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  • Writer's pictureStephanie Jeret

Understanding Cluttering: A Comprehensive Guide to Symptoms, Impact, and Speech Therapy


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You may have heard about stuttering disorders, but cluttering disorders are much less known. In fact, people who clutter often go misdiagnosed or undiagnosed because it's not a widely recognized disorder. Both stuttering and cluttering fall under the category of fluency disorders; however, differ in a variety of ways.


Stuttering is when someone knows precisely what they want to say and how to say it, but they struggle with the actual production of speech.


Cluttering, on the other hand, presents a different challenge. It involves an imbalance between speech rate and language formulation. Essentially, people who clutter speak faster than their ability to organize their thoughts into coherent speech, resulting in a jumbled and disorganized message that's difficult for others to understand.


In this blog post, we are going to dive deep into the nature of cluttering, the common symptoms, the differences between stuttering and cluttering, and how speech therapy can help. More specifically, we discuss:



What is Cluttering?

Just like no two people who stutter are the same, no two people who clutter are the same. They may not have the same symptoms and present differently from eachother.


Cluttering is a multifaceted disorder, and symptoms can include:


Fast Speaking Rate

The speaking rate of a person who clutters can be perceived as "too quick." To qualify as a person who clutters, you must have more than just the symptom of 'fast speech.'


Speaking at a Jerky or Irregular Rate

Typical speakers pause at the end of sentences or phrases. People who clutter may have awkward breaks/pauses in unnatural places, or they may have no pauses at all.


Speaking with an Excessive Amount of Typical Disfluencies

People who clutter may experience more than usual typical disfluencies, including incomplete words with revisions, filler words (also known as interjections), and phrase/word repetition.


Collapsing Sounds/Syllables or Whole Words

People who clutter may sound as though they are mumbling, almost as if they are producing a lot of words which are being pushed together as opposed to each word being separate. If consistent with cluttering, this symptom would not be due to an articulation or phonological disorder, rather from the speech mechanism going too quickly, that sounds are being dropped.


Abnormal Pauses, Stress Patterns, and/or Speech Rhythm

A person who clutters may have abnormal speech patterns including difficulty with volume control, abnormal word/syllable stress, and abnormal intonation patterns. In addition, they may have challenges managing breath and speech at the same time.


Use of Language that Lacks Clear Organization and Planning

People who clutter often demonstrate challenges producing language that is understood by listeners. They often demonstrate challenges monitoring their own speech and the reactions of listeners.


Challenges Reported by People who Clutter


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Some difficulties reported by people who clutter, as reported by the International Cluttering Association (ICA), include:

  • Racing thoughts

  • Difficulty organizing thoughts and/or getting to the point

  • Words sound like they are running together

  • Lots of starts and stops

  • Excessive use of interjections

  • Limited awareness of how speech sounds to others

  • Difficulty slowing down when asked to

  • Tendency to interrupt conversational partners

  • Words or ideas come out differently than intended


How Cluttering Can Impact Daily Life

Cluttering can significantly impact daily life and social interactions in several ways:


  • Communication Challenges: Individuals who clutter may experience difficulties expressing themselves clearly, leading to frustration in conversations.

  • Relationships: Cluttering may strain relationships with family, friends, and colleagues due to misunderstandings and communication breakdowns.

  • Educational and Professional Settings: Cluttering can Impact academic and professional performance, leading to challenges in classroom participation, job interviews, presentations, and other communication-related activities.

  • Self-esteem: Persistent difficulties with speech fluency may decrease self-confidence and self-esteem, impacting overall quality of life.

  • Avoidance Strategies: Despite these challenges, individuals with cluttering often develop strategies to cope with their cluttering, such as avoiding specific speaking situations, modifying their speech patterns, or seeking support from speech-language therapists.


Overall, cluttering can have a profound impact on various aspects of daily life and social interactions, highlighting the importance of effective diagnosis, treatment, and support for individuals affected by this communication disorder.


Causes of Cluttering

The possible causes of cluttering include:


  1. Difficulty with language processing and self regulation. In other words, a possible cause of cluttering is the individual's challenges with processing the language they want to say and then regulating how they say it.

  2. Inhibition problem in the basal ganglia, which are important for executive functioning, specifically self-regulation and monitoring.

  3. A symptom of a co-occurring diagnosis.


How Common is Cluttering?

  • About 1.1-2.1% of school-age children clutter.

  • There is a 4:1 male to female ratio.

  • Research estimates that at least 1/3 of children and adults who stutter also present with some component of cluttering.

  • Cluttering is more common when co-occurring with stuttering.

  • Cluttering is more common when co-occurring with other disabilities, especially when the disability impacts attention or language.


