AS and OCD co-morbidity?

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We noticed today that our pediatric neurologist's letter from two years ago mentioned that some of our son's behaviors fit an "OCD" pattern, in addition to the AS and ADHD. I was a bit taken aback by this (I just saw the letter again today in some paperwork during our meeting with the school). With all of the behaviors I can think of that my son displays that _could_ fit OCD, I can't think of any of them that might not just as well be explained by the AS and/or ADHD.

So I questioned this, sort of in passing, to the school speech therapist. She wrote a question mark beside it on another form.

Was I right to question this? I don't particularly care what combination of letters they diagnose him with (wink), as long as he gets the services he needs.

Or should I have left well enough alone? I don't know if they'll strike that from the dx altogether, or what. I didn't tell them to do that, just that I wasn't sure personally if I really felt like my son had OCD in addition to the other dxs.

Does OCD occur often with AS? Just curious about it in general, too.

I would be concerned about OCD being used for an educational label. They might use that to push your child into an Emotional Disturbance classroom.

I always thought it did fit.

However, during an appointment with my sons assesment team I mentioned something that 9yr old J had been doing, and the doc's were pretty quick to say that sounds obssesional and we need to try to stop this. So I didn't then go on to tell them the other things he does.

Maybe it's the degree of obsession? I don't know Im just thinking out loud.

Well I mean, he's a very picky eater, and he does chew/pick at his nails and cuticles a fair bit, and apparently at school he's rather particular about not having his things touched (who isn't?)...but that's about all I can think of, right off the top of my head. He will eat the same two or three things continuously at home (though not in huge amounts), and he will also wear the same article of clothing for several days if I let him and it doesn't get too dirty.

But it's not like he's washing his hands obsessively, or keeping his room clean (far from it!). Or do I not have a clear idea of what OCD really entails? What I'm saying is, I don't really see any/much RITUALISTIC obsessive or compulsive behaviors.

I'm not sure any of his behaviors really qualify as OCD. ??

I also wasn't aware that OCD was considered a sign of "emotional disturbance," per se. Is it generally seen as a neurological thing, or a behavioral (learned) thing?

Ok well now you've got me thinking lol
J does alot more than that, perhaps I should be talking with the docs about it more.
Heres the list I would be curious to know if other kids do the same or more or if I should infact even mention it.
J will not sleep in his room until I have pulled down his blind completely
His bed needs to be pushed tight against the wall (I have tried to not push it so tight but he always gives it a last minute shove before getting in)
J will not use the bathroom without shutting the window
He turns on the lights in each room in our house as he enters (doesnt matter if the room is already bright and sunny) I have turned them off and he screams
J has an issue with his underwear this Im sure is sensory but could be turning into obsessional behaviour if he thinks even a drop of urine has touched his underwear it will be taken off (this he has even done at school and hidden in his bag or pocket)
J will check traffic light buttons before touching them (germs)
He has refussed in the past to let people touch him because he has accused them of having germs/unclean hands

AS has been frequently misdiagnosed as OCD, especially pre-94, when few were really watching for AS. There are AS symptoms that do resemble OCD, but they're part of the overall syndrome rather than a stand-alone disorder. If you think you're looking at something with aspects of both OCD and HDD, you might very well read up on it and see if the symptoms seem familiar - if they are, suggest AS as a possibility. It might be a better fit, theraputically speaking. And if it's AS, they should be less likely to throw drugs at it, as they won't change anything (unless there's severe and chronic depression involved, and even then 'hesitate to medicate').

If you're just beginning to learn about Asperger, I strongly recommend reading as many different sources as you can find. One thing I've noticed is that researchers who don't HAVE A.S. sometimes describe certain symptoms in ways that are succinct, but not very explanatory. I suppose that's what happens when you're trying to explain something that's only been described to you by another person. Sometimes only after reading several slightly different phrasings describing the same symptom, did the light bulb come on and I'd think "Oh! You mean...."

One that puzzled me for a bit was the statement that "autistics may see lights or hear sounds that others don't" Then I realized that the researcher wasn't talking about hallucinations. It didn't say lights and sounds that AREN'T THERE. Then I remembered a conversation from years ago, in which I was comparing something to that noise that old vacuum tube televisions made - a high pitched squeal that was barely, but constantly audible even when the sound was turned down. Two of the people I was talking to looked at me like I was speaking Martian, until the third, who was an electronics buff said "Yeah, that's the such 'n'such and explained how it worked. Apparently I was hearing a noise that normally only dogs and mosquitoes hear, but it WAS there. And I'd assumed all my life that everybody heard that.

Pardon me, I seem to have gone galloping after another Aspergian rabbit. Tally Ho!

OCD tendencies or pattern does not mean he has OCD. Our neurologist says that some of the things my child does seem OCDish and has called them "OCD tendencies" but did NOT diagnose him as OCD. She believes that it may just be PART of his Asperger's.

My child has some serious issues with food touching. Gets distressed if he cannot wear his favorite clothes. Hates to change socks. Needs his bed a certain way, among some others. She is watching him and re-evaluating him later for the OCD tendencies to see if he really needs to be diagnosed with it, or if it is part of the Asperger's.

C. (now 22) had some 'pattern behaviors' as a young child. Putting him to bed involved about an hour's worth of things that had to happen in sequence -- some by us, some by him. We all worked with a pyschologist to break that pattern and it worked fine.

He has been through all the "ADD drugs" so many I can't recall them all. Most effective was dextroamphetamine - this normally makes people more energetic (and able to focus), but for ADD, it seemed to have calmed him down (while being able to focus). Ritalin and others were anti-depressants including prozac. He finally switched to Effexor XR which has worked fine.

There came a time 3 summers ago when C. wanted to go 'cold-turkey' off all his medications. With anti-depressants, you have to stop them gradually. The result was a sudden appearance of OCD-like hand washing. He went back on the Effexor and the hand washing has calmed down. It now mostly appears at the end of the day. His conern isn't necessarily with germs he might pick up from surfaces, but from his own body. He travels with Lysol wipes in his backpack. I wish his concern was germs all the time (no, not really), because he leaves litter all around the house and bathroom. His toothbrush sits out on the bathroom counter all the time.

The psychiatrist he now sees explains that it's not really OCD, but is OCD-like and probably a reaction to his 'cold-turkey' experience with Effexor.

Just getting pretty obsessive about
a. lining things up
b. sorting them into colors, shapes, categorizations etc..
c. collecting things
d. timetabling (ie: wanting to do things correctly to time)
e. accuracy - eg: refusing to estimate in mathematics classes

will all appear to the untrained eye as OCD.

These things are comorbids but I think they're really parts of Aspergers, not separate traits.

See my blog;

What are Comorbid Conditions and how do they fit into Aspergers? (Life-with-Aspergers blog)

The "OCD tendencies" is the correct statement and from observation here and research elsewhere it is a part of Asperger's.

The difference being the cause of the Actions.

People with actual OCD do their repetitive rituals because they are afraid (or envision) that something bad will happen, if they do not continue with their Action, that has nothing to do with their Action. (if I do not wash this dish three times, my grand mother will fall over and die)

Aspergians do not have the same motivation. I do the triple hand wash thing when I've touched something icky, or i've been sweating a lot. I'll flip light switches because it is funny. I place stuff in patterns on the table when I am eating out (glass, fork, other glass, knife, other glass, spoon) simply to keep my brain occupied. I'll over-groom my hair because it is soothing.

finding the motivation behind each action is the key.