Hoarding Disorder Basics

Children with hoarding disorder have extreme difficulty in parting with possessions, irrespective of their actual value. This guide lays out how to recognize hoarding disorder in children and how it's diagnosed and treated.

Hoarding: What Is It?

Hoarding is a disorder characterized by a person’s not only acquiring objects in great excess, but also being unable or unwilling to part with them, causing great personal and family distress. Children who hoard develop overpowering emotional attachments to their possessions, resulting in cluttered rooms and contributing to tension in the family, especially when a parent tries to clean away some of the mess. Children diagnosed with the disorder are so worried about their possessions it interferes with their functioning.

Hoarding: What to Look For

Hoarders tend to acquire and hold onto objects that for most people would have very little use. Examples might include rocks, toilet paper tubes, paper, Happy Meal boxes, and food. Children might also hoard toy boxes and toys. The objects may or may not have typically sentimental value to the child. Whereas a rock or stamp collector will search out specific items for his collection, a hoarder will acquire items seemingly at random and then struggle when asked to part with them. Adult hoarders are often identified by the clutter they accumulate, which results in complete disorganization and unlivable spaces. Children’s hoarding tends to be more contained—for example, under their bed or in areas of their bedroom—and might not be immediately obvious to an observer because disorganization is common among kids. For children the most notable sign of hoarding is the emotional reaction to their possessions. Children will be constantly worried about them, so much so that it becomes impairing and creates a major source of tension with their parents.

Hoarding: Risk Factors

Approximately half of all people who hoard also have a relative who hoards, making this a behavior that runs in families. Experiencing stressful and traumatic events may also be a factor.

Hoarding: Diagnosis

When diagnosing hoarding, mental health providers check for three principal characteristics: persistent difficulty discarding or parting with possessions, regardless of their actual value; cluttered living spaces from having so many possessions; and significant distress or functional impairment.

Hoarding: Treatment

How hoarding is treated depends on the age of the child. For children eight and younger, psychologists often work with parents to set up a behavioral plan, to first stop a child from acquiring new things and then use incentives to work on gradually getting rid of some of her hoarded objects. For older children, cognitive behavior therapy (CBT) with a therapist who has experience treating hoarding is helpful. CBT helps children understand why they feel compelled to hoard and teaches them how to decide which possessions are worth keeping and which should be discarded.

The medications most often used in a treatment plan for hoarding are a selective serotonin reuptake inhibitors, or SSRIs. Not all hoarders respond to medications.

Hoarding: Risk For Other Disorders

Many people with hording disorder also have depression or another anxiety disorder, including social anxiety disorder, general anxiety disorder, or OCD.