Definition:
Cluttering is a communication disorder resulting in decreased fluency and intelligibility that often coexists with stuttering.
Description:
An exact description of cluttering has not been accepted or agreed upon universally. In general, it is a communication disorder that results in decreased speech intelligibility and may involve one or a combination of the following areas: language, articulation, and fluency, as well as rate and self-monitoring skills.
Characteristics:
The characteristics of cluttering vary among clients, but a consistent characteristic is an excessive speech rate. More than 60 other symptoms are listed in well-known chapters and books on cluttering. Some common characteristics include:
-Monotone voice
-Indistinct, “mumbling” speech involving sound distortions and omissions.
-Errors in connected speech that are not present or less pronounced in single-word production or connected speech that is produced slowly.
-Transpositions of sounds in words, phrases, or sentences (ex: “Many people think so” becomes “Many thinkle peep so”)
-Language deficiencies
-Auditory processing difficulties
-Client may be unaware of his/her speech disorder and surprised when other people do not understand him/her
Stuttering vs. Cluttering
Stuttering:
- Disfluencies on units smaller than the word level, such as sound prolongations and sound/syllable repetitions
- Effort/physiologic tension associated with disfluent moments
- Typically person has awareness of disfluencies and a sense of loss of control
- Difficulty making fluent transitions from one sound or syllable to the next.
Cluttering:
- Disfluencies typically involve units larger than the sound or syllable level, such as word and phrase repetitions, incomplete phrases, and revisions.
- Little apparent physiologic tension
- Often demonstrate poor self-monitoring skills and decreased awareness of speech errors
- Difficulty making smooth transitions from one syntactic unit to another or one lexical choice to the next or sequencing his/her message cohesively and coherently
- Do not typically produce prolongations or tense pauses
- Fast and/or spurty speaking rate
- Linguistic encoding difficulties leading to poor cohesion and coherence of connected speech
- Reduced speech intelligibility due to articulation errors secondary to fast rate
Causes:
Unknown
Diagnosing this disorder:
Since cluttering affects articulation, language, voice, and fluency, its assessment includes each of these areas.
-Individuals may not clutter in all situations. Important to examine in several contexts: Reading lists of multisyllabic words, Reading passages, Spontaneous speech
-Rate language/speech samples for:
– Intelligibility
– Naturalness
– Overall speech rate
– Regularity of rate
– Disfluencies
– Overall articulation accuracy
– Pragmatic language appropriateness
-Interview client regarding perception of speech difficulty and perception of social penalty of speech difficulty
-Writing sample analysis
– Short paragraph about vacation, etc.
- Looking for illegible writing
- Omissions of letters, syllables, words, as seen in speech
Treatment:
Two fluency-enhancing strategies can be useful in addressing cluttering: prolonged speech and reduced speech rate.
ASHA outlines that therapy should focus on:
Slowing rate (metronome, pacing boards, visuals, etc.)
Heightening monitoring
- Use video or audio-taped conversations and have client identify places where he/she failed to monitor.
- Prepare samples of worst, mediocre and best speech, have them listen/rate daily to assist with ability to monitor on-line.
Using clear speech
- “over-articulate“ multisyllabic words/ discuss what they are feeling
- Imagine they are talking to a person with hearing loss
Using organized language
- Example: focusing on one topic at a time
Interacting with listeners
- taking turns in conversation at reasonable durations (such as 30 seconds)
- thinking about the listener as you speak
Reducing excessive disfluencies
- identifying mazes in his/her speech
Also important to work with parents on modeling clear speech and organized language.
Resources:
Books for Clinicians:
The Source for Stuttering and Cluttering
by David Daly
- feelings and attitudes of adolescents
- Structured word, phrase & sentence tasks
- Addresses Clinician forms for tracking progress
- Self-evaluation forms for client
- Audiotape to model speech patterns
- Techniques for cluttering intervention
Websites:
References:
Byrd, C. (2011). Fluency Disorders Fall 2011, Unit I: Slide Set 3 [PowerPoint slides].
Ramig, P.R. & Dodge, D.M. (2005 ). The child and adolescent stuttering treatment and activity resource guide. Clifton Park, NY: Delmar Learning.
Shipley, K.G. & McAfee, J.G. (2004). Assessment in Speech-Language Pathology: A resource manual (3rd ed.). Clifton Park, NY: Delmar Learning.
St. Louis, K.O. & Myers, F.L. (1994). Clinical management of cluttering. Language, Speech, and Hearing Services in Schools, 26, 187-195.
Do you have more great resources for families or community members? We would be happy to add any great resources to this webpage. Please email us with the link or content.
Also check out: Cleft Lip/Palate Speech Implications and Resources
Are you in the Austin Texas Area and looking for Speech Therapy for Cluttering?
If you are looking for Speech Therapy in Austin Texas for Cluttering, we are here to help. Contact our clinicians by visiting our Speech Therapy Austin Clinic Page and give us a call or send us a message.
We look forward to serving you.
