Abstract
Pica is a potentially deadly form of self-injurious behavior most frequently exhibited by individuals with developmental and intellectual disabilities. Research indicates that pica can be decreased with behavioral interventions; however, the existing literature reflects treatment effects for small samples (n = 1–4) and the overall success of such treatments is not well-understood. This study quantified the overall effect size by examining treatment data from all patients seen for treatment of pica at an intensive day-treatment clinical setting (n = 11), irrespective of treatment success. Results demonstrate that behavioral interventions are highly effective treatments for pica, as determined by the large effect size for individual participants (i.e., NAP scores ≥ .70) and large overall treatment effect size (Cohen’s d = 1.80).
Similar content being viewed by others
References
Ali, Z. (2001). Pica in people with intellectual disability: A literature review of aetiology, epidemiology, and complications. Journal of Intellectual and Developmental Disability, 26, 205–215.
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.
Campbell, J. M. (2003). Efficacy of behavioral interventions for reducing problem behavior in persons with autism: A quantitative synthesis of single subject research. Research in Developmental Disabilities, 24, 120–138.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
Danford, D. E., & Huber, A. M. (1982). Pica among mentally retarded adults. American Journal of Mental Deficiency, 87, 141–146.
Decker, C. J. (1993). Pica in the mentally handicapped: A 15-year surgical perspective. Canadian Journal of Surgery, 36, 551–554.
Edwards, C. H., Johnson, A. A., Knight, E. M., Oyemade, U. J., Cole, O. J., Westney, O. E., & Westney, L. S. (1994). Pica in an urban environment. The Journal of Nutrition, 124, 954–962.
Emerson, E. (2001). Challenging behaviour: Analysis and intervention in people with severe intellectual disabilities. Cambridge: Cambridge University Press.
Favell, J. E., McGimsey, J. F., & Schell, R. M. (1982). Treatment of self-injury by providing alternate sensory activities. Analysis and Intervention in Developmental Disabilities, 2, 83–104.
Hagopian, L. P., Rooker, G. W., & Rolider, N. U. (2011). Identifying empirically supported treatments for pica in individuals with intellectual disabilities. Research in Developmental Disabilities, 32, 2114–2120.
Hanley, G. P., Iwata, B. A., & McCord, B. E. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36, 147–185.
Heyvaert, M., Saenen, L., Campbell, J. M., Maes, B., & Onghena, P. (2014). Efficacy of behavioral interventions for reducing problem behavior in persons with autism: An updated quantitative synthesis of single-subject research. Research in Developmental Disabilities, 35, 2463–2476.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20, 1982).
Kennedy, C. H. (2004). Single case designs for educational research. Boston, MA: Pearson.
Mahoney, M. J. (1977). Publication prejudices: An experimental study of confirmatory bias in the peer review system. Cognitive Therapy and Research, 1, 161–175.
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., 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., & Napolitano, D. A. (2004). Behavioral Interventions to reduce the pica of persons with developmental disabilities. Behavior Modification, 28, 45–72.
McLoughlin, I. J. (1988). Pica as a cause of death in three mentally handicapped men. British Journal of Psychiatry, 152, 842–845.
Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: Nonoverlap of all pairs. Behavior Therapy, 40, 357–367.
Parker, R. I., Vannest, K. J., & Davis, J. L. (2011). Effect size in single-case research: A review of nine nonoverlap techniques. Behavior Modification, 35, 303–322.
Piazza, C. C., Fisher, W. W., Hanley, G. P., LeBlanc, L. A., Worsdell, A. S., Lindauer, S. E., & Keeney, K. M. (1998). Treatment of pica through multiple analyses of its reinforcing functions. Journal of Applied Behavior Analysis, 31, 165–189.
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.
Rose, E. A., Porcerelli, J. H., & Neale, A. V. (2000). Pica: Common but commonly missed. Journal of the American Board of Family Practice, 13, 353–358.
Sham, E., & Smith, T. (2014). Publication bias in studies of an applied behavior analytic intervention: An initial analysis. Journal of Applied Behavior Analysis, 47, 1–16.
Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric feeding disorders: A quantitative synthesis of treatment outcomes. Clinical Child and Family Psychology Review, 13, 348–365.
Stiegler, L. N. (2005). Understanding pica behavior: A review for clinical and education professionals. Focus on Autism and other Developmental Disabilities, 20, 27–38.
Vollmer, T. R. (1994). The concept of automatic reinforcement: Implications for behavioral research in developmental disabilities. Research in Developmental Disabilities, 15, 187–207.
Williams, D. E., & McAdam, D. (2012). Assessment, behavioral treatment, and prevention of pica: Clinical guidelines and recommendations for practitioners. Research in Developmental Disabilities, 33, 2050–2057.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Call, N.A., Simmons, C.A., Mevers, J.E.L. et al. Clinical Outcomes of Behavioral Treatments for Pica in Children with Developmental Disabilities. J Autism Dev Disord 45, 2105–2114 (2015). https://doi.org/10.1007/s10803-015-2375-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-015-2375-z