My son has a obsession with spitting

[4UTyler]

Our son just turned 11 and throughout his life has been "different".  As a younger boy he often did quirky little hand movements and ever so often freakishly displayed a very wide open mouth and strange face while watching TV or being excited.  We were able to get his attention and correct his behavior and it was never completely out of control.  This eventually subsided when he was about 8 or 9 years old so we thought he grew out of it.  About two months ago  out of the blue seemingly overnight all the hand gestures and open mouth stuff came back with a vengence.  It all seemed to come back due to a book that he was reading for a school assignment.  The book was "scary" according to him.  It literally scared the crud out of him!!  Ever since that day, we have seen doctor after doctor.  He has a tentative diagnisis of Aspergers with a multitude of problems.

With his evident Asperger symptoms, he also seems to have a need to spit.  He says that he has a bad taste in his mouth and spitting gets it out.  He spits all the time.  He spits into his shirt, in the trash can on the floor by accident, outside, and everywhere.  We have bought him hankerchieves for school but our public school which have put him in very special ed classes due to his sudden Asperger symptoms have serious complaints.  His school is being outrageously stupid by wanting to do their own diagnosis and care, trying to tell us that he is emotionally unstable.

We have no idea what to do.  We live in Montana where there is only one child psychologist in the entire state and is booked for a 1 1/2 months.  We firmly agree that he has Asperger due to what we have researched online but don't know how far the characteristics of Aspergers reaches.  

Is it possible that the spitting is part of his Aspergers Syndrome or is it a OCD connected by AS?  How do we handle each problem?

[Rachel Thompson, Ph.D., BCBA]

As you probably know, repetitive behaviors are a characteristic of Aspergers, and these behaviors can take many forms. Independent of you son's diagnosis, I recommend that you seek some recommmendations regarding how to address you son's behavioral concerns. Certainly, spitting would tend to isolate your son socially. There are a number of very effective behavioral interventions available for repetive behaviors such as spitting. But, you would need to find a qualified professional who could observe you son and make recommendations. I can understand your frustration in finding qualified professionals in your geographic area. It may be necessary, as it is for many families, to travel quite a distance to find professionals qualified to help.

[Sally44]

