Welcome to the September edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Neuhaus, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

We welcome you to send us your questions and Dr. Neuhaus will do her best to answer them each month. Send your questions to theautismblog@seattlechildrens.org.

Why does my child with ASD hoard items that are not valuable or useful to him? Why does my child with ASD have pica?

Thanks for writing in! Both of the issues you mention – hoarding and pica – are behaviors we often see among individuals with ASD, even though they aren’t part of the official diagnostic descriptions. Thinking first about pica (eating non-food items such as rocks or paper), my colleague Dr. Emily Rastall (the original Dr. Emily!) shared some great information and resources on that topic a few years back. Check out her thoughts here

With regard to hoarding items that don’t seem to be valuable, this is similar to pica in the sense that there could be lots of reasons for it but those reasons can vary from person to person. For example, it could be that the items your child collects that seem useless to other people connect with his interests in some way (e.g., collecting junk mail because it has a picture of a favorite animal or character). Another possibility is that the things he collects remind him of something he liked or enjoyed (e.g., receipts from favorite purchases). Sometimes, we do also see hoarding that’s related to anxiety; in those cases, hoarding or collecting items might suggest a need for more support. If you suspect that anxiety might be playing a role for your child, that’s something to bring up with your pediatrician.

For other ways of thinking through some of these issues, please see this link.  

My son (who’s 14 years old) has recently been diagnosed with ASD. He steals a lot and is getting himself into a lot of trouble with the police. Could this be part of ASD?

I’m sorry to hear about your son’s troubles with the police – that’s such a stressful situation for your family. It sounds like your son is at a tricky age, whether he had an ASD diagnosis or not. Teenagers do sometimes experiment with risky behaviors such as stealing, but that doesn’t mean it’s easy for their families to handle. As to whether this behavior is part of ASD – stealing (and breaking the law/rules in other ways) isn’t part of the definition of ASD, but there are elements of ASD that could be playing into the situation. People with ASD can have more trouble than their peers with what’s called “executive function”, meaning it can be more difficult to control impulses, understand the consequences of behavior, and make choices that are based on careful thought rather than on momentary impulse. Another aspect of ASD that could be relevant is difficulty taking other people’s perspectives or points of view – for example, understanding that someone else might perceive “borrowing” something as stealing it.

If your son has a therapist already, they are likely in the best position to help you figure out what’s going on for your son. If he doesn’t have a therapist, you could talk with his primary care provider to see whether it would make sense to find one and how to do that. Good luck to you both!!