THE LONG-TERM TREATMENT OF LIFE-THREATENING PICA - A CASE-STUDY OF A WOMAN WITH PROFOUND MENTAL-RETARDATION LIVING IN AN APPLIED SETTING

The effect of a long-term intensive treatment program on the occurrenc e of pica in a woman with profound mental retardation and epilepsy was investigated. The study utilized four treatment strategies: (1) edibl e/inedible discrimination training with hand held restraint; (2) edibl e/inedible discrimination training with facial screening, hand held re straint and a baiting procedure; (3) disposal training with facial scr eening, hand held restraint, and a baiting procedure; and (4) disposal training with hand held restraint and a baiting procedure. The strate gies were implemented in phases to: (a) eliminate life-threatening pic a; (b) determine the impact of facial screening on pica, and (c) deter mine which components were effective at eliminating pica. Pica was suc cessfully reduced after 5 years of intensive program implementation. F acial screening played a substantial role in the reduction of pica. Th e most effective treatment package: (a) taught the client to dispose o f inedibles, (b) used baiting sessions, and (c) consequated pica with 15 sec of hand held restraint. At follow-up, the client's pica behavio r was responsive to staff monitoring and verbal reprimands. Interpreta tion of the results were limited given the research design employed.