Does your child collect sticks, rocks or items they've gotten for free?

Does your child have a "meltdown" when you try to throw away their "stuff?

Do you know the 3 best ways to respond to a child hoarder?

Children Can Also Be Hoarders

Many assume that hoarding is a problematic behavior that occurs only in adult and geriatric populations, like Mom and Dad, but it does affect children and adolescents too. It is just more difficult to observe it in those populations than it is in adults because children don't have the same resources and opportunities. Little information is known and fewer studies have been done about hoarding in children so public awareness of the issue is very low.

What To Look For

There are number of significant differences between children who hoard and adults who hoard, primarily because of the limitations that children face due to their developmental age. Oftentimes children are not able to accumulate large amounts of clutter as parents will limit the items that are brought into the home or saved. From our clinical work we found that parents generally restrict items to a single area in the home, such as the child's bedroom or play room. Parents also tend to discard items while the child is in school or asleep. Children are also unable to compulsively purchase items due to lack of resources (e.g., money) as well as developmental age (e.g., being too young to drive, inability to go out without parents' permission).

Because of these limitations children generally hoard items that are obtained for free (e.g., cards from friends, schoolwork, ticket stubs from movies/amusement parks), items that are already in their possession (e.g. broken toys, old school projects, clothes they no longer wear) or items that are easily found outside (e.g., sticks, rocks, trash). As clutter and acquisition of items are limited in children who hoard, the most prominent characteristic of these children is the inability to discard items. Parents often report that children become extremely distressed and agitated when items are discarded, where the child may "melt down" or have a temper tantrum (e.g., screaming, crying, yelling). These behavioral outbursts may escalate to the level of the child experiencing "rage attacks" - kicking and hitting parents and/or breaking items and furniture within the home after learning that a broken toy was discarded.

Does your child have OCD?

How To Respond

Restrict space

Parents can limit the amount of items that are hoarded within the home by restricting the space in which hoarded items can occupy. For example, if a child has hoarded items scattered throughout his bedroom, parents can start to enforce a rule where a child may only keep items that fit on bookshelves, desks and closet space. Any items found outside of these places will be discarded. Be sure to specify how much space on the bookshelf, closet or desk is designated for hoarded items. Without specifying, children may then stack so many items into these places, the hoarded items will preclude the ability to use these spaces in the manner it was intended (e.g., no space on the desk to complete homework, closet filled with random items rather than clothes).

One in, one out

Another way to limit the accumulation of new items into the home is to implement a "one in, one out" rule. According to this rule, children can bring in any new items into the house they want – but if something new comes in, something old must be discarded. Not only does this manage the number of hoarded items that are brought into the home, but also it allows children to practice making decisions on what they may deem "worthy" of bringing into the home.

Provide rewards

It is important for parents to keep in mind that it is very difficult for children who hoard to discard items. Because of this, children should be rewarded when they exhibit "preferred behavior" (i.e., when they discard items or when they refrain from bringing into the home new items). It is best if these rewards were not tangible items, as giving items as rewards will result in more "stuff" that will increase the clutter within the home. Instead, rewards can be activity based. (For example, have a family movie night where the child can choose the movie, go ice skating, have a picnic, set up a play date, have a sleep over, allowing the child to choose what is for dinner, make the child's favorite dessert)

Research – Past and Future

Little information is known regarding hoarding behavior in children and adolescents. However, adults who hoard often report that hoarding symptoms onset during childhood (Grisham et al., 2006). As the childhood hoarding literature is scant, the prevalence, trajectory and prognosis of the behavior are unknown. To date, research regarding hoarding in children is primarily focused on obsessive compulsive disorder (OCD) populations, where hoarding behavior is a symptom presentation of OCD (Storch et al., 2007). However a case series examination of foster children and an empirical investigation of ADHD youth have also demonstrated that pathological hoarding behavior is present outside of OCD (Hacker et al., 2012; Plimpton, Frost Abbey, & Dorer, 2009).

As hoarding behavior is considered a chronic disorder that is associated with significant impairment in adulthood, it is important to understand the nature of hoarding behavior in childhood. Better understanding of the disorder will facilitate early identification and treatment, thereby possibly curbing the trajectory of the disorder.

If you are interested in participating in a study that is examining childhood hoarding, go to http://www.massgeneral.org/psychiatry/services/child_cbt_hoarding_study.aspx for more information.





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Sources https://www.anxiety.org/hoarding-disorder-struggling-to-let-gohttps://www.anxiety.org/hoarding-disorder-struggling-to-let-goReferences Grisham, J.R., Frost, R.O., Steketee, G., Kim, H.J., & Hood, S. (2006). Age of onset of compulsive hoarding. Journal of Anxiety disorder, 20, 675-686. Hacker, L.E., Park, J.M., Timpano, K.R., Cavitt, M.A., Alvaro, J.L., Lewin, A.B., ... Storch, E.A. (2012). Hoarding in children with ADHD. Journal of Attention Disorders. doi:10.117/1087054712455845 Plimpton, E.H., Frost, R.O., Abbey, B.C., & Dorer, W. (2009).Compulsive hoarding in children: Six case studies. International Journal of Cigntiive Therapy, 2, 88-104 Storch, E.A., Lack, C.W., Merlo, L.J., Geffken, G.R., Jacob, M.L., Murpphy, T.K. & Goodman, W.K. 2007). Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Comprehensive Psychiatry, 48, 313-318.