I am a care giver toa woman who we think might possibly be miss-diagnosed. The following are some of the habits she is displaying on an almost constant basis.
She used to do "search-a-word" puzzles, and now she, (when left alone and uninterrupted) will use the index finger of her right hand, and as she is asking outloud, to no-one in particular, "is this s l e e p", she is drawing a line in forms that the word might be found in the puzzle, and spelling it out. Where did I find "it" whatever word she is looking for, and after eating, "did I find tuna fish?" When going to the bathroom, she needs someone to tell her "what did I find here?', i.e. did I find "boom boom", I can't believe I found that.
Very nearly everything in her daily routine involves the questions and spellings of whatever it happens to be.
If you ask her about her parents, animals, friends, collegeyears, etc. she becomes totally lucid, and will converse with you with astounding clarity, and grammatically correct verse.
The other actions come into play if things are quite, and when she lies down to rest or sleep, etc.
She would normally not be rude or abrasive, and now she is, and if she asks you to take her somewhere, she will ask you to say you are her friend, not her caregiver.
Are any of these actions what you are seeing with pick's.