When your child’s room is more than just messy and letting go of small items causes deep distress, it’s confusing. This pattern may signal hoarding, a recognized condition that needs support. This guide will help you understand the signs and learn how to help.
What is hoarding in children?
Hoarding disorder involves a persistent difficulty discarding possessions, regardless of their actual value. This difficulty is due to a perceived need to save items and the distress tied to discarding them. For children, this results in cluttered living areas that compromise their use. While the condition can start as young as ages 6-7, it affects approximately 2% of adolescents.
How to spot signs of hoarding in your child
Recognizing the difference between a childhood collection and a clinical concern involves observing specific emotional and physical patterns. This information can feel overwhelming, but noticing these signs is the first step toward getting your child the right support.
Emotional warning signs to watch for
Your child’s emotional responses to their possessions can include:
- Intense distress: They become extremely upset, anxious, or angry when asked to discard items, even things that seem insignificant.
- Decision paralysis: They are unable to decide what to keep or discard, often getting stuck when trying to organize or clean.
- Social isolation: They avoid having friends over because they feel embarrassed or ashamed of the clutter in their room.
- Defensiveness: They become secretive or defensive about their possessions and the state of their personal space.
Physical signs in your child’s living space
The clutter itself is often the most visible sign. Look for these patterns:
- Unusable spaces: Their bed is used for storage instead of sleeping, or their desk is too cluttered for homework.
- Pathways through clutter: They have created narrow trails to navigate through piles of belongings on the floor.
- Excessive acquiring: They frequently bring home items they find, such as rocks, flyers, or broken toys.
- Disorganization: Items are not grouped in a meaningful way, appearing as random piles rather than an organized collection.
When your child objects to throwing things away
A child’s attachment to objects can be complex. To better understand this dynamic, it’s helpful to consider the perspective of Dr. Jerry Bubrick, a leading psychologist at the Child Mind Institute.
The feeling they have when they pick something up is a sense of desire. That thing looks cool. I really want it. Or I need it. This could help me in some way. The anxiety comes when they’re forced to get rid of it.
— Dr. Jerry Bubrick, Clinical Psychologist, Child Mind Institute
This anxiety is a core feature of hoarding and separates it from typical childhood collecting.
Hoarding vs. collecting: understanding the difference
Many children have collections, and this is a healthy part of development. However, there is a clear line between a hobby and a hoarding problem.
Normal collecting behaviors in children
Collecting is an organized and social activity that helps children learn categorization and responsibility. Hallmarks of a healthy collection include:
- Pride and organization: The child enjoys displaying, organizing, and talking about their collected items.
- Social connection: They share their interest with friends or family, often trading items and discussing their hobby.
- Discernment: They are selective about what they add to their collection, focusing on specific types of items.
- No functional impairment: The collection is kept in a designated area and does not interfere with daily living.
When collecting becomes hoarding
Collecting crosses into hoarding when the accumulation of items becomes excessive, disorganized, and causes significant distress or problems in daily life. Key differences include:
- Lack of organization: Items are kept in chaotic piles, mixed in with trash and other random objects.
- Shame and secrecy: The child feels embarrassed by the clutter and tries to hide the extent of the problem.
- Indiscriminate acquiring: They save everything, unable to differentiate between items of value and things that are broken or useless.
- Impaired functioning: The clutter makes rooms unusable, creates safety hazards, and negatively impacts family relationships.
Common myths about hoarding in children
Understanding the facts about pediatric hoarding is essential for early intervention. Misconceptions can delay much-needed support for a child who is struggling.
“It’s just a messy phase”
While many teens have messy rooms, hoarding is different. It involves a level of clutter that makes spaces unusable and an emotional distress tied to discarding items that goes far beyond typical untidiness. The problem is about accumulation and anxiety, not just a lack of cleaning.
“They’ll grow out of it”
This is one of the most dangerous myths. Many adults with hoarding disorder trace their behaviors back to their childhood. As Dr. Jennifer M. Park of Stanford University notes, early patterns are a significant indicator.
A lot of the adult literature has shown that hoarding behavior actually starts in childhood. In many retrospective reports, adults say, ‘I’ve had these problems ever since I was a kid.’
— Dr. Jennifer M. Park, PhD, Stanford University
Ignoring the signs means missing a critical window for intervention.
Why do children develop hoarding behaviors?
There is no single cause of hoarding in children. It is a complex condition that often results from a combination of biological predispositions and environmental factors. It’s important for parents to understand these factors are beyond their control.
