Storch, Eric A.

Although compulsive hoarding may pose health, social, and developmental impairment for children, there are few phenomenological and treatment studies to guide assessment and treatment. Current evidence-based questions the link between hoarding and obsessive compulsive disorder (OCD) and the effectiveness of cognitive behavioral therapy protocols for OCD to adequately address the unique challenges of poor insight, poor emotion regulation, and increased family accommodation in children with compulsive hoarding. This case study seeks to illustrate a family-based behavioral approach to outpatient treatment of compulsive hoarding with a 9-year-old girl (pseudonym Lily). Treatment included psychoeducation, exposure to discarding items, exposure to acquiring cues, and parent behavior management techniques.

Selective Mutism (SM) is a highly impairing disorder which typically presents upon entry to school and affects approximately 0.7% of children. Despite its impact on social and academic development, it is a difficult disorder to treat and there is a small evidence base for behavioral treatment. Preliminary evidence suggests that behavioral treatment focused on exposure to social interactions, social skill building, and involvement of caregivers in treatment may be promising. This article presents two cases of early childhood SM to demonstrate the importance of tailored treatment implementation to meet the individual needs of each family and help children resume typical social development.