Many parts of this article have been changed to protect identity.
There are some parts of this article that should be rated PG-13 because they discuss human sexuality.
Roger was a 12 year boy who was diagnosed with Asperger Disorder. His father worked for UPS and was away from home frequently. His step-mother was a devout Episcopalian, who believed in following religious teaching closely.
Roger had a distinctive voice problem. It sounded like he was whining all of the time. He also had some unusual habits that were consistent with his diagnosis. The family had to lock food storage cabinets and the refrigerator because of his unusual food preferences (he liked to eat sticks of butter or margarine, dry drink mix powder, and the liquid from pickle jars). The behaviors that caused him to come to my attention were his wearing of his infant brother's diapers, and the fact that he refused to take showers. He would also become angry because his step-mother would yell at him for wearing the diapers. They attempted to solve the problem by locking up the clean diapers. Roger solved that problem by wearing the wet/soiled diapers that he took out of the trash. He was smart enough not wear diapers to school.
Roger never talked about his reason for wearing the diaper. I did not know of a medication for diaper wearing, so I did not refer him to a psychiatrist. I'd bet that most psychiatrists would figure out a medication to use.
Ms. Wanatoast came in about a month after therapy started. She was in a tiff. She had discovered why Roger was wearing diapers. This proper lady found him seated on the bathroom floor with a diaper under his bottom, masturbating. She told me that he was going to hell because he was masturbating, and she did not care what my beliefs were about that. I had to stop him from doing that. My first thought on the matter was that Roger's masturbation had actually caused a vision impairment - her's. I told her that I would work on the problem.
She went into the waiting room, and Roger came in. He looked very dejected. "Roger, you are not going to hell because of what you did. I cannot stop you from doing what you did. I can help you solve your problem and improve your situation." He looked up and smiled. "Let me guess, Roger. You were using your brother's diapers as a way to get rid of the mess." He smiled and shook his head in the affirmative. "Are you interested in learning about a way to get rid of the mess without your mother finding out?" Of course he was. I told him that if he masturbated in the shower, the water would wash the mess down the drain. He liked the idea.
Ms. Wanatoast came in for the next session. She was smiling as she came in to the office and said, "You are a genius! Roger is not wearing diapers anymore. He stopped masturbating, and he is taking a shower every day. Sometimes he takes two showers a day." It was difficult to keep myself from laughing, but I thanked her for her praise."
Roger and I worked on his mother's anger. We figured out a way to keep him from responding to it. It worked. Do you want to know how? Ask in a comment, and I'll tell you.