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Multicenter Study
. 2021 Feb;147(2):e20200462.
doi: 10.1542/peds.2020-0462. Epub 2021 Jan 6.

Pica, Autism, and Other Disabilities

Victoria L Fields  1 , Gnakub N Soke  2 , Ann Reynolds  3 , Lin H Tian  2 , Lisa Wiggins  2 , Matthew Maenner  2 , Carolyn DiGuiseppi  4 , Tanja V E Kral  5 , Kristina Hightshoe  6 , Laura A Schieve  2
Affiliations
Multicenter Study

Pica, Autism, and Other Disabilities

Victoria L Fields et al. Pediatrics. 2021 Feb.

Abstract

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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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
The flowchart reveals the way in which the sample of children was divided into different groups and subgroups. The main study groups are ASD, DD, and POP. The ASD and DD groups were subdivided into children with and without ID. The DD group was further subdivided into children with and without ASD characteristics. a Seventeen children with ASD were missing data on IQ. b Nine children with DD were missing data on IQ.
FIGURE 2
FIGURE 2
Pica prevalence in SEED study groups and subgroups. aThis includes children missing data on IQ, as noted in Fig 1.
See this image and copyright information in PMC

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