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My daughter just turned 3 earlier this week, and last night some behaviors that we'd noticed that we thought she would just grow out of got a lot more concerning and worse. She's always been particular about being clean and her hands being clean, though I didn't think too much of it. Lately when she gets upset, particularly when she wakes up at night, she has started to spit on her hands, which gets her even more upset, but she keeps doing it. Used to be we'd hand her a washcloth, she'd towel her hands and would be fine, but last night a washcloth was not enough and we had to take her to the sink to wash her hands. This worked twice, but then when she woke for the third time (ugh) last night, she was so worked up that taking her to the sink didn't calm her down and she started forcing her fingers down her throat and would gag and even threw up once. I'm at a loss as to what to do, especially since as she just turned three she can't communicate abstract thoughts yet, and I've been scouring the internet and can't find anything about a toddler spitting on themselves when it upset them so much. Other things, my husband is on the OCD scale and sees a lot of him in her. He's not at the point where it interferes with his daily life but he has obsessions and compulsions and has had a few panic attacks that has resulted from them. Her older brother (6) and myself are both autistic, however, she does not have any autism warning signs and does some rather pro-social behaviors that I don't think that's what it is. Other behaviors that are concerning: -She keeps her room immaculate to the point where she doesn't even let toys into her room. When I put in her big girl bed I decided to add some toys and stuffed animals and she threw a fit until I took them out. And I've tried to let her take a toy in her room for quiet time but she refuses to have one with her. She will throw anything that does not belong in her room into the hallway and cleans it twice a day, at nap/quiet time and at bedtime and has done this since she was 18 months. -She's very particular about how the covers are on her bed. The covers have to be just so and there can't be any lumps and she sometimes gets upset that we can't make her feet lumps go away. -She changes her clothes between 2-3 times per day. If she so much as splashes a drop of water on her shirt while washing her hands she gets upset and wants a new shirt. -She is starting to ask to wash her hands a lot and find reasons to do it. Like when I take her to pick her brother from school or go to the store she will ask to go potty, then she'll sit on the potty without going or even giving it long enough to have a good try at going, and immediately ask to wash her hands. -She has elaborate getting into the car seat and good night routines, where there's an ordered sequence of how everything goes, we have to give her a high five a certain number of times (though the amount of times changes) and then we have to say "good bye" to her in a particular way with a specific tone of voice and a certain number of times. I had thought it was just typical toddler until last night, but now I'm starting to worry that it might be the beginnings of OCD. The spitting almost seems like she does it to have a reason to wash her hands but then she gets so upset that her hands are dirty she spits again and works herself up even more and it causes a viscous feedback cycle and I don't know how to stop it. I actually work with children and have taught child development, and I've spent the morning contacting professionals I know and ruling out sensory processing disorder and other common childhood things, though everyone agrees that this is not normal and the only thing we can't rule out is OCD, however, I have not heard of it manifesting this early (3 years and 3 days) and there is so little on the internet about it that I'm wondering if I'm overreacting or if it will just blow over. The only other thing we can think of is that she's acting out to get attention because her brother is autistic, yet she spends the day home alone with me while he is at school (which is an intensive therapy program for autistic kids so he's getting all the help in one place and I'm not shuttling him from place to place, it would just be like having a typical sibling in a typical school for her) and he's high functioning enough that he plays well with her, he's outgrown his tantrums and typically either entertains himself when he's home or plays with her, though I don't know how she sees it from her POV. Does anyone have any insight or resources? Her well child visit is Friday and I plan to bring it up but I also think that the doctor will tell me I am crazy if I bring up OCD.