What do we know about hoarding behaviours among care-experienced children (CEC)? A systematic review

Objectives and methods
Anecdotal evidence suggests a high prevalence of hoarding behaviours among care-experienced children (those in foster, residential, adoptive, or kinship care). This systematic review, aimed to examine the prevalence of hoarding among care-experienced children, their lived experience, and the effectiveness of any hoarding interventions for this population. Primary research articles were included on hoarding behaviours in care-experienced children, published in English in indexed journals from ever to September 2024.

Results
Three eligible uncontrolled, observational studies, including 374 children and 23 carers, were identified. While hoarding was not clearly defined, there were high levels of hoarding behaviours specific to storing food (26%), associated with confirmed maltreatment in care (Odds Ratio = 17.4). Empirical lived experience perspectives were few and polarised between views that food hoarding was punishment towards caregivers or a trauma-survival mechanism. We identified no interventions involving assessment or management of hoarding behaviours in this population.

Conclusions
There is a paucity of evidence about hoarding behaviours among care-experienced children and a small amount of poor-quality evidence suggesting a high prevalence of food-related hoarding. In contrast, stakeholder consultation suggests hoarding may be common, long-lasting, and involve not just food but many other objects. Further research is required to understand the extent and type of hoarding behaviours, and effective interventions. Care-experienced children experience health, educational, and well-being outcomes across the life course, which are much poorer than their non-care peers, and this research offers a new avenue of enquiry to understand and improve their experiences and lives.