How genetics and family history play a role
Genetics are a significant factor in the development of hoarding disorder. Studies show that hoarding behaviors are heritable, meaning they can run in families. If a close relative has hoarding disorder, a child has a greater chance of developing the condition themselves.
The connection between trauma and hoarding
For some children, hoarding behaviors can be triggered by stressful or traumatic events, such as the loss of a loved one or family instability. Acquiring and saving objects can become a coping mechanism, providing a sense of comfort, control, or security in a world that feels unpredictable.
Getting your child evaluated for hoarding
Your sense that something significant is happening deserves professional attention. Choosing to pursue an assessment is a proactive step toward understanding what your child is experiencing and how you can best support them.
What happens during an assessment?
A mental health professional will conduct a comprehensive evaluation to understand your child’s behaviors. This typically involves:
- Interviews: The clinician will talk with both you and your child (separately and together) about the symptoms.
- Rating scales: You may be asked to fill out questionnaires, such as the Child Saving Inventory, to measure the severity of the hoarding behaviors.
- Observation: In some cases, a clinician may ask to see photos of the cluttered areas or even conduct a home visit.
Questions your healthcare provider will ask
To get a clear picture of the situation, the provider will likely ask about:
- Types of items: What does your child save?
- Acquisition methods: How do they get new items?
- Clutter levels: How much do the items interfere with the use of rooms in your home?
- Distress levels: How upset does your child get when asked to discard things?
- Functional impairment: How does the behavior affect school, friendships, and family life?
Finding the right mental health professional
Look for a licensed psychologist, psychiatrist, or therapist who has experience with Obsessive-Compulsive and Related Disorders. It’s important to find someone who uses evidence-based treatments for hoarding. Your pediatrician or your child’s school counselor can be excellent sources for a referral.
Treatment options for children who hoard
Effective treatment for hoarding is available and can significantly improve a child’s quality of life. Early intervention often leads to better long-term outcomes.
Exposure and Response Prevention (ERP) therapy
Exposure and Response Prevention (ERP) is a specialized type of therapy that is highly effective for hoarding. It helps children confront their fears about discarding items in a gradual, supported way. A therapist guides them through exercises where they practice letting go of possessions without performing compulsive saving rituals.
Cognitive Behavioral Therapy for different age groups
Cognitive Behavioral Therapy (CBT) helps children identify and challenge the unhelpful thoughts and beliefs that drive their hoarding behaviors. For younger children, CBT is often play-based and involves the parents heavily. For teens, it focuses more on developing insight and building motivation to change.
When medication might be considered
Currently, there are no medications specifically approved by the FDA to treat hoarding disorder in children. However, a doctor may prescribe medication to treat co-occurring conditions like anxiety, depression, or ADHD, which can help reduce the overall symptom burden and make therapy more effective.
The role of family therapy
Hoarding impacts the entire family, so family therapy is often a crucial part of the treatment plan. It provides a space to improve communication, set consistent boundaries, and learn how to work together as a team. This approach helps reduce conflict and ensures everyone feels supported.
How parents can support their child at home
Your role in your child’s recovery is vital. Creating a supportive and structured home environment can make a significant difference. As one expert notes, supporting the parent is often the key to helping the child.
Creating boundaries without causing distress
Setting firm but compassionate limits is essential. The goal is to manage the behavior without shaming your child.
- Designate clutter-free zones: Agree on common areas, like the kitchen and living room, that must be kept clear.
- Limit new items: Restrict the acquisition of non-essential items, especially those that are free.
- Focus on safety: Prioritize clearing pathways and ensuring that doors, windows, and vents are not blocked.
The “one in, one out” rule
This simple rule can help manage the volume of possessions. For every new item that comes into the house (like a new toy or shirt), one similar item must be donated or discarded. This teaches the concept of finite space and encourages mindful acquisition.
Reward systems that work
Positive reinforcement can be a powerful motivator. Create a system that rewards effort and progress, not just results.
- Focus on behavior: Reward your child for participating in a sorting session for 15 minutes, regardless of how much they discard.
- Use non-material rewards: Offer rewards like extra screen time, a special outing with a parent, or choosing the family movie.
- Celebrate small wins: Acknowledge and praise every step in the right direction to build their confidence and motivation.
Communication scripts for difficult conversations
When emotions are high, it’s helpful to have a plan for what to say. Use “I” statements to express your feelings without blaming your child.
- To start a conversation: “I love you, and I’m worried about how the clutter in your room is affecting you. Can we talk about how we can work on this together?”
- When they are distressed: “I see that letting go of this is really hard for you. Let’s take a break and come back to it in a few minutes.”
