I have a 3 yo dcb who simply refuses to wash his hands. Everyone else washes up for lunch and he stands there screaming "can you help me" over and over. We have taught him how to wash hands and even my not even 2 year olds can do it themselves. If we do help him we have to physically do everything for him with us hold his hands under the water and him trying to pull his hands away from the water. If we ignore his request for help he will cry and scream. Once it was an hour and still refused. This is while everyone else is eating snack or lunch and he wants to eat just refuses to wash hands. Parent says it is a water phobia. I don't think they wash hands at all as Monday morning his hands are always filthy when he comes in. Any suggestions? Obviously he has to wash, but I don't want to physically force him to do so. And his screaming wakes up the babies. Out of ideas on this one.

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If it's truly a phobia, it's beyond my scope of knowledge. But here's what I'd try:
Don't "ask" him to wash. Simply take him to the sink, and take his hands in yours, talking him through the motions: First, hands in the water! Now, some soap! Scrub, scrub scrub Rinse, rinse, rinse. Dry them off. All done! Go eat
All positive, no matter his response
Hopefully it's just gotten to be a bad habit and you will help him develop a new habit. To do this, be careful to use similar words and motions each time, so that he gets used to it.
Also, I wouldn't worry if he's washing for two minutes (recommended) but start where you can, and increase the time gradually.

Once he can go through those 'helped' motions, give him a little time, and then slowly introduce independence. I'd start at the end: drying off. After a while, add in rinsing by himself, etc. Hopefully before you get back to the beginning he will want to do it himself.

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Yes, that's what we did for the first three months. Now we're trying to get him to do it himself. He flat out won't do it. Do you think we should just do it for him so it's done or should we fight this one and make him do it himself? I haven't put water in the sensory table in a while but I'm going to test it out next week to see if he will play in the sensory table. Test their phobia theory.

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Sure, why wouldn't you have water in the sensory table? It's not just based on his needs/desires Observation without pressure sounds like a plan to me.
As to washing, I would still back off beginning with the last segment. Make that his next 'new habit'. By starting at the end, hopefully he doesn't get tense with anticipation from the get-go. Don't expect it to happen right away, just like it didn't for the past three months. The goal is progress; it's not magic

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I wash the kids hands myself anyway. I give them a good clean and massage. They aren't good at it tull they are four or five ime. I would do it for him.

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