting ASD characteristics, or having intellectual disability (ID).
- These findings underscore the importance of recognizing and addressing the specialized healthcare requirements for children with these conditions.
- The study provides crucial epidemiological data on pica, informing clinical practice and support services for affected children and their families.
Background And Objectives:
Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or intellectual disability (ID), there has been little systematic study of pica prevalence. We assessed pica in children 30 to 68 months of age (median = 55.4 months) with and without ASD.
Methods:
Our sample from the Study to Explore Early Development, a multisite case-control study, included children with ASD (n = 1426), children with other developmental disabilities (DDs) (n = 1735), and general population-based controls (POPs) (n = 1578). We subdivided the ASD group according to whether children had ID and the DD group according to whether they had ID and/or some ASD characteristics. Standardized developmental assessments and/or questionnaires were used to define final study groups, subgroups, and pica. We examined pica prevalence in each group and compared ASD and DD groups and subgroups to the POP group using prevalence ratios adjusted for sociodemographic factors.
Results:
Compared with the prevalence of pica among POPs (3.5%), pica was higher in children with ASD (23.2%) and DD (8.4%), and in the following subgroups: ASD with ID (28.1%), ASD without ID (14.0%), DD with ID (9.7%), DD with ASD characteristics (12.0%), and DD with both ID and ASD characteristics (26.3%); however, pica prevalence was not elevated in children with DD with neither ID nor ASD characteristics (3.2%). Between-group differences remained after adjustment (adjusted prevalence ratio range 1.9-8.0, all P <.05).
Conclusions:
Pica may be common in young children with ASD, ASD characteristics, and ID. These findings inform the specialized health care needs of these children.
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