Is this OCD?

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My 14 year old son, who has AS, has a few behaviors that may be OCD. I'm thinking they are not, but his dad thinks they are, and has taken him to a therapist. He wants to try meds for them. I would rather stay clear of meds and don't like the therapist much because he doesn't know anything about AS (I am AS too, self-diagnosed).

But is it really OCD? This is what my son does--

About a year ago, when he started 8th grade, he started insisting that I (his mom) wipe his butt after he had a poo. (before this, he wiped himself). He makes me wipe it many times until he thinks the toilet paper is clean, and if I say "enough" he gets angry. Sometimes I wipe him 20 times. The number is random. Then he washes his hands a lot and walks out of the bathroom with wet hands, as he doesn't like to use the towels much.

During the day he will go into the bathroom and do a quick rinse-off of his hands, maybe 2 or 3 times during the whole day. Before bed he asks for another "butt-wipe", claiming that his butt is itchy/sweaty, which I reluctantly do, although I sometimes make a joke about it or ask him why he can't or won't do it himself.

One time I suggested that he wanted the "butt-wipes" because he liked the feeling and he got really angry, screaming and pounding his fist on the wall.

Is this OCD? I can see how it might be but I don't think he has the O of the OCD?

This doesn't sound like a healthy way of doing things to me. I don't mean to anger or discourage you, but it sounds to me like you are being too indulgent with him. There is no good reason whatsoever why he can't wipe himself, and he is going to have to start doing it at some point , so you should make sure he realises this by not entertaining 'insistences' and tantrums on the matter. He might have AS, but it's no excuse to be entirely unreasonable.

And no, I wouldn't have thought that demonstrated OCD . . . I myself am very fussy and have to check and re-check various things before I am satisfied and calmed, and I am also very particular about cleanliness, but I don't have OCD. I don't think it can be defined as such unless the behaviours cause distress in the individual, are time-consuming, and reduce the individual's day-to-day functionality.

I suggest family therapy. This is a severe invasion of privacy for a boy who is in the eighth grade and, I assume, not physically disabled; and you have to find a way for him to do this on his own. Unless there's something going on here that we're not being told about (there are problems that can make it necessary for an autistic person to need help with toileting), it should be absolutely possible for him not to need help in the restroom.

He sounds like he has some pretty serious sensory issues, and maybe some problems with dependency. This happens sometimes to disabled kids when they are raised in an environment (school, home, even therapists) where they're told that they cannot do things for themselves, and must depend on others to solve their problems. They start thinking that they can't do things on their own even when they are capable of doing them.

I suggest you talk this over with a therapist. There could be sensory or psychological issues; there could be some OCD-like issues. But it worries me that a kid this age is insisting on having something done for him that he's been doing before--either he's lost the ability to do it, for some reason (sensory? Learning-related? Stress-related?); or else he's asking you for some other reason. Either way, there's a problem, and it needs to be figured out.

He should also have a physical checkup. Sometimes there are problems with allergies, digestion, infections, etc., that can cause issues with toileting.

While it may or may not be OCD (that's not for us to diagnose or even suggest), it's definitely abnormal and needs to be brought to someone's attention. I suggest you talk to a (new, understanding of the autism spectrum) therapist. He needs to understand that it's completely unacceptable and will not continue one more day. Simply refuse to do it. Let him scream and cry and shout, if that's what he wants to do; OCD or not, he needs to act on the compulsion himself while things get sorted out.