First post:
I thought this article was quite interesting. The research study on the Functional Analysis and Treatment of Cigarette Pica was interesting and informative to read about and evaluate in real-life situations. In this field, you come across clients on the spectrum who have intensive behavioral intervention plans based on SIB, Pica, and Stereotypical behavior. Research literature has demonstrated evidence-based treatments that may decrease the effects of certain target behaviors. Research conducted by Piazza et al., 1996 demonstrates an FBA that determines the function or “why” of the behavior occurring by a young man with mental retardation for treatment of pica in the consumption of cigarette butts as you mentioned earlier. I learned that results indicate the individual was automatically reinforced due to oral stimulation and not other environmental variables. Baselines were conducted before manipulating the environmental antecedent, the experimental session was evaluated and modified based on using other reinforcing stimuli to decrease target behavior consumption of pica such as social reinforcements, food, chewy toys, or herbals. Pica consumption decreased when the individual was reinforced to other oral stimulations such as food, chewable toys, or edibles such as popcorn.
This article is relatable as we work with a variety of clients who are on the spectrum. Some of these individuals are automatically reinforced by pica consumption of tar, granite, sand, crayons, and paper. FBA indicates these individuals are automatically stimulated by pica when being in outdoor settings, such as recess time, gym time, or playground area. The environmental settings outdoors stimulate pica consumption. The evidence-based treatment used to decrease target behavior is response block in conjunction with DRA, DRO, such as using chewable toys, or edibles to replace pica.
A case study conducted by Williams et al., (2009) demonstrates the long-term process for the Prevention, Treatment, and Management of Pica. The article discusses a variety of crisis intervention approaches for the temporary prevention of pica in clinical, home and school settings and a long-term approach. These included 1 to 1 staffing, FBA, restrain, and or response block; research showed these temporary methods were inefficient for long-term progress. The article discusses a clinical management approach implemented during a 9-year period for 41 individuals with developmental disability and pica. These individuals were monitored, analyzed, trained, and evaluated. Restrain was eventually eliminated. A functional behavior assessment, pica risk assessment, rights protections, hierarchy behavior intervention, environmental clinical management system, and staff training were used throughout the clinical trials. Results indicate 85% of participants experienced a 75–100% reduction in pica
In conclusion, people with developmental disabilities who are at risk of pica consumption are able to decrease behavior with long-term behavioral intervention packages with the use of evidence-based treatment programs. The article demonstrates how temporary methods are inadequate for long-term progress.
Have you had any clients who have a history of consuming pica, and if so what type of intervention plans does your team or BCBA have in place to prevent this behavior?
Reference
Piazza, C. C., Hanley, G. P., & Fisher, W. W. (1996). Functional analysis and treatment of cigarette pica. Journal of Applied Behavior Analysis, 29(4), 437-450.
Williams, D. E., Kirkpatrick-Sanchez, S., Enzinna, C., Dunn, J., & Borden-Karasack, D. (2009). The Clinical Management and Prevention of Pica: A Retrospective Follow-Up of 41 Individuals with Intellectual Disabilities and Pica. Journal of Applied Research in Intellectual Disabilities, 22(2), 210–215.
Second post:
Thank you for your informative post. Piazza et al. (1996) discusses in the article the functional analysis and treatment plan for pica of cigarette butts. This study gave important information on how to perform a functional analysis for pica and procedures that were done. Pica is a form of self injurious behavior and can have severe consequences. Call et al. (2015) conducted an analysis to examine the effectiveness of the behavioral intervention that were being used at an intensive day treatment clinic. The results provided insight that the intervention has been effective for pica. The goal of the treatment was to eliminate the behavior due to the risk that the behavior could have. Caregivers were properly trained in preventive and monitoring strategies before implementing the behavioral intervention for pica. Call et al. (2015) found that automatic reinforcement maintained the behavior. Therefore making it difficult to generalize the intervention due to a number of challenges that are out of the therapist’s control and unpreventable. This makes it difficult to implement extinction based intervention plans due to the difficulty to completely eliminate the behavior.
Have you experienced working with an individual that has pica and if so was there a behavioral intervention plan put in place? I had a student once that would ingest cleaning supplies. Therefore the plan that was put in place was just to hide the cleaning supplies, but that only worked in the classroom. Therefore it was difficult to control the environment outside of the classroom and the student would engage more in the behavior outside of the classroom due to the availability.
Call, Simmons, C. A., Mevers, J. E. L., & Alvarez, J. P. (2015). Clinical outcomes of behavioral treatments for pica in children with developmental disabilities. Journal of Autism and Developmental Disorders, 45(7), 2105–2114. https://doi.org/10.1007/s10803-015-2375-z
Piazza, Hanley, G. P., & Fisher, W. W. (1996). Functional analysis and treatment of cigarette pica. Journal of Applied Behavior Analysis, 29(4), 437–450. https://doi.org/10.1901/jaba.1996.29-437
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