Licking hands and feet

[Mom2Chaz]

My 8 yr old son who has been diagnosed with Asperger's has started licking his hands and feet. He'll do it after he's been playing outside (yuk). I've offered him wipes when we are not near a sink as well as lotion. He said he does it because he needs to feel "moist". I've read that this could be a vitamin/mineral deficiency. He's not on any meds and never has been. He loves to eat salty things (chips), but he does eat a variety of foods including fruit/veggies (as long as nothing is touching on the plate!) I am a special ed coordinator, so he's gotten all the early interventions, and he's doing very well in school and socially, but this is freaking me out. I told him if he doesn't try to stop it, I'm going to take him to the doctor to get medicine to help him. I'm afraid it's OCD. He's also starting closing the car door 3 times every time he gets in the car. Now he sits in the middle of the back seat to keep himself from the compulsion of opening and closing the door. (He's very bright).

What should my first course of action be? Behavioral, medical, psych?

Help!

Jacqui in Florida

[Rachel Thompson, Ph.D., BCBA]

As I am sure you are aware, repetitive behaviors are characteric of Asperger's disorder. Hand mouthing or licking and saliva play are fairly common forms of repetitive behavior. Apart from the obvious health and hygiene concerns, this behavior can result in tissue damage if it persists. Therefore, I would encourage you to intervene as soon as possible. There are several well-studied behavioral interventions for repetive behaviors like those that your son is displaying. Generally, effective approaches include (a) providing an alternative form of stimulation that matches the stimulation produced, (b) interrupting or preventing the behavior, and (c) redirecting the individual to perform another activity. So, you are on the right track. I like your ideas about providing wipes and lotion. I also recommend interrupting him whenever he begins licking. You might also consider having him wash his hands each time he performs the behavior. If you (and others caring for your son) do these things consistently, I would expect to see a reduction in this behavior.

[MaryannesMom]

My daugther used to lick her hand & then blow on it because she liked the sensation.  Now she likes to suck on ice, so she is constantly in the freezer getting ice.  I think your options are either to let it go, or try to pursuade him to a "more acceptable to you" behavior.  I would not go to meds for this issue.  It does not sound like OCD.  I think he just likes how it feels.

[Sally44]

As odd as the behaviour seems to you, I would rather go with it then prescribe medication.  Try to accommodate his need if you can.  Normally a licking/tasting thing is a hypo sensitive reaction ie. not getting enough information througth the senses that they need to taste to get the information they need.  Do you have the impression that any of his other senses are not functioning eg. vision, hearing, smell, etc.  I know that from a 'normal behavioural approach' what your son is doing is going to appear weird to others.  But don't medicate just because of that!  It sounds like it is mainly down to sensation.  What about taking a bottle of water with you and letting him clean his feet. then offer him a lollipop.  Try to analyse the behaviour.  If he loves salty things his taste could by hyposensitive and he is using his taste in licking hands/feet to understand his enviornment.  Try giving him other things to mouth eg. keys, lollipops, chewy sweets etc to see if this helps.
Do you suspect any problems with his other senses.  Is his vision okay.  Does he have problems with floor colours or patterns, depth perception etc.  Is his hearing okay, or does he have problems with loud noises.
What is he like with food in general.  Is he quite restrictive.  Does he always ask for a certain kind of food and drink?
There can be OCD tendencies, but it is just as plausible that it could be rigid behaviours and routines.  So don't panic yet!  
Sometimes they have a new behaviour/obsession and it lasts a couple of months and they grow out of it.  Don't give it too much attention, but try to analysis it as much as you can.  Ask him about it and what he is doing and why.