Expert: Ettina - 7/30/2008

Question
I have an autistic 6 yr old boy who this summer has started to play with his saliva.  He gathers spit in his mouth and then strings it out and plays with it.  He has been checked out for digestive problems and is fine.  What is causing this and can we stop it?

Also this summer he has started picking at his anus until he has several bowel movements.  He does this primarily in the afternoon at home and inside but more so outside in the  yard.  Again what is causing this and how can we stop it?
Thanks for any help.

Answer
I'm not sure, but I have several ideas.
Regarding playing with spit, my guess is that he likes the feel of it. It could either be primarily be sensations in his hands or in his mouth (or both), though more likely his hands.
A good idea would be to find more appropriate ways to get the same sensation. Letting him play with playdough or gum would give him a similar tactile sensation. If he's wanting stimulation in his mouth, then chewing gum or sucking on a candy might help.
As for picking at his anus, my big question is: what kind of digestive problems have been ruled out? Some kind of parasite, such as pinworms, could cause that behavior. He could also have some kind of rash or something. Is he toilet trained? If not, then he could have a diaper rash. He could also be itchy because of the feel of his clothes, especially if he tends to wear rough textures.
It could also be a tactile stim, just like playing with spit. If so, giving him something else to do with his hands could help, or even encouraging him to pick somewhere else.
Given that you said he does this until he has several bowel movements, it might be that he's doing this in reaction to needing to poop. In which case, taking him to the bathroom to poop whenever he does that may be a good solution, and will minimise sanitary problems because he'll be washing his hands afterwards.
Other suggestions would be giving him clothes that are hard for him to get into, such as coveralls, distracting him when you see him doing it, and just continuing to tell him to stop and pull his hand away until he finally stops doing it.