Pica in a Four-Year-Old XXXX with @entity245 .

@entity1 @entity3250 @entity245 @entity1159 @entity306
CASE: Emily is a 4 and half-year-old @entity1 whose foster mother is concerned about her odd eating behaviors. Emily has been with her foster mother for 1 year after exposure to domestic violence. Emily's habit of eating nonfood items led to her foster mother providing "100% supervision." Emily constantly picks up, smells, and tastes nonfood items, particularly rocks and things made of metal. She "explores everything with her tongue." Emily scoops dirt and gravel from sidewalk crevices into @entity3250 . Although toileting, she catches and licks urine in her hand and searches for stool to put in @entity3250 . With redirection, Emily stopped putting feces into @entity3250 , but after spending time with her biological family, this behavior recurred.Emily does not like to eat foods that are hard or require chewing. She does not choke or gag on solid foods or liquids. She likes foods that are sweet. She refuses to eat vegetables and foods with certain textures. Emily pulls food apart with her hands before putting it in @entity3250 .Emily has @entity245 , @entity306 , @entity1159 in her legs, and strabismus. A medical workup resulted in a diagnosis of trisomy 4p and monosomy 9p. Emily works with a physical therapist and occupational therapist; she attends preschool in a special day class. She is an alert, playful, and socially engaging @entity1 who walks with an abnormal gait, speaks in short sentences, and follows simple directions.
