1. 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.
2. Red Light Green Light Reading
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3.
4. These fluency and rate deviations are the
essential symptoms of cluttering.
• Does not sound “fluent”, does not seem
to be clear about what he/she wants to
say or how to say it.
• Has excess levels of “normal
disfluencies”, such as interjections and
revisions
• Has little or no apparent physical
struggling in speaking
• Has few if any 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” based on overall
impression or actual syllable per minute
counts.
• Sounds “jerky”
• Has pauses that are too short, too long
or improperly placed.
The clinical picture of a typical cluttering
problem would be enhanced if the person
in question had any of the following:
• Confusing, disorganized language or
conversational skills.
• Limited awareness of his or fluency and
rate problems.
• Temporary improvement when asked to
“slow down” or “pay attention” to
speech
• Mispronunciation or slurring of speech
sounds or deleting non-stressed syllables
in longer words (for example “ferchly” =
“fortunately)
• Speech that is difficult to understand
• Several blood relatives who stutter or
clutter
• Social or vocational problems resulting
from cluttering symptoms
• Learning disability not related to
reduced intelligence
• Sloppy handwriting
• Distractibility, hyperactivity, or a limited
attention span
• Auditory perceptual difficulties
5. Speech-language
pathologist
Multiple sessions
Reports by
•Teachers
•Special educators
•Psychologists
•Neuro-psychologists
Measures
•Fluency
•Co-existing oral-motor
•Language
•Pronunciation
•Learning or social problems
Co-existing disorders
•Difficulties with language
formulation
•Inadequate organization of
thought processes
•Sound-specific articulation
disorders
•Speech motor discoordination
•Attention deficit hyperactive
disorders (ADHD) or other
learning disorders
•Auditory processing disorders
•Asperger’s syndrome
•Apraxia
6. Causes
Unknown, but there
are several theories
Caused by abnormal
development of
brain structure
related to:
Speech rate
control
Speech-language
planning and
execution
Other fluency-
related behavior
Stereotypes
Not the same as
stuttering
Cluttering is not
well known
Many who clutter
are mis-identified
as stutterers
Cluttering often
occurs along with
stuttering
Who?
There is not enough
research to determine
if it affects boys more
than girls, vice versa.
Prevalence
Pure cluttering has been
estimated to comprise 5-
17% of all fluency
disorders
Clutterers who also
stutter has been
estimated to include 30-
67% of fluency disorders
7. Speech therapy includes various
combinations of the following
goals:
Reducing the speaking rate
Enhancing or improving the
ability to self monitor speech
Practicing speech characterized careful
enunciation of all of the words and
syllables
Constructing sentences that are
–
•Carefully organized
•Appropriately arranged
•Important to the communication
Learning to recognize and respond
appropriately to listener cues of
misunderstanding
8. Support
What to do when speaking with someone who
clutters
Don’t treat them like something is “wrong”
with them. Treat them like everyone else.
If you don’t understand, politely ask for
clarification.
Understand that it isn’t their fault and don’t
get frustrated with them.
No TEASING: it’s just not OK to tease others.
9. Symptom Stuttering Cluttering
What gets stuck Word, sound, syllable Message
Know what to say Yes No
Awareness Typically yes Yes and no
Rate differences
Can be a secondary (person who stutters
may speak quickly to avoid stuttering), but
is not central to stuttering itself
Yes; mandatory for a diagnosis of cluttering
(rate has to be rapid or both, but does not
have to be both)
Disfluencies
Mostly stuttering-like disfluencies, such as
repetitions, prolongations, blocks
Mostly non-stuttering-like disfluencies, such
as interjections/filler words, phrases
repetitions, revisions
Examples of disfluencies
Repetitions of sounds like syllables:
y-y-you
w-w-watermelon
Prolongations: sssso; thiiiis
Blocks: sound gets stuck and person has
difficulty moving forward to the next sound:
p—eople
Interjections/filler words: um, uh
Phrase repetitions: I love, I love you
Revisions: I would like ice cream, no, please
make that a shake
Articulation difficulties (difficulties
pronouncing sounds in words)
Not in pure stuttering (stuttering without
any additional communication disorders)
May sound “mushy” and “slurred”, typically
can be corrected by such strategies as
slowing rate
Prosody (the rhythm and melody of one’s
speech)
Typically normal
May be impacted; especially by change in
pausing related to irregular rate
How it sounds Repetitions, prolongations, blocks Rushes of speech, lots of restarts
Affective and cognitive components Can be
Negative reactions and communication
avoidance have been identified
Pragmatics (social aspects of language) Typically okay
A secondary consequence of decreased
communication effectiveness
