Eileen is a 23-month-old girl who is being evaluated for autism spectrum disorder because her pediatrician is

concerned about the presence of developmental red flags. She has just a few words of speech and has not put together any meaningful two-word phrases. While taking a history from Eileen’s mother the PMHNP learns that for approximately the last 2 months Eileen has been seen eating paint chis that are peeling off the baseboard and window sills in the family home; when sees one she puts in her mouth. This is a concern because they live in an old farmhouse and there may be lead-based paint in some of the paint layers. The PMHNP considers that which of the following is not consistent with a diagnosis of pica?