Autism and Hoarding: Incidence, Clues, and Clinical Implications

Hoarding behaviors can significantly impact daily life, yet their connection to autism is not widely discussed. While hoarding disorder is a recognized condition, individuals on the autism spectrum may accumulate items for different reasons, influenced by unique cognitive and sensory factors. Understanding this link could help in better identifying and supporting those affected.

Research suggests that autistic individuals who engage in hoarding-like behaviors do so due to distinct motivations compared to the general population. Recognizing these differences is essential for clinicians, caregivers, and individuals seeking support.

Reported Incidence in Autism

Research on hoarding behaviors in autistic individuals remains limited, but emerging studies suggest a notable prevalence. A 2019 study in the Journal of Autism and Developmental Disorders found that autistic adults reported significantly higher hoarding tendencies than neurotypical controls, with about 30% meeting the clinical threshold for hoarding disorder. In contrast, the general population prevalence is estimated at 2-6%, according to the American Psychiatric Association. While this suggests a link, the motivations and underlying mechanisms appear different from those in individuals with standalone hoarding disorder.

Autistic individuals may accumulate objects not due to distress over discarding, as seen in hoarding disorder, but because of intense interests, attachment to specific items, or a need for environmental consistency. A 2021 systematic review in Autism Research found that autistic participants often described their collections as sources of comfort and predictability rather than clutter causing distress. This suggests that traditional diagnostic criteria for hoarding disorder may not fully capture the experiences of autistic individuals.

Longitudinal studies provide insight into how these behaviors develop over time. A cohort study in Psychological Medicine tracked autistic individuals from childhood into adulthood and found that hoarding tendencies often emerged in late adolescence and persisted into adulthood. Unlike in neurotypical populations, where hoarding disorder is frequently linked to anxiety or obsessive-compulsive traits, autistic individuals showed stronger associations between hoarding behaviors and sensory sensitivities, executive functioning challenges, and rigid thinking patterns. These findings highlight the need for tailored assessment tools that account for autism-specific factors influencing object accumulation.

Behavioral and Cognitive Factors

The cognitive and behavioral mechanisms underlying hoarding tendencies in autistic individuals differ from those in classic hoarding disorder. Executive functioning challenges, such as difficulties with organization, planning, and decision-making, significantly impact how objects are accumulated and retained. Research in Neuropsychology Review indicates that autistic individuals often struggle with cognitive flexibility, making it harder to categorize possessions, determine necessity, or establish a clear system for managing them. This can lead to uncertainty when making decisions about discarding items, reinforcing accumulation patterns.

Emotional attachment to objects also plays a role. Unlike individuals with hoarding disorder, who may experience distress at the thought of discarding possessions due to perceived utility or sentimental value, autistic individuals often form deep connections with specific items based on texture, color, or association with personal interests. A study in the Journal of Autism and Developmental Disorders found that autistic participants frequently described their collections as extensions of their identity or as sources of emotional regulation. These objects provide stability and reduce anxiety in an unpredictable environment.

Repetitive behaviors and restricted interests, core characteristics of autism, further contribute to hoarding-like tendencies. Many autistic individuals develop intense fascinations with particular subjects or object categories, leading to systematic acquisition of related items. Unlike compulsive hoarding, which is often driven by an inability to discard, these behaviors are typically linked to a need to explore, categorize, and engage with objects in a structured manner. A 2022 study in Autism Research found that autistic individuals who displayed hoarding behaviors were more likely to collect items related to their focused interests, such as books, figurines, or specific textures, rather than accumulating miscellaneous clutter.

Varied Presentation in Different Age Groups

Hoarding tendencies in autistic individuals manifest differently across life stages, shaped by cognitive development, social influences, and evolving emotional needs. In childhood, object accumulation often revolves around specific interests, with children methodically gathering items that align with their fascinations. These collections may be highly organized, with a clear system for storage and display. Unlike neurotypical children, who may lose interest in certain possessions over time, autistic children often maintain strong attachments, incorporating them into daily routines and self-soothing behaviors.

