Help for possible PICA?

[mayflowers9]

DS is three and on the pathway for an autism assessment. He is very active and has some sensory seeking behaviours, including licking objects and putting everything in his mouth. This worries me in case he were to choke. Does anyone have any advice on how to minimise or redirect this behaviour?

I have bought him teethers, chewable jewellery and a bouncy horse for sensory input. I try to take him to the park every day so that he can run around and use the swings and equipment.

We are paying quite a lot for private SALT at the moment and can’t comfortably afford OT as well, but maybe that’s the only way forward?

A sensory OT assessment would help. Not all ICB’s commission sensory OT on the NHS, and when they do, it is often cursory, but if your area does offer sensory OT, it is worth a referral. In some areas, you can self refer.

Does DS have an EHCP? If so, SALT and OT can both be included in there. Although some have to appeal to get it included. When is the next annual review?

Some people find certain sensory input helps. For example, some find crunchy food reduces eating non-edible items. Others find using an electric toothbrush with strong smelling toothpaste helps. I even know someone whose DC likes the feedback from mouthing vibrating sensory toys.

You might find some of the ideas in this booklet helpful. Also look at the Occuplaytional Therapist’s resources.

It is worth keeping a diary to look at patterns of when DS eats non-edible items, what he puts in his mouth, etc. Some find regular snacks and structured activities reduces the behaviour.

Have you spoken to the GP about it? Sometimes you can be referred with a focus on PICA, which in some areas is quicker than the wait for an ASD assessment. Has DS had blood tests to look at nutritional deficiencies? Some DC have a spike in eating non-edible items when they are deficient in things.

Also, have you had a home OT assessment? This can look at making the house safer and better meet DS’s needs.

@2x4greenbrick, thank you so much for your detailed response and for sharing those resources.

DS doesn't have an EHCP yet, but we will start the process with his preschool SENCO in the new year. I'll be sure to mention that OT should be included.

I haven't contacted the GP about PICA specifically, but will do so! I was wondering about a possible nutritional deficiency, though DS is a big eater. He loves fruit but rarely eats vegetables now, so perhaps he is low in certain nutrients.

We haven't had a home OT assessment, but I will look into this.

Thanks again for your help.

You can request an EHCNA yourself. On their website, IPSEA has a model letter you can use. You don’t need the preschool to get the ball rolling or agree - some try to put parents off.

Blood test are a good idea IMO. Does DS take any supplements? Once DS has had blood tests, I would try to add a general multivitamin into DS’s daily routine. He should take vitamin D, anyway.

DS is in an ASD classroom in his preschool, so they have been very supportive. We will have a meeting soon to discuss their thoughts and observations from a visiting OT.

He currently takes vitamin D, but I'll look into an A–Z multivitamin. Thanks again, will definitely book the blood test.