“Hoarders” is a television show in the United States that looks at people who suffer from hoarding disorder. These people often feel a need to keep possessions and struggle with determining how useful an object is and how to let it go.
However, there is a connection between autism and hoarding. Any parent of children on the autism spectrum knows what it’s like to have their child fight them when they try to throw away some possessions. But how do you know when it is autism, when it is hoarding, and when both may be at play? What can you do to help your loved one who is hoarding?
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Autism Behavior Interventions
What is hoarding disorder?
The Cleveland Clinic explains hoarding disorder is a mental health condition where a person goes beyond collecting possessions into the realm of being unable to let anything go. Hoarding can get to a point where it affects a person’s daily life.
Hoarding often leads to a person not getting rid of items with no intrinsic value. Some examples of hoarding include people who keep every issue of a newspaper they’ve ever bought or do not get rid of clothes they have outgrown or can no longer wear.
Hoarding behavior often leads to clutter, creating unsafe living conditions. Plus, it has been shown to cause shame and stress for the person who can’t let their possessions go.
How is hoarding different from collecting?
Many of us have had a collection over the years. For some, it’s coins or stamps, while for others, it may be comic books or movies. Collections are often grouped together and kept neatly on display as proud possessions that bring joy into the home.
When possessions become disorganized and accumulate around living areas, they are not collections but clutter. Hoarding is when clutter goes beyond just being an inconvenience.
Hoarding behaviors can make rooms in the home completely unusable. For example, a bedroom may not be available for sleep because the homeowner has too many possessions sitting in piles.
What’s the link between autism and hoarding?
While there’s no direct link between autism and hoarding disorder, research has found a significant crossover between the two conditions. Studies have found nearly 25% of autistic children demonstrate hoarding behaviors.
That’s significantly higher than the neurotypical population, which usually only sees hoarding behaviors in two percent of children and grows to six percent for adults near age 70. But why do these symptoms seem to overlap?
Research has found both are connected to restricted and repetitive behaviors and interests or RRBIs. Findings suggest many people with autism spectrum disorder may struggle with organization and planning. These similar struggles have been seen in hoarding behaviors.
Both may struggle to look to the future and plan ahead. They don’t recognize that accumulating all these possessions without getting rid of others or developing strategies for proper storage can hamper daily life and social interactions.
How do you recognize hoarding behaviors in autistic people?
Since autism and hoarding may share similar behaviors, it can be difficult to recognize when hoarding behaviors are present. However, parents should be aware of some common signs and symptoms.
Research shows these can include:
- Difficulty discarding items – Autistic children can often become attached to items. However, if the item has no significant value, such as string or paper, it can be a sign of potential hoarding behavior.
- Severe distress when getting rid of items – Autistic children exhibiting hoarding behaviors may experience significant distress when asked to throw away paper, lint, or string. While emotional attachment is not uncommon, their response could be a clear sign of hoarding.
- Cluttered bedrooms – If your child has difficulty discarding items, this can lead to too much clutter in their bedrooms. Over time, this accumulation can make it almost impossible to use their bedroom for its intended purpose.
- Obsessive-compulsive disorder – Autistic people can start acquiring new items obsessively. They may constantly think about items connected to what they see as their collections. However, these items may appear to have no apparent value to anyone other than the person with autism spectrum disorder. Eventually, these repetitive behaviors can lead to dysfunction.
- Secrecy about possessions – If your autistic children become secretive and don’t want to show off their new possessions, it can be a sign of hoarding behavior. The children may fear that someone who sees their possession may try to steal it, and they can’t bear to part with it.
What causes hoarding behavior in autism?
Sensory struggles have been shown to lead to hoarding behaviors among autistic people. Children may have trouble discarding items that have addressed specific sensory needs in the past. They may find comfort in the toys or collect objects that continue to address those needs.
Special interests can also lead to hoarding for almost anyone. An autistic person may become fixated on a special interest and want any items related to that interest. Over time, if they don’t get rid of older items that are no longer useful, it may lead to a hoarding situation rather than a collection.
Autistic children may also experience a need for control. Hoarding items may help them feel like they have a sense of control and predictability in their environment. That sense of predictability can often provide comfort and security.
Difficulty with decision-making can also contribute to hoarding behaviors in autistic people. They may struggle with deciding what to discard so they don’t get rid of anything. That way, they never have to make the decision, but it will lead to hoarding and clutter.
Managing autism hoarding
While hoarding among people with autism spectrum disorders can be an issue that may create significant distress for both the people on the spectrum and their caretakers, there are ways to manage hoarding behaviors. These methods include practical intervention strategies, empathy, and cognitive behavioral therapy.
Practical intervention strategies
These strategies help address hoarding by providing organizational techniques to help the autistic person understand the system’s benefits. These include:
- Defined storage – Use a structured system involving bins and labels that allows those with autism to visualize what they need to do for proper storage. My wife and I have a toy chest with different colored bins for our son to put his toys away.