During adolescence, hoarding tendencies can become more pronounced due to increasing cognitive demands and environmental changes. Greater independence, heightened sensory sensitivities, and executive functioning challenges may contribute to difficulties in managing possessions. Adolescents may struggle with discarding items, not necessarily due to distress over loss but because of difficulty determining what is essential versus expendable. Social dynamics also play a role, as some teens accumulate objects to maintain familiarity in an unpredictable world, while others develop collections tied to emerging passions or identity exploration.

In adulthood, these behaviors can become more complex, particularly when managing personal living spaces. Some autistic adults maintain meticulously curated collections that provide structure and emotional regulation, while others may struggle with organization, leading to cluttered environments. The degree to which these behaviors impact daily functioning varies widely, with some individuals integrating their collections seamlessly into their lives and others facing challenges that interfere with home organization and well-being.

Overlapping Characteristics With Other Conditions

Hoarding behaviors in autistic individuals often share features with other psychiatric and neurodevelopmental conditions, complicating diagnosis. Obsessive-compulsive disorder (OCD) is one of the most frequently cited overlaps, as both conditions can involve repetitive behaviors and difficulty discarding possessions. However, the underlying motivations differ. In OCD-related hoarding, anxiety-driven compulsions lead to excessive accumulation due to distressing intrusive thoughts. In contrast, autistic individuals may accumulate objects due to rigid thinking patterns, deep personal attachment, or a need for environmental consistency rather than intrusive fears.

Attention-deficit hyperactivity disorder (ADHD) also presents behaviors that resemble hoarding, particularly in individuals with executive functioning deficits. Difficulty with organization, impulsivity, and forgetfulness can lead to excessive accumulation, not necessarily due to emotional attachment but because of challenges in managing possessions effectively. Unlike in autism, where hoarding behaviors are often structured around specific interests, ADHD-related clutter tends to be more disorganized and unintentional.

Signs in Personal Living Spaces

The way hoarding tendencies manifest in an individual’s living environment can provide important clues about their underlying motivations. In autistic individuals, these signs often differ from those seen in traditional hoarding disorder, where disorganization and distress about discarding dominate. Instead, autistic individuals may display structured arrangements of possessions, categorizing items based on personal logic rather than conventional organization methods. Collections may be grouped by color, shape, or sensory appeal, and disruptions to these arrangements can cause significant discomfort. This preference for order contrasts with the chaotic accumulation often observed in hoarding disorder, where objects are frequently piled without clear organization.

Another distinguishing factor is the emotional significance attached to possessions. While hoarding disorder is often linked to an inability to let go of items due to perceived future utility or sentimental value, autistic individuals may retain objects due to deep personal connections, sensory comfort, or a need for environmental familiarity. Rooms may contain clusters of items that serve self-soothing functions, such as soft fabrics, specific textures, or visually stimulating objects. Unlike in hoarding disorder, where accumulated items can impair living conditions, autistic individuals may integrate their collections into daily life in a meaningful and functional way.

Potential Influence of Sensory Processing

Sensory sensitivities play a significant role in how autistic individuals interact with their environments, shaping patterns of object accumulation. Many autistic individuals experience heightened or diminished sensitivity to sensory inputs, influencing the types of items they collect and retain. Objects with specific textures, sounds, or visual properties may be particularly appealing, leading to the accumulation of soft fabrics, smooth stones, or items that produce repetitive auditory feedback. These preferences are not necessarily driven by a desire to hoard in the clinical sense but rather by the need to engage with sensory stimuli that provide comfort or regulation.

For some, sensory-seeking behaviors manifest in collecting objects that provide a predictable and controllable sensory experience. This can be seen in individuals who gather items with consistent tactile properties or those who accumulate objects producing specific visual effects, such as prisms or patterned fabrics. Conversely, sensory avoidance can also contribute to hoarding-like behaviors, as individuals may hold onto familiar objects to minimize exposure to new or unpredictable stimuli. These sensory-driven motivations highlight the need to distinguish autism-related object accumulation from pathological hoarding, as interventions may need to focus on sensory regulation strategies rather than traditional hoarding treatments.