Understanding Pica and Delayed Developmental Milestones in Children with Intellectual Disability: A Psycho-educational Case Study

This psycho-educational case study investigating the relationship between Pica, a feeding and eating disorder characterized by the persistent ingestion of non-nutritive substances, and significant developmental delays in a child with Intellectual Disability (ID) and co-occurring Neurodevelopmental disorders. The study assessed the behavioural, cognitive, and adaptive profile of Tinashe, a 14-year-and-4-month-old male who had never attended formal schooling and presented with profound developmental delays, non-verbal communication, and chronic Pica behaviours. A mixed-methods approach was utilized, incorporating caregiver interviews, direct behavioural observations, a Mental Status Examination, and the Vineland Social Maturity Scale (VSMS) to assess adaptive functioning. Findings indicated that Tinashe exhibited profound delays in speech, motor coordination, and social interaction, consistent with moderate ID and mild Autism Spectrum Disorder (ASD) traits. His Pica behaviour, which included the ingestion of sand and stones, posed serious health risks and was compounded by poor impulse control and lack of safety awareness. Adaptive functioning was significantly below age expectations, reflected by a Social Coefficient (SQ) of 35, and a failure to establish toilet training. The case concluded that the persistence of Pica and severe developmental delays necessitates urgent multidisciplinary support, including medical evaluation, Applied Behaviour Analysis (ABA) based therapy, and specialized educational placement with an Individualised Educational Plan (IEP), contingent upon successful toilet training. Recommendations focus on structured routines, positive reinforcement, environmental safety, and comprehensive caregiver training.