Management of Pica and Speech Regression in Children with Autism

Initial Assessment and Medical Management

A comprehensive neurobehavioral evaluation by a multidisciplinary team including a psychologist, developmental pediatrician, and speech/language pathologist is recommended for children with autism and pica, to assess fine and gross motor skills, adaptive function, and autism symptoms through parent report and clinician observation, as suggested by the American Academy of Pediatrics 1
Genetic testing for PTEN mutations may be considered for children with autism and pica, as some may have underlying genetic conditions requiring specific management, according to the American College of Medical Genetics 1, 2

Speech/language therapy is essential for addressing speech regression in children with autism, and evaluation for an augmentative/alternative communication device should be considered for those with minimal verbal skills, as recommended by the American Speech-Language-Hearing Association 1, 2
Early intensive behavioral interventions focusing on communication skills are recommended, with strong evidence supporting their efficacy, as stated by the American Academy of Pediatrics 3, 4

Structured teaching methods that accommodate working memory and processing speed deficits often seen in children with autism are recommended, and techniques such as forward or backward chaining with reinforcement for completion of tasks may be used, as suggested by the National Autism Association 1, 2
Parent training to implement interventions at home, particularly for pica prevention and communication development, is crucial, and regular follow-up to monitor progress and adjust interventions as needed is necessary, as recommended by the American Academy of Pediatrics 3, 5