Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and restricted, repetitive patterns of behavior. Hoarding Disorder (HD) involves persistent difficulty discarding possessions, regardless of their actual value, resulting in debilitating clutter. Studies suggest that hoarding behaviors are notably more prevalent in autistic individuals (up to 7.4% of autistic adults) compared to the general population (2.6%). The manifestation of hoarding in autism often stems from unique underlying mechanisms, requiring a specialized understanding that goes beyond a standard HD diagnosis.
Understanding Hoarding in the Context of Autism
Hoarding behavior in autistic individuals frequently differs from classic Hoarding Disorder because the accumulated items serve a functional, rather than purely sentimental, purpose. For many, these objects act as physical anchors that provide comfort, predictability, or a means of managing an overwhelming environment. This need for sameness often leads to the collection of reliable items, acting as a buffer against anxiety and the unpredictability of social interactions.
The types of items accumulated often reflect these underlying needs, commonly including objects with specific sensory qualities or those linked to a special interest. Examples range from soft, textured materials that provide tactile comfort to objects like string, paper scraps, or bottle caps that possess a specific visual pattern or function. The drive is not an inability to assess monetary value, but rather a perceived necessity for the item’s function in sensory regulation or emotional stability.
A key distinction from non-autistic hoarding is the focus of distress. For the autistic individual, the intense emotional reaction is often triggered by the disruption of the collection. Being forced to discard objects causes significant distress because it feels like losing a necessary coping mechanism or a physical representation of their internal world. The resulting clutter is a side effect of the inability to part with functional objects, rather than the primary source of the hoarding drive.
Cognitive and Sensory Drivers of the Behavior
Executive Function Challenges
Difficulties with executive functions—the cognitive processes responsible for planning, organization, and decision-making—are a substantial driver of accumulation in autism. The complex task of sorting, categorizing, and discarding possessions can be overwhelming, often leading to avoidance. When faced with uncertainty about whether an item might be needed, challenges with cognitive flexibility and decision paralysis lead to the default choice of keeping everything. This inability to initiate and complete decluttering means items accumulate by default, regardless of the individual’s desire for a tidy space.
Sensory Regulation
Sensory processing differences inherent to autism also contribute directly to object accumulation. Certain items are saved because they provide a highly specific form of sensory input, such as a preferred texture, weight, or visual detail. These objects function as sensory tools, helping the individual to either seek stimulating input or filter out overwhelming stimuli. The attachment to these sensory anchors makes them feel indispensable, meaning disposal is perceived as losing a tool vital for daily regulation and comfort.
Special Interests
The intense, focused interests characteristic of autism frequently translate into the compulsive acquisition and retention of related items. For the autistic person, these collections are not merely hobbies; they are a physical manifestation of their identity, knowledge base, and source of well-being. Acquiring every item associated with a topic provides a sense of completeness and mastery, which is highly regulating. Discarding any part of this collection can feel equivalent to losing a piece of their expertise or self, making disposal emotionally traumatic.
Strategies for Management and Support
Addressing hoarding in autism requires strategies that respect the underlying cognitive and sensory differences, often necessitating modification of standard Hoarding Disorder treatments. Interventions must focus on functional organization and safety rather than aesthetic decluttering or challenging the core emotional attachment to the objects. A non-judgmental approach is necessary, acknowledging the intense emotional significance and functional role the items serve for the individual.
A practical approach involves breaking down the sorting process into small, manageable steps to accommodate executive function challenges. Using visual schedules, external supports, and clear sorting categories—such as “keep,” “interest zone,” and “dispose”—can reduce decision paralysis and anxiety. Establishing designated “safe spaces” or “interest zones” for collections allows the individual to maintain necessary sensory tools and special interest items without spreading into unsafe living areas.
Functional organizational systems, such as clearly labeled bins or shelves, provide the structure necessary to manage the volume of items without forcing outright disposal. Because hoarding often serves as a coping mechanism for anxiety, addressing the individual’s underlying stress and co-occurring anxiety disorders is an integral part of long-term support. Support should involve the autistic individual in the decision-making process, ensuring that any changes align with their specific sensory and emotional needs.