INFORMATION ON PICA

I have been taking care of a friends daughter for the last 3 weeks and have noticed that she has PICA.  I counsel adults and adolescence, so my limited course work has not equiped me with the answer to some questions.

This child is 3 years 2 months of age.  She eats balls of her hair, stuffing from her stuffed animals, and plactic fragments that she may find.  She often appears to dissasociate and even goes into trance states.  There are clear signs of emotional neglect and discipline problems from her young mother, though there is no "deliberate abuse".

She is quite intellegent, yet falls excessively when with her mother (several bumps to the head).  During play sessions she states "Mommy let me fall".  She tends to go into a trance when walking and does not look in the direction she is walking.  When trying to get her to look forward she appears to not be aware of her surroundings and can not discontinue staring at the person or object that has obtained her attention.  

I am at a loss as to what to do.  What could be other causes of Pica?  Neglect, Stress, Depression?  I want to suggest family therapy to the mother.  Would that be a good beginning or should the child be evaluated individually first?  The mother is a low-income single mother who will probably reject paying for therapy.

Any sugesstion will be appreciated.  ***@****

[Kevin Kennedy, Ph.D.]

Dear Ms. Smiley,

You are wise to be comcerned about this little girl. If you'll check the reply to Collette from July 21, and also click on MedHelp's Search button, you'll see info. re: pica, so I won't repeat it here.

The proper course would be a referral for a pediatric mental health evaluation, in the course of which a plan for treatment (likely to include some intervention for mom) will be developed. It's not clear whether the little girl is experiencing only the emotional sequelae of inadequate parenting, or whether some neurologically-based condition might also be interfering with her development.

Given the low income nature of the family's situation, is the child covered by Medicaid? If not, perhaps the local or state governing entities have provisions (most staes do) to cover such referrals, so the cost is not borne by the parent.