Hoarding disorder (HD) has been recently added as a separate diagnostic category in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. HD is a common and disabling disorder, with an estimated prevalence in the general population of 2–6%. Although evidence suggests that the onset of hoarding symptoms is usually during childhood and adolescence (youth), relatively little is known about HD in this population. The present article is a selective review of emerging literature on the clinical features of hoarding in youth.

Hoarding disorder (HD) is characterised by difficulties in discharging or parting with possessions irrespective of their actual value, urges to save and acquire new items and excessive clutter in living areas. There is an urgent need to advance the understanding of HD in child and adolescent populations. The aim of this paper is to cover the assessment, treatment strategies and tools currently available. In general, data on assessment of paediatric HD are scant. Only one psychometrically sound scale, the Child Savings Inventory, which is a parent-rated scale used to assess the severity of hoarding symptoms, was found. However, this scale is not sufficient to produce a diagnosis of HD. Regarding treatment, there was only a limited number of case studies suggesting the effectiveness of cognitive behavioural therapy that includes exposure to discarding and not collecting new items, using contingency management for exposure and oppositional behaviour, cognitive training and instructing parents to assist with home-based exposures. In conclusion, there is an urgent need for properly validated Diagnostic and Statistical Manual of Mental Disorders assessment tools, and we encourage practitioners and researchers to develop and test a Cognitive behavioral therapy (CBT) protocol for paediatric HD based on the aforementioned components.

Hoarding disorder (HD) is a psychiatric condition that negatively impacts individual sufferers, their families and the larger community. The disorder goes beyond problems with excessive clutter; it also presents with deficits in executive functioning, attachment and affect regulation deficits. This paper focusses on the needs of adult children of parents with HD, who directly experience the consequences of the disorder throughout their life cycle. We explore the existing research on the psychological, relational and social impact of parental hoarding on adult offspring. We discuss the clinical implications of these findings and offer possible psychological interventions that may be of help in this vulnerable population.

Hoarding is associated with problems engaging in social activities, lower social support, increased isolation and poses substantial challenges to family functioning. The aim of this investigation was to explore the relationship between hoarding severity and family and social functioning variables in 60 treatment-seeking adults with hoarding disorder (HD). Participants completed a battery of self-report measures during a baseline assessment completed prior to treatment. Forty-seven percent of participants reported they live alone. Forty-eight percent of participants reported that family and friends never visit them in their home, and 33% indicated they never had visitors to their home, not even service workers or repair people. Twelve percent of participants indicated they never visit with family or friends outside of their home; however, 55% of participants endorsed phoning family or friends more than 9 times each month. Increased clutter and hoarding severity was associated with a lower frequency of family and friends visiting in the home. Family competence and conflict were both positively associated with hoarding severity. Our results shed light on family and social impairment in HD and their relationship with symptom severity; however, additional research should examine social dysfunction among non-treatment-seeking individuals who may be more impaired or isolated.

The perspective herein is based upon the lived experience of adult Children of Hoarding Parents (COHP). The weight of parental hoarding on COHP is not derived solely from the physical adversity of living within a hoarded home but also comes with the social and psychological challenges they carry into adulthood. The view of hoarding as a family disorder with lasting impact evokes research questions including the exploration of the relationship between childhood adversity and parental hoarding, and the application of attachment theory to hoarding behaviours and family relationships. These types of research studies may lead to policy adoption and programme development for early identification of and intervention within families where parental hoarding represents a threat to child welfare.

This essay is a first-person narrative of the author’s experience as the child of a hoarder. It is published anonymously to protect the privacy of those discussed.

Children raised in animal hoarding situations experience both short- and long-term physical and emotional hazards. Far too often, the needs of children are under-served due to lack of interagency cooperation, societal misperceptions and other mitigating factors. These issues are discussed as they relate to the effects of animal hoarding on children in the home. Content is drawn from the lifelong experience of a humane law enforcement and animal care professional. A sampling of case studies is offered, and observations are presented regarding the immediate and long-term risks and trauma experienced by children in the hands of people who hoard animals. Included are a universal definition of animal hoarding, an explanation of animal behaviour in hoarded homes, information about humane law enforcement agencies and problems associated with a lack of interagency cooperation.

Despite a rapidly growing understanding of hoarding disorder (HD), there has been relatively limited systematic research into the impact of hoarding on children and adolescents. The goal of this paper is to suggest future research directions, both for children with hoarding behaviours and children living in a cluttered home. Key areas reviewed in this paper include (1) the need for prospective studies of children with hoarding behaviours and those who grow up with a parent with HD; (2) downward extensions of cognitive-behavioural models of adult HD that emphasise different information processing and behavioural biases in youth HD; (3) developmental research into the presentation of emerging HD in childhood compared with adulthood presentations of the disorder, with consideration of typical childhood development and unique motivators for childhood saving behaviours; (4) developmentally sensitive screening and assessment; and (5) the development of evidence-based treatments for this population. The paper concludes with a discussion of methodological suggestions to meet these aims.

This paper considers how what has been learned about hoarding difficulties in adults can be applied to working with children and adolescents and how our knowledge of child development can improve how we help the younger person with this problem. In particular, attachment relationships to objects and organisational difficulties will be focused upon. The importance of earlier interventions, earlier in life, to prevent problems in the future is stressed. Future directions including a research agenda are put forward.

This is a call for action to protect and assist children of hoarding parents. Action that minimises harm to children living in hoarded homes also promotes family safety and health. Optimal care involves the whole family system, both children and parents. Prevention of harm through early identification and intervention for hoarding can reduce the burden of a disorder that often increases in severity over a lifetime and deprives humans of a full and safe life. Helping children and their parents severely affected by hoarding disorder is for the public good. Public policy and funded programmes can reduce long-term and immense costs to children, families and the many systems hoarding affects. Specifically, public policy can facilitate and fund outreach, education, coordination of providers of health, social and public services, and research-driven methods for assessment and intervention on behalf of children, individuals and families. Releasing people from the grips of hoarding disorder can enable them to devote generative resources to themselves, their families and their communities. Ultimately, prevention of hoarding through early assessment and intervention for minors and young adults is the most efficient, long-term and cost-effective method for minimising harm. When unidentified, hoarding disorder intensifies, people go into hiding, risk increases and opportunity for detection and intervention decreases. Informing the public about hoarding disorder must be followed with sufficient resources to address it, otherwise, helplessness ensues, and people will likely remain in the hidden world it governs.

Hoarding is a complex and persistent mental illness that may pose significant threats to the health, safety and optimal functioning of the sufferer and their family members. Children and youth who live in hoarded environments are especially vulnerable to safety hazards and the negative social and developmental impacts that can result from this challenging behaviour. Some educational, health and protective service organisations are compelled to act on legal and regulatory mandates that necessitate interventions for hoarding in cases where children and youth are residing and may be at risk. Striking the balance between individual rights and protection of some of society’s most vulnerable citizens is a significant challenge. Carefully executed multidisciplinary interventions grounded in an ecological system’s approach offer some hope for minimising adverse impacts on youth and families while reducing the potential for harm caused by hoarding behaviour.