Cluttering (also called tachyphemia) is a speech disorder and a communication disorder characterized by speech that is difficult for listