Fluency Disorders: Stuttering vs Cluttering

By: William L. Smith Ph. D.
Submitted: 2007-01-17 16:43:25
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The title of this article Fluency Disorders: Stuttering vs Cluttering is not to advance an oppositional position between stuttering and cluttering. And the word cluttering as used in this context is not about "things" that take up space but serve no useful purpose. Cluttering is a fluency disorder. Several clinical studies have shown that stuttering and cluttering are two distinct and different fluency disorders. According to several research studies the two most common problem of fluency is stuttering and cluttering (Daly, D.A., 1996) and (Myers, F.L. & St. Louis K.O., 1998).

Cluttering is the orphan of speech-language pathology

From a historical perspective the syndrome now known as cluttering did not appear on the radar of speech-language professionals until the mid-sixties. In 1964, a researcher named, Desco Weiss published his classic text on cluttering. According to Weiss, cluttering has always been with us. Weiss described cluttering as a neglected stepchild in the family of speech-language pathology (Weiss, 1964). In 1981, almost two decades later, David Daly, from the University of Michigan, said that cluttering was considered the orphan of the speech-language disorders. Recent studies support the belief that very little had change in the forty years. Even today, cluttering is still an obscure term for many American speech-language clinicians.

A cursory examination of the available literatures show that earlier texts either described cluttering in a superficial manner or it is omitted completely. This omission is passed on by many contemporary college texts, in which cluttering is still treated as the "stepchild" of the fluency disorders family. For example, a college text used to research this article; Survey of Communication Disorder (Lue, 2001) devotes eight pages to explain stuttering and allocated only a half page to explain cluttering. The primary reason for this void in recognition is that cluttering is so difficult to diagnose. For instance, some individuals who clutter sometime stutter, as well. And the reverse is also true. Therefore, differential diagnosis can be problematic for the most seasoned speech-language diagnostician.

Fluency defined

The American Speech-Language-Hearing Association (ASHA) defined fluency as the aspect of speech production that refers to the continuity, smoothness, rate, and/or effort with which phonologic, lexical, morphologic, and syntactic language units are spoken. Dysfluency, on the other hand, is defined as a break in the continuity of producing phonologic, lexical, morphologic, and/or syntactic language units in oral speech (ASHA, 1999).

Stuttering as a fluency disorder is well-known and widely studied. On the other hand, cluttering is almost unheard of by the general public and is often misdiagnosed or under diagnosed by the professional speech community, this is especially true for academic and the mental health community. Both stuttering and cluttering is a fluency disorder, however, the two disorders are not the same. Cluttering involves excesses breaks in the normal flow of speech which result in disorganized speech planning, talk too fast or in spurts, or even being uncertain of what one wants to say. The individual who stutters often knows exactly what he or she wants to say but is momentarily unable to say it.

What is cluttering?

According to the American Speech-Language-Hearing Association: "Cluttering is a fluency disorder characterized by a rapid and irregular speaking rate, excesses disfluencies, and often other symptoms such as language or phonological errors and attention deficits. To identify cluttering, you must listen to un-stuttered speech of the speaker." The individual who clutter would exhibit a rapid and/or irregular speaking rate; talks too fast, sounds are jerky with pauses that are too short, too long, or improperly placed. The list of cluttering symptoms and the remarks expressed by those with the disorder explain, in part, why defining cluttering is so problematic; too often it is very difficult to know which symptoms are essential to cluttering and which are incidental.

Diagnosis

It is very important that individual suspected of cluttering be diagnosed accurately by a qualified speech-language clinician before seeking or providing therapy. The diagnostic process can be extensive and may require two or more sessions. It is also recommended that contributions and reports from other professionals, such as classroom teachers, special educators, and osychologists be included. The assessment should naturally include the fluency problem, but also any co-existing speech-language, pronunciation, learning, or social problems.

The clinical diagnostic process of a typical cluttering problem is illuminated if the individual exhibited any of the following characteristics: confusion, disorganized language or conversational skills, often with difficulties finding the right word. The individual is unaware of his/her fluency and rate problem. The individual experience temporary improvement when asked to "slow down" or pay more attention to speech, such as mispronunciation, slurring of speech, or omitting non-stressed syllables in longer words. For example, "ferchly" for "fortunately." Also, these facts should be taken into consideration; blood relatives who stutter or clutter; social or vocational problems resulting from cluttering symptoms, and learning disabilities unrelated to impaired intelligence.

In addition, classroom teachers should watch out for these symptoms which often associated with cluttering; sloppy handwriting, distractibility, hyperactivity, and limited attention span, difficulty with organizational skills for daily activities, and auditory perceptual difficulties (St. Louis & Myers, 1995). Often cluttering will go unnoticed until the stuttering diminished spontaneously or from speech therapy.

Finally, what is equally frustrating for speech-language clinicians are the absence of self-awareness and the laid-back attitude of many individuals who clutter. Their self-monitoring skills for speech and social situations are seriously impaired and highly deficient.

Daly, D. (1986). The Clutter. In K.O. St. Louis (Ed.), The Atypical Stutter: Principles and Practices of Rehabilitation. New York: Academic.

Weiss, D. (1964). Cluttering. Englewood Cliffs, New Jersey: Prentice-Hall.

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