Pica

Pica is defined as the persistent ingestion of non-nutritive, non-food substances (e.g., plaster, charcoal, paint, clay, dirt, and wool) for a period of at least one month.
The eating behavior must be inappropriate for the child's developmental level; a minimum age of 2 years is typically required to differentiate it from the normal mouthing and tasting behavior of infants and toddlers.
The behavior must not be part of a culturally supported or socially normative practice (such as geophagia in certain rural societies).
A distinct diagnosis of pica is made only if the eating behavior is severe enough to warrant independent clinical attention, especially when it presents alongside other mental or neurodevelopmental disorders.

Pica is most commonly observed in children under 5 years of age.
Biological and nutritional risk factors include deficiencies in essential minerals, most notably iron, zinc, and calcium.
Psychosocial and environmental risk factors include low socioeconomic status, maternal deprivation, parental neglect or abuse, and family disorganization leading to poor supervision.
The condition is highly prevalent in children with significant developmental delays, intellectual disability, and autism spectrum disorder.
Pica can also be associated with obsessive-compulsive and schizophrenic disorders, and the prevalence tends to increase alongside the severity of concurrent intellectual disability.

Complication Category	Specific Clinical Examples
Toxicity and Infection	Highly associated with lead poisoning (from paint/soil) and parasitic infestations (from soil).
Gastrointestinal	Can cause mechanical bowel problems, intestinal obstruction, and intestinal perforations.
Nutritional	Frequently associated with the development or exacerbation of iron-deficiency anemia.
Miscellaneous Sequelae	Dental injury and the formation of gastric bezoars (e.g., from hair ingestion), which may require surgical removal.

Effective treatment relies on a combination of behavioral, social, and medical approaches, initiated after a thorough assessment for child neglect and family supervision.
Behavior modification is a cornerstone of therapy; applied behavioral analysis (ABA) is particularly effective for patients with concurrent intellectual disability or autism spectrum disorder.
Medical management directly targets the resulting complications, requiring routine screening for lead poisoning, therapeutic deworming for parasites, and iron supplementation for documented deficiencies.
Psychosocial interventions must focus on alleviating underlying environmental stress and educating caregivers on providing a safe, adequately stimulated, and supervised environment for the child.