#263 - PICA or Oral Seeking? Sensory Strategies for Both!

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC July 05, 2023

#263 - PICA or Oral Seeking? Sensory Strategies for Both!

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PICA or Oral Seeking? Sensory Strategies for Both!

Today’s episode is an answer to a listener's question! 

We dive into what PICA is, its causes, and how it differs from typical oral seeking behaviors.

We provide practical strategies for managing PICA and oral seeking, such as providing alternatives, using visual cues, and implementing sensory diets.

Whether you're a parent, caregiver, or a professional working with children who struggle with sensory processing, this episode is filled with valuable information and insights!

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What is PICA?

PICA and Autism 

PICA or Oral Seeking: Sensory Strategies for Both!

Babies and toddlers possess an innate curiosity to explore their surroundings using their mouths. Nonetheless, when this behavior is coupled with a Pica diagnosis, it gives rise to legitimate concerns.

What Is Pica?

Pica is an eating disorder marked by the compulsive ingestion of non-food items that lack nutritional value or purpose. The occurrence and significance of pica vary based on the specific circumstances and motivations driving the behavior.

Although pica may appear harmless or even typical in certain situations, it can have severe consequences if your child consumes toxic or hazardous substances. Pica is frequently associated with low iron levels and is more prevalent among individuals in the autism community.

How Is Pica Different From Oral Seeking Behavior?

Oral seeking is a comprehensive term used to describe behaviors, such as thumb-sucking and object chewing, that often indicate a need for oral sensory input. These behaviors can sometimes be confused with pica, but there is a distinction between the two.

Engaging in oral-seeking behaviors often results from seeking self-regulation and comfort in stressful or uncomfortable situations. Moreover, these activities can offer sensory input that aids children in maintaining focus on tasks and managing anxiety.

Pica differs from oral-seeking behaviors by its compulsive, repetitive nature. Pica often indicates a more significant underlying mental disorder or medical condition, whereas oral seeking is primarily a sensory-seeking behavior.

Prevalence Of Pica

A research article published in the American Academy of Pediatrics found that pica affects a small percentage of children in the general population, accounting for only 3.5%. However, the prevalence of pica is notably higher among children with autism, ranging from 14% to 28%.

It is essential to recognize that certain cultures and religions have well-established and socially accepted practices of pica. A compelling example is the ritual of consuming soil at a Roman Catholic shrine in New Mexico, which holds deep religious significance.

Similarly, it is a widespread tradition among young women in numerous cities across South Africa. These instances not only exemplify the enchanting nature of pica but also illuminate its profound cultural and religious significance.

Risk Factors For Pica Development

Children exhibiting symptoms of pica experience nutritional deficiencies, such as minerals or other essential nutrients. Iron, calcium, and zinc insufficiencies are among the primary underlying causes.

Another crucial factor to consider is the influence of mental health conditions. Stress and anxiety can contribute to the onset and progression of pica, serving as a coping mechanism or outlet for individuals going through it.

The occurrence of pica is often associated with factors that are present from birth. These factors may encompass developmental abnormalities during gestation or genetic disorders inherited from parents.

Moreover, it is crucial to note that certain medications may play a role in developing pica or similar behaviors. However, it remains unclear whether these medications directly trigger pica or if they manifest as side effects.

Get Curious: Pica or Oral Seeking Behavior?

To distinguish between oral-seeking behavior and pica, maintain daily notes. Record the specific times when your child consumes nonedibles, the preceding circumstances, their emotional state, and their activities to identify patterns and trends.

Assessing the severity of oral-seeking behaviors and developing a comprehensive safety plan for your child, particularly in cases of pica, is of utmost importance. To gain a deeper understanding of your child’s needs and explore alternative solutions, engaging in a meaningful conversation can prove immensely valuable.

This approach empowers your child to develop vital skills and acquire knowledge for advocating for themselves and regulating their emotions. It occurs in a safe, nurturing environment that meets their sensory needs.

Sensory Strategies For Both Oral Seeking And Pica

If your child has a habit of putting everything in their mouth, the first step is to modify the environment to ensure that items they are prone to eating are not within their sight or reach. If that is not feasible, you can employ visual cues, such as a prominent X or a stop sign attached to an object, to help them comprehend that they should refrain from putting it in their mouth whenever they encounter the stop sign.

In addition, using a social story to educate your child about safe and unsafe foods can be helpful. Create a social story that clearly explains which foods are safe to eat and which to avoid due to their potential bodily harm.

Highlight the potential health risks associated with consuming these foods, and if your child expresses interest in them, offer healthier alternatives instead. Additionally, you can support their understanding through visual aids, role-playing, and practice sessions to engage them in the social story.

Participating in activities involving substantial body movements, physically demanding tasks, and applying deep pressure can be particularly advantageous if your child requires oral motor input. These actions provide calming proprioceptive input to the entire body, offering soothing benefits.

Furthermore, it is essential to identify alternative activities if your child puts objects in their mouth, such as:

  • Using oral tools, such as chewy snacks, crunchy food, or a vibrating toothbrush.
  • Engaging in obstacle courses or enjoying outdoor activities.
  • Blowing a cotton ball with a straw, creating a mountain of bubbles, or sipping a smoothie through a straw.
  • Mimicking mouth movements in front of a mirror.
  • Inflating a balloon.

To effectively address your child’s needs, it is crucial to take a proactive approach and prevent triggers from arising by establishing and maintaining a consistent routine across all environments.

Ways to Further Assist Your Child with Pica

Evaluating your child’s primitive reflexes can provide valuable insights into their well-being. It is also essential to consider the potential effects of toxins and trauma in their environment. By doing so, you can better understand their development and take appropriate measures to support their growth and health.

Creating a pristine home environment involves multiple steps, such as installing water filtration systems, adding mineral supplements, purifying the air, and making dietary adjustments like eliminating food dyes, gluten, soy, and dairy. Moreover, opting for organic foods whenever possible can yield numerous advantages.

Consider the potential development of candida overgrowth or leaky gut syndrome, which a functional medicine practitioner can effectively manage. In addition, incorporating electrolytes or using mineral-enriched filtered water can offer significant benefits.

If your child is open-minded about food, you can elevate their meals by incorporating delightful options like meatloaf or nutrient-rich organ meats such as beef liver. To infuse a unique twist, consider grating beef liver into taco meat, sloppy joes, or powdered liver to subtly enhance its flavor.

Promoting your child’s overall growth and development involves enhancing their nutritional intake and incorporating sensory strategies. It’s important to remember that if you have any concerns about your child’s health, it’s always advisable to seek advice from a medical professional.




While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.

This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.

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