Abstract
It is well established in the literature that pica displayed by individuals with developmental disabilities is most likely to be maintained by automatic reinforcement. However, there is a need for additional research regarding interventions that emphasize skill acquisition by teaching individuals with automatically maintained pica, multiple alternative behaviors to reduce the occurrence of this behavior. For the current study, pica emitted by three participants with developmental disabilities was targeted for assessment and treatment. Results of a functional behavioral assessment, which included a functional analysis, showed each participant’s pica was maintained by automatic reinforcement. Treatment was individualized for each participant, but primarily focused on response interruption and redirection, as well as differentially reinforcing alternative behaviors such as discarding and vacuuming potential pica items. After thinning the schedule of reinforcement for each participant, treatment was generalized across settings and people. Overall, low rates of pica were maintained over time for all participants.
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References
Ali, Z. (2001). Pica in people with intellectual disability: A literature review of etiology, epidemiology and complications. Journal of Intellectual and Developmental Disability, 26, 205–215.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed., text rev.) Washington, DC: Author.
Ashworth, M., Hirdes, J. P., & Martin, L. (2009). The social and recreational characteristics of adults with intellectual disability and pica living in institutions. Research in Developmental Disabilities, 30, 512–520.
Bogart, L. C., Piersel, W. C., & Gross, E. J. (1995). The long-term treatment of life-threatening pica: A case study of a woman with profound mental retardation living in an applied setting. Journal of Developmental and Physical Disabilities, 7, 39–50.
Fisher, W. W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491–498.
Fisher, W. W., Piazza, C. C., Bowman, L. G., Kurtz, P. F., Sherer, M. R., & Lachman, S. R. (1994). A preliminary evaluation of empirically derived consequences for the treatment of pica. Journal of Applied Behavior Analysis, 27, 447–457.
Goh, H. L., Iwata, B. A., & Kahng, S. (1999). Multicomponent assessment and treatment of cigarette pica. Journal of Applied Behavior Analysis, 32, 297–316.
Hagopian, L. P., & Adelinis, J. D. (2001). Response blocking with and without redirection for the treatment of pica. Journal of Applied Behavior Analysis, 34, 527–530.
Hagopian, L. P., Gonzalez, M. L., Rivet, T. T., Triggs, M., & Clark, S. B. (2011a). Response interruption and differential reinforcement of alternative behavior for the treatment of pica. Behavioral Interventions, 26, 309–325.
Hagopian, L. P., Rooker, G. W., & Rolider, N. U. (2011b). Identifying empirically supported treatments for pica in individuals with intellectual disabilities. Research in Developmental Disabilities, 32, 2114–2120.
Hagopian, L. P., Rolider, N. U., & Rooker, G. W. (2012). Behavioral assessment and treatment of pica. In J. K. Luiselli (Ed.), The Handbook of high-risk challenging behaviors in people with intellectual and developmental disabilities (pp. 161–176). Baltimore: Brookes Publishing.
Hammond, J. L., Iwata, B. A., Rooker, G. W., Fritz, J. N., & Bloom, S. E. (2013). Effects of fixed versus random condition sequencing during multielement functional analyses. Journal of Applied Behavior Analysis, 46, 22–30.
Hanley, G. P., Piazza, C. C., Fisher, W. W., Contrucci, S. A., & Maglieri, K. A. (1997). Evaluation of client preference for function-based treatment packages. Journal of Applied Behavior Analysis, 30, 459–473.
Iwata, B. A., DeLeon, I. G., & Roscoe, E. M. (2013). Reliability and validity of the functional analysis screening tool. Journal of Applied Behavior Analysis, 46(1), 271–284.
Kern, L., Starosta, K., & Adelman, B. E. (2006). Reducing pica by teaching children to exchange inedible items for foods. Behavior Modification, 30, 135–158.
Lerman, D. C., Iwata, B. A., & Wallace, M. D. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 32, 1–8.
Matson, J. L., & Bamburg, J. W. (1999). A descriptive study of pica behavior in persons with mental retardation. Journal of Developmental and Physical Disabilities, 11, 353–361.
Matson, J. L., & Vollmer, T. R. (1995). User’s guide: Questions about behavioral function (QABF). Baton Rouge, LA: Scientific Publishers.
Matson, J. L., Hattier, M. A., Belva, B., & Matson, M. L. (2013). Pica in persons with developmental disabilities: Approaches to treatment. Research in Developmental Disabilities, 34, 2564–2571.
McAdam, D. B., Sherman, J. A., Sheldon, J. B., & Napolaiano, D. A. (2004). Behavioral interventions to reduce pica of persons with developmental disabilities. Behavior Modification, 28, 45–72.
McCord, B. E., Grosser, J. W., Iwata, B. A., & Powers, L. A. (2005). An analysis of responses-blocking parameters in the prevention of pica. Journal of Applied Behavior Analysis, 38, 391–394.
Northup, J., Fisher, W., Kahng, S. W., Harrell, R., & Kurtz, P. (1997). An assessment of the necessary strength of behavioral treatments for severe behavior problems. Journal of Developmental and Physical Disabilities, 9, 1–16.
Paisey, T. J., & Whitney, R. B. (1989). A long-term case study of analysis, response suppression, and treatment maintenance involving life-threatening pica. Behavioral Interventions, 4, 191–211.
Piazza, C. C., Hanley, G. P., & Fisher, W. W. (1996). Functional analysis and treatment of cigarette pica. Journal of Applied Behavior Analysis, 29, 437–450.
Piazza, C. C., Roane, H. S., Keeney, K. M., Boney, B. R., & Abt, K. A. (2002). Varying response effort in the treatment of pica maintained by automatic reinforcement. Journal of Applied Behavior Analysis, 35, 233–246.
Pipkin, C. S. P., Vollmer, T. R., & Sloman, K. N. (2010). Effects of treatment integrity failures during differential reinforcement of alternative behavior: A translational model. Journal of Applied Behavior Analysis, 43, 47–70.
Rapp, J. T., Dozier, C. L., & Carr, J. E. (2001). Functional assessment and treatment of pica: A single-case experiment. Behavioral Interventions, 16, 111–125.
Stiegler, L. (2005). Understanding pica behavior: A review for clinical and education professionals. Focus on Autism and Other Developmental Disabilities, 20, 27–38.
Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367.
Vollmer, T. R., Marcus, B. A., Ringdahl, J. E., & Roane, H. S. (1995). Progressing from brief assessments to extended experimental analyses in the evaluation of aberrant behavior. Journal of Applied Behavior Analysis, 28, 561–576.
Wasano, L. C., Borrero, J. C., & Kohn, C. S. (2009). Brief report: A comparison of indirect versus experimental strategies for the assessment of pica. Journal of Autism and Developmental Disorders, 39, 1582–1586.
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Schmidt, J.D., Long, A., Goetzel, A.L. et al. Decreasing Pica Attempts by Manipulating the Environment to Support Prosocial Behavior. J Dev Phys Disabil 29, 683–697 (2017). https://doi.org/10.1007/s10882-017-9548-y
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DOI: https://doi.org/10.1007/s10882-017-9548-y