12 year old granddaughter

[Ma63]

My granddaughter is 12. She has PPd-NOS
She has been scratching her arms and legs to the point that they bleed. Her Mother takes her to the doctor all the time and they give her cream , etc. Her arms and legs will almost heal up and when they scab over she pulls them off.
I know she will be scarred if something don't change. Do you have any advice I could pass along.
It hurts me to see her like this
Ma63

[ddaniell]

It is important to find out if it is winter dryness itchiness and it so give her the lotion and have her apply it herself.....then she is actively doing something similar to scratching.  Give her a little bottle to put in her backpack so she has it when she itches.  If it is behavior you can give her something else to fiddle with.....a bracelet.....a rubber band on her wrist.  She is getting some kind of relief from the scratching.  The secret is finding out what the relief is......also they have surgical scrub brushes that are really fine and soft....get one for her and tell her she can only rub her skin with that instead of scratching.

[Sally44]

Could it be a sensory behaviour or an anxiety behaviour.
If it is sensory you need to look at things like her clothing.  What material is it (cotton is usually okay - man made fibres can feel bad on their skin).  Are her arms and legs covered.  Some children prefer them covered all the time, some prefer them uncovered all the time - what is her preference.
Soaps etc can dry out the skin and make it feel itchy.  You could try goats milk soap as this is much better on the skin and doesn't dry it out.  Get it plain, not perfumed.  It maybe the itchiness of the scabs causes her to scratch again.  This is a vicious circle because scabs do itch when they are healing.  Make sure her nails are cut short.  If there are problems with cutting nails then that will confirm that she has sensory issues.  Try to keep her in long sleeved cotton tops and bottoms.  
She may need a moisturiser rubbing into her skin every day.  I don't know one to suggest other than E45 if her skin is very dry.  If not then just a plain unperfumed one - and make sure she likes the smell of it first or it could make things worse.
If it is a sensory thing, then you have to understand that certain sensations can remain with them for a long time eg. cutting nails.  Many children and adults have said that it is unpleasant, even painful, and that the sensation can stay with them for days.  So if showering and using soap is making her skin dry and itchy it may feel like that for days afterwards.  Using creams to rub in afterwards should help - but she may resist this at first and advice from an Occupational Therapist with experience of autism and SID should be able to give some advice.
If the behaviour is anxiety based, then you need to look at what may be causing her to do this.  Or is it an attention seeking behaviour?  Is your granddaughter verbal?  If she has any communication issues then you need to improve those to be sure she isn't doing it because it makes her mother give attention to her.  She may have learnt that when she scratches herself her mother spends time with her.  If she has social interaction or language problems she may depend on that behaviour because she hasn't learnt any other way.  In that case you need to start with visual symbols that represent needs and teach her how to use them.  But I am presuming that PDD NOS she is verbal and can communicate her needs easily.