- Sorting – When our older son’s room became too cluttered, we used different types of boxes and bags for sorting. He had a donation pile, a trash pile, and a keep pile. It allowed us to clear out his bedroom while giving usable toys to new homes.
- Addressing anxiety – Many autistic people may also suffer from anxiety disorders. Addressing anxiety disorders will allow them to understand the process behind discarding items and why it’s necessary to manage hoarding.
Empathy
Autistic adults and children experiencing hoarding disorder may need patience and understanding when you address their hoarding behaviors. This is where empathy comes into play.
Their emotional attachment to an item may cause them to become frustrated when someone tries to separate them from it.
Rather than dismissing those emotional attachments, working with your loved one to understand their attachment can help you acknowledge their concerns and fears and help them detach from the item.
Respecting and validating their feelings can make it easier to address hoarding in the future.
Cognitive behavioral therapy
Cognitive behavioral therapy, or CBT, will help your loved one understand hoarding behaviors and address how to change them. CBT can also help your loved one understand triggers for hoarding and recognize the thought processes associated with the behaviors.
The therapist can then help the caregiver challenge this thought process to help address hoarding disorder.
Hoarding risk factors
Hoarding behaviors can lead to several safety concerns and risk factors for people with autism spectrum disorder. One of the biggest issues can be the person’s mental health.
Many autistic adults and children suffer from low self-esteem, and hoarding disorder can make these issues worse. Anxiety disorders are also common among people on the spectrum. Hoarding can both be a symptom and cause of some anxiety issues.
Hoarding has also been linked to obsessive-compulsive disorder, which has been shown to be one of many co-morbid conditions with autism. While the person on the spectrum may find some relief in the routines associated with hoarding, it can negatively affect their overall well-being.
Hoarding disorder can also threaten physical health. It often leads to clutter that can create fire hazards, tripping hazards, and sanitary issues. All of these risks can be detrimental to the person’s physical health and safety.
When to seek professional help
If your loved one’s hoarding reaches a level that starts impacting daily functioning, then you may need to seek professional help. A cognitive behavioral therapist will likely be the first help from a professional you seek.
However, hoarding disorder may also be linked to anxiety or depression. It may be good to seek a psychologist, psychiatrist, or other behavioral health professional to address all the issues at play because medication may be necessary at that point.
Approach hoarding with patience and understanding
It can be difficult to see someone you love struggle with hoarding behaviors. It’s hard to understand why the person wants to keep an abundance of objects that seemingly have no meaning. But it’s important to understand that just throwing away the objects won’t stop the hoarding behaviors.
Provide empathy and understanding to help them know that you recognize the importance of the objects to them and are also trying to help them. Encourage them to seek professional support to address these behaviors. Working together, caregivers and loved ones can help address hoarding disorder and help keep collections while preventing safety concerns for the person who is hoarding.
FAQs
Q: Is hoarding common with autism?
A: While overall research has found hoarding disorder to be mixed when it comes to association with autism, a 2018 study found that 25% of children with co-occurring autism spectrum disorders and anxiety disorders experienced hoarding behaviors.
Q: What disorder causes hoarding?
A: While hoarding disorder can exist on its own, research has found that it can be caused by obsessive-compulsive disorder, obsessive-compulsive personality disorder, attention deficit hyperactivity disorder, and depression.
Q: Why do people with autism collect objects?
A: Research has found many reasons why people with autism spectrum disorders collect items. Some may find the collections calming and comforting. Others may have trouble with decision-making, and collecting the objects makes it easier because they don’t have to choose. Collections have also been linked to increased focus and concentration.
Q: Is hoarding a symptom of autism?
A: While hoarding disorder has been observed in people with autism spectrum disorders, research found they are two distinct conditions that are not a symptom of the other. Both can still easily co-occur with each other. However, the majority of people with autism do not hoard, and the majority of hoarders have not been diagnosed with autism spectrum disorder.
Resources
Do patients with hoarding disorder have autistic traits? https://www.researchgate.net/publication/51779463_Do_patients_with_hoarding_disorder_have_autistic_traits
Goldfarb, Y., Zafrani, O., Hedley, D., Yaari, M., & Gal, E. (2021). Autistic adults’ subjective experiences of hoarding and self-injurious behaviors. Autism, 25(5), 1457-1468 https://doi.org/10.1177/1362361321992640
Mohamed Abouzed, Amgad Gabr, khaled Elag et al. The Prevalence, Correlates, and Clinical Implications of Hoarding Behaviors in High-Functioning Autism, 31 May 2024, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-4344496/v1]
Storch EA, Nadeau JM, Johnco C, Timpano K, McBride N, Jane Mutch P, Lewin AB, Murphy TK. Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response. J Autism Dev Disord. 2016 May;46(5):1602-12. doi: 10.1007/s10803-015-2687-z. PMID: 26749256
The relationship between experiential avoidance and autism spectrum traits with hoarding behaviors with mediating role of saving cognitions https://shenakht.muk.ac.ir/article-1-505-en.pdf
