Children with scores ≥11 were considered potential ASD cases regardless of their initial classification. 25 After enrollment, mothers of all children were administered the Social Communication Questionnaire (SCQ) 26 to screen for ASD symptoms in their child. Although children were initially identified as eligible for 1 of the 3 study groups, final study classification was determined by standardized research developmental assessment results. This analysis included children from all 3 study groups (ASD, DD, and POP) who were not missing data on pica. Children were 30 to 68 months of age (median = 55.4 months) at the time of their SEED developmental assessment. Therefore, in this report, we refer to the respondent as the mother. The child was required to live with the biological mother in the second phase of SEED data collection but not the first nonetheless, the respondent for 98% of children in the first phase was the biological mother. Participants and Study Group ClassificationĬhildren eligible for SEED enrollment were those who lived in the respective site’s study area both at birth and at enrollment and lived with a caregiver since at least 6 months of age who could provide legal consent and communicate in English (all sites) or Spanish (2 sites). SEED included a diverse sample of children with ASD and other DDs, a general population-based control (POP) group, and a collection of detailed information about children’s development to systematically classify case status and case subtypes. We evaluated pica in preschool-aged children with and without ASD using data from the Study to Explore Early Development (SEED), a large multisite case-control study. There is a need for more comprehensive epidemiological assessments of pica prevalence in children with ASD and other DDs, such that health care providers and parents are aware of the potential risks and can implement appropriate prevention measures and, if needed, initiate behavioral treatments early. Previous studies were limited by small sample sizes, nonstandardized classification of ASD or DD, nonrepresentative (clinical) samples, and the lack of a general population comparison group. the total prevalence of pica is likely higher than reported in these studies. Because most studies in this review were limited to severe cases of pica resulting in intervention. In a literature review conducted by Matson et al, 1 pica prevalence estimates in children or adults with ASD and/or ID ranged from 4% to 26% the highest estimates were found in populations that were institutionalized because of their disabilities. Neumeyer et al 23 assessed children with ASD who were treated at 15 Autism Treatment Network sites they reported pica prevalence was 3.0% in children 6 years old. In their prospective population-based cohort study, Emond et al 22 reported that children who were eventually diagnosed with ASD were more likely to have increased pica behavior at 38 and 54 months (12.3% and 12.5%, respectively) than controls (2.3% and 0.7%). 2, 3, 14– 21 In few studies has pica prevalence in individuals with ASD been systematically assessed. Available information is primarily from published case series and reports. However, studies of pica in individuals with ASD and other developmental disabilities (DDs) are limited. 5, 7, 9– 11 Individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID) have higher rates of self-injurious behavior (all types) than the general population, 12, 13 and pica specifically has been implicated as a problem for these populations. Pica is considered a self-injurious behavior, defined as self-inflicted, harmful behavior that occurs without apparent intent of willful self-harm. 3– 6 These complications are associated with substantial morbidity and have led to fatalities in some patients. Pica, the repeated ingestion of nonfood items lacking nutritional value, 1, 2 can result in gastrointestinal parasites, lead toxicity, nutritional deficiencies, choking, poisoning, sepsis, and intestinal obstruction or perforation.
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