The long-term treatment of life-threatening pica: A case study of a woman with profound mental retardation living in an applied setting

Abstract

The effect of a long-term intensive treatment program on the occurrence of pica in a woman with profound mental retardation and epilepsy was investigated. The study utilized four treatment strategies: (1) edible/inedible discrimination training with hand held restraint; (2) edible/inedible discrimination training with facial screening, hand held restraint and a baiting procedure; (3) disposal training with facial screening, hand held restraint, and a baiting procedure; and (4) disposal training with hand held restraint and a baiting procedure. The strategies were implemented in phases to: (a) eliminate life-threatening pica; (b) determine the impact of facial screening on pica, and (c) determine which components were effective at eliminating pica. Pica was successfully reduced after 5 years of intensive program implementation. Facial screening played a substantial role in the reduction of pica. The most effective treatment package: (a) taught the client to dispose of inedibles, (b) used baiting sessions, and (c) consequated pica with 15 sec of hand held restraint. At follow-up, the client's pica behavior was responsive to staff monitoring and verbal reprimands. Interpretation of the results were limited given the research design employed.