Cluttering
is a form of speech disfluency characterized by an excessive rate
and irregular rhythm of speech, often with condensation of sounds
and collapsing of words. It ranges in severity from a form with
somewhat annoying, but generally intelligible speech, to a severe
disabling form with virtually unintelligible speech. The condition
is distinct from stuttering, the person who stutters typically
knows exactly what he or she wants to say but is temporarily unable
to say it. Therefore the person who clutters typically has disorganized
speech planning, they doe not seem to be clear about what they
want to say or how to say it.
The definition
of cluttering, adopted by the fluency disorders division of the
American Speech-Language-Hearing Association, is: "Cluttering
is a fluency disorder characterized by a rapid and/or irregular
speaking rate, excessive disfluencies, and often other symptoms
such as language or phonological errors and attention deficits".
Therefore
fluency disorders (ones that are not stuttering), generally meeting
the following criteria:
Speech does not sound “fluent”.
Does not seem to
be clear about what he or she wants to say or how to say it.
Exhibits excessive levels of “normal disfluencies”,
such as interjections and revisions.
Has little or no apparent physical struggle in speaking.
Has few if any accessory (secondary behaviors).
A rapid and/or
irregular speaking rate would be present in a speaker who has
any or all of the following:
Talks too fast.
Sounds “jerky”
Have pauses that are too short, too long, or improperly placed.
Therefore
fluency and rate deviations are the essential symptoms of cluttering.
Associated
Features:
Cluttering
often occurs along with stuttering.
Articulation Errors.
Dyslexia.
Sloppy Handwriting.
Memory Abilities.
Coordination, Rhythm, and Speech Melody impairments.
Reading and Writing difficulties.
Tachylalia is common.
Relatives may Stutter or Clutter.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Stuttering.
Dyslexia.
Phonological Disorder.
Attention Deficit Disorder.
Fragile
X Syndrome (FXS).
Cause:
It has been
suggested by some researchers that in most cases, a child’s
stuttering began with cluttering. However, since cluttering is
neither common nor well understood the causal factor is not known
for certain.
Treatment:
Therapy is useful and generally
addresses the contributing problems first before focusing directly
on fluency. Ordinarily, one of the first goals of therapy is to
reduce the speaking rate, although this may not be easy for the
clutterer to achieve. Some clutterers respond well to "timing"
their speech to a delayed auditory feedback (DAF) device; some
do not. In general any therapy techniques that focus attention
on fluency targets such as easy onset of the voice, more prolonged
syllables, or correct breathing can also help the person to manage
many of the cluttering symptoms.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Speech Therapists
may perform evaluation and treatment of speech and language disorders.Relaxation
and visual imagery exercises may also prove useful.