Disorders that can Occur Together with Cluttering

People who clutter can sometimes have coexisting disorders. Common disorders that occur alongside cluttering, but are not the cause of cluttering, include:



The Difference Between Stuttering and Cluttering

Stuttering

Cluttering

Language is planned

Language planning is often incomplete

Struggle or tension is exhibited when producing the intended message

Message is rapid and/or disorganized with minimal tension

When their focus and awareness shifts to their own speech, disfluencies often increase (this is typically because the emotional response from speaking will increase tension, thus increase disfluencies)

When their focus and awareness shifts to their own speech, disfluencies often decrease (this is because they may organize their speech better, thus decreasing disfluencies)

With speaking experiences, there tends to be more behavioral or emotional responses

With speaking experiences, there tends to be minimal to no fears

Disfluencies include part-word repetitions, blocks, sound prolongations, whole-word repetitions with tension

Disfluencies include interjections, phrase repetitions, revisions, and whole-word repetitions without tension

Tension is experienced, motoric issues present (these issues include prolongation, repetition, etc.), secondary behaviors present

Minimal to no tension, linguistic issues present, no secondary behaviors present

Strategies to Improve Speech for Individuals that Clutter


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Some useful strategies that can be implemented by those who clutter during communication include:

  • reducing rate of speech by adding pauses in natural places

  • reducing overall rate of speech by speaking at a slower pace

  • exaggerating each sound in connected speech (called over-articulation). This is most helpful if you experience symptoms of collapsed syllables.

  • developing awareness around your speech so you recognize cluttering episodes and implement strategies to address them in real time.


How we Evaluate Cluttering

To thoroughly evaluate cluttering, we ensure a comprehensive assessment of all dimensions of communication and related disorders commonly associated with cluttering. Some individuals who clutter may exhibit slowed speech during evaluations due to awareness of being assessed, particularly in structured situations. We conduct assessments over extended periods to prevent misdiagnosis or overlooking potential diagnoses.


Gathering Relevant Information

Questionnaire: We may ask you to fill out an intake form to describe your/your child's speech, when the difficulty was first noticed, how speech changed over time, self-awareness of the challenges, how communication breakdowns are dealt with during conversation, and what situations are more challenging versus less challenging.


Case History: We collect pertinent information regarding the purpose of your evaluation, encompassing details such as developmental history, onset of symptoms, and prior treatment experiences.


Family History: We inquire about any family history of speech or language disorders, including fluency disorders.


Medical History: An exploration of medical or neurological conditions is conducted to identify potential contributing factors.


History of Learning and Behavioral Problems: Given the potential coexistence of cluttering with disorders such as ADHD, learning disabilities, and auditory processing disorders, we assess any history of learning and behavioral difficulties in school or work settings.


Obtain Subjective Rate of Speech: We may ask family members or close friends for their perception of the client's rate of speech. We do this because during the evaluation, our perception of their rate may not be how they consistently produce speech.


Evaluation of Speech

Variety of Speaking Situations: We may prompt clients to speak in diverse situations, including spontaneous speech, conversation, narrative, and expository discourse. In some cases, involving additional conversational partners may alter the frequency of speech breakdowns. We will be assessing a variety of components during these speaking situations, including organization, stress patterns, stress rhythm, disfluencies, rate of speech, and articulation.


Oral Reading: Clients may be asked to read aloud during assessments.


Assessment of Articulation/Language: Articulation and/or language screeners/assessments may be administered to determine the presence of an articulation or language delay/disorder.


Evaluation of Writing

Samples of written work from school assignments may be collected, or prompts may be provided during the evaluation process. Oftentimes those who clutter tend to write how they speak. They may also have difficulty writing, in which case, they may need to be referred to an occupational therapist.


Self-Awareness

How aware are you when there is a communication breakdown?


Speech Therapy for Cluttering in Skokie, Illinois

Speak with Stephanie offers in-person speech therapy for children and adults near Skokie, Evanston, Wilmette, and nearby neighborhoods to children and adults who clutter.


At Speak with Stephanie, we make it our mission to understand your specific communication challenges. By identifying where communication breakdowns occur, we can tailor our goals to suit your needs perfectly. Together, we'll explore what causes these breakdowns and how they affect your ability to communicate effectively.


Our approach is all about empowerment. We'll help you recognize cluttering and its impact on your communication, and provide you with practical strategies to improve. From enhancing your skills to learning how to monitor your speech, we'll equip you with the tools you need to confidently engage with others.


Online Speech Therapy for Cluttering Throughout Illinois, New York, and New Jersey

In addition to providing in-person speech therapy, we offer online speech therapy for children and adults to those who clutter throughout Illinois, New York, and New Jersey.


Frequently Asked Questions


Role of speech therapist in cluttering and resources for cluttering in Skokie Illinois

What role does a speech therapist play in cluttering?

A speech therapist plays an important role in the assessment, diagnosis, and treatment of cluttering.


Are there any resources for those that clutter?

The International Cluttering Association is an excellent resources for those that clutter. There are some resources for those that clutter on the Stuttering Foundation website including a cluttering brochure.


 

About the author:  


Stephanie Jeret is a Speech-Language Pathologist and the owner of Speak with Stephanie LLC. She obtained her Bachelor's and Master's degree from the City University of New York. She has practiced speech therapy in a number of settings including outpatient rehabilitation, telepractice, skilled nursing facilities, schools, and a private practice. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including articulation disorders, receptive/expressive language disorders, and fluency disorders. Information is available by emailing her at stephanie@speakwithstephanie.com or by visiting www.speakwithstephanie.com.




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