- To validate their feelings: “It sounds like you feel this item is very important. Can you help me understand why?”
School accommodations and support
Hoarding behaviors can impact a child’s ability to succeed at school. Partnering with their school is a key part of a comprehensive support plan.
Working with teachers and school counselors
Schedule a meeting to discuss your child’s challenges. Teachers can watch for issues like disorganization in their desk or backpack, difficulty with assignments, or social problems. School counselors can provide in-school emotional support and help facilitate communication.
Creating a 504 Plan or IEP
If hoarding symptoms interfere with your child’s ability to learn, they may be eligible for formal accommodations through a 504 Plan or an Individualized Education Program (IEP). These legal documents can provide support, such as:
- Organizational help: Check-ins to help keep their locker, desk, and backpack organized.
- Extended time: More time for assignments if executive functioning challenges make it hard to get started.
- Reduced homework load: Modifications to assignments to prevent them from feeling overwhelmed.
When to seek emergency help
In some situations, hoarding can create immediate safety risks that require urgent attention. These moments are frightening for any parent, and your response shows how much you care for your teen’s well-being.
Creating a family safety plan
A safety plan is a proactive tool to use if a crisis arises. It should include:
- Clear pathways: Ensure all exits are accessible and free of clutter.
- Fire safety: Check that smoke detectors are working and that there are no flammable materials near heat sources.
- Contact list: Have the numbers for your child’s therapist, pediatrician, and local crisis team readily available.
- Safe person: Identify a trusted adult or family member your child can talk to if they feel overwhelmed.
988 Suicide & Crisis Lifeline support
If your child is expressing thoughts of harming themselves or is in immediate danger, do not leave them alone. You can connect with trained crisis counselors for free, confidential support 24/7.
- Call or text 988 to reach the Suicide & Crisis Lifeline.
- Go to the nearest emergency room or call 911.
Impact on siblings and family life
Hoarding doesn’t just affect one child; it creates stress for the entire family. Acknowledging this impact is important for the well-being of everyone in the home.
Supporting other children in the home
Siblings may feel frustrated, embarrassed, or neglected. It’s important to:
- Carve out one-on-one time: Ensure they feel seen and valued.
- Create a safe space: Protect their personal space and belongings from the clutter.
- Provide age-appropriate information: Explain their sibling’s condition in a way they can understand.
- Seek support: Consider therapy or support groups for siblings to help them process their feelings.
Managing family conflict and stress
Conflict over clutter, cleaning, and rules can be constant. To manage this stress:
- Hold family meetings: Create a structured time to discuss challenges and work on solutions together.
- Focus on harm reduction: Prioritize safety and function over achieving a perfectly clean house.
- Practice self-care: As a parent, taking care of your own mental health is crucial. You cannot pour from an empty cup.
Long-term outlook for children who hoard
With early identification and consistent, evidence-based treatment, the long-term outlook for children with hoarding behaviors is positive. Intervention can change the trajectory of the disorder. As Dr. Eric Storch from the University of South Florida emphasizes, starting early is key.
We know that if you start treatment early, you’re more likely to be successful versus when you start at age 57 and the clutter is 9 or 10 on a scale of 10.
— Dr. Eric Storch, PhD, University of South Florida
Success stories and recovery milestones
Recovery is a journey with many small victories. A published case study of a child treated with CBT for hoarding showed substantial improvements in symptoms and family functioning, which were maintained a full year after treatment ended. Milestones can include your child independently cleaning a small area or willingly donating a toy they no longer use.
Building resilience and coping skills
Treatment helps children build essential life skills. They learn to tolerate distress, challenge anxious thoughts, and solve problems more effectively. These skills not only help manage hoarding behaviors but also build resilience that will support their mental health long-term.
How hoarding in children differs from adult hoarding
While they share a core diagnosis, hoarding presents differently in youth. Understanding these differences is key to providing age-appropriate support.
Limited control over environment
Children often do not have full control over their living space or what comes into the home, which can sometimes mask the severity of the functional impairment. They rely on parents to set limits on acquiring items and to structure their environment.
Types of items children typically hoard
Unlike adults who may hoard a wider range of items, children and teens often focus on things they can get for free without parental permission. Common items include:
- Broken toys or parts of games
- School papers, flyers, and old artwork
- Wrappers, containers, and packaging
- Rocks, sticks, leaves, and other outdoor finds
Final thoughts
Recognizing these behaviors is the most critical first step. Your next action is to schedule an appointment with your pediatrician. With professional treatment and your support, your child can learn to manage this condition and build healthier coping skills.