There are a number of conditions/disorders that can tend to cluster together sometimes in one person or within the family.  These are things like autism/aspergers, OCD, touretts, Bi-polar, Dyspraxia, Sensory Integration Disorder, Learning Difficulty etc etc.
My understanding of OCD is that it is usually anxiety driven and the person usually feels that if they don't do the ritual/routine that something bad will happen to them or family members.  That is different to how someone with Aspergers may need a ritual or routine because it makes the situation familiar and predictable.  If your son is talking about a bad taste in his mouth making him want to spit that sounds like it could be a sensory thing because it is the 'bad taste' driving him to spit, not anxiety or a need for a predictable outcome.  It is quite possible that he does indeed have a 'bad' taste in his mouth because he is oversensitive to something.  Taste is also closely connected to smell.  Does he ever complain about smells or like to smell things?
If you are able to pay for a private Psychologist report then it could be very useful, especially if there are co-morbid conditions (ie. not just one diagnosis going on).  Make sure it is someone with expertise in autism/aspergers.  You should also try to find out about any parent support/advocates in your area.  This will help you find out what your rights are by law.  Anyone who assess your son through Education or Health will have a 'budget' they are working with and the idea is to provide the least amount they can get away with.
So you need a specialist evaluation that will show you what your sons strengths and weaknesses are and how Aspergers affects him from a language, social interaction, imagination, cognitive, behavioural, life skills point of view.  Then you need to know your legal rights and what you can ask for from a support point of view.  For example if it says in a report that your son needs to be in small group work, what does that mean.  You need it quantified ie. a small group of 3-5 children.  Otherwise his school could define a small group as being 15 children.  The same will apply to every recommendation they make.  Eg. he needs help to make friendships.  What specialist is going to advise school on that.  Who will they train in the daily implementation of that programme in school.  How often will it be included in his weekly timetable.  How will they monitor his progress.  How often will it be reviewed and by whom.  If that is not specified then the school may interpret that recommendation as 'he needs to play a game with another pupil' to fulfill that specification and it will only happen when they have the time to do it.  So it needs to be specific.  I've sort of gone off on a tangent, but once you get the information from reports (private ones if you can afford, and if you can't afford it aim for one private report a year), get recommendations quantified in terms of hours and staffing provision.  Otherwise if you don't get it quantified you can never prove if they are providing the support mentioned in the reports.  And they can also try to mainstream him if there are no quantified hours ie. a pupil needing 22+ hours a week support in one to one and small group work of no more than 5 children is less likely to get mainstreamed than a child whose reports state he needs 'significant' support, but who has only ever received 5 hours extra support a week if it was available.  That child will get mainstreamed first.
Try to prioritise reports from a need point of view.  If there are lots of things 'going on' that you are unclear about a private Psychologists report might be the most sensible first.  Depending on what that identifies you may need an Occupational Therapist's report next etc etc.
If there is other sensory stuff going on such as a dislike of loud/sudden noises, an aversion to certain types of clothing or tags in clothes or shoes and socks, an aversion to brushing/washing hair, problems with food texture or smells, problems with balance or proprioception (motor co-ordination), problems with recognising the samer person/environment even if there are slight changes etc then I would recommend you google the name Olga Bogdashina and read an article by her printed in Autism Today website.  She has two autistic children herself and is the principle of a school for autistic children in the Uktraine.  Her book Sensory and Perceptual Differences in Aspergers and Autism is groundbreaking stuff and gives a real insight into the strange behaviours we see (such as the spitting you mention with your son).
I'm not sure about the face pulling etc.  Could be part of anxiety due to fear through the book you said he read.  You have to remember that they don't have the imagination to recognise what is fact and fiction.  They take what they see and read literally.  You may need to explain to him that the book is not real and although it is really scary some people like that, but that he is safe because it is not real.
My son had alot of problems around stuff he saw on TV that he thought was real.  I had a touch time trying to explain to him what actors were and that they were playing out a story.  Even now he sometimes doesn't get that it is not real.  He can watch a film and get really upset with the storyline, especially if someone dies or gets hurt.  To us it is obvious that it is fiction, but to them it is real and they can get scared that it will happen to them.
Hope some of that makes sense and is helpful.

[4UTyler]

Since my original post we have continued our quest by seeing literally a host of doctors.  His main doctor has put him through all the MRI's, EEG's, blood work, etc. - cleared him on any type of physical type of abnormality and now he has been given a precise diagnosis of Aspergers.  We found a Child Psychologist that travels to our house once every other week and does wonders for him!  His spitting seems to be just one of the compulsive, repetitive things that he does.  The spitting is the leading repetitive symptom he has, then hand flapping, then mouth gaping.  He tends to get confused, and lost once in a while in our own house but that is on a bad day.
     His Child Psychologist says that we, especially me, need to do more activities with him because that seems to be the only thing that motivates him to speak with her.  Now that I have had time to think about this and spend quality time outside of the house with him, I've found that he seems to be more of a "normal" boy when fly fishing or even out on day hikes.  Yes, he can do both of those things.  They involve repetative things over and over again and he seems to catch more fish than me but when we get back in the car or give him a multi task condition, he struggles or can't do it.  She also agrees with the diagnosis but feels that there are things we can do to help in her words "manipulate" his brain into a way of thinking a little differently so that he can be a little more socially active and not be afraid of books, movies.
    I do have a question and I don't know if you can answer.  Since my last post, I have quit my job and will be starting another job in a week.  The new job will have much fewer hours so I'll be able to take much better care of my son but we will have a significant income drop.  My wife carries our insurance for us so it looks like I will be the primary care giver for our son.  I have come to the conclusion that he isn't going to come out of this thing and he will always need special attention from one of us.  Our finances are completely fouled up to put it bluntly and we have now put in for Medicade on our Son.  We have also set up a interview for Social Security for our Son also.  This has been an ongoing fued between my wife and I for a long time.  She refuses to believe that he has a life long ailment.  I believe he has a life long ailment that can be delt with just fine as long as he is properly taken care of in the beginning.  I promised my wife I would ask this question...If our son was to be granted social security for 12 years and then became a successful business person like a lot of people can do with Aspergers, will he have to pay social security back???
  Sorry for the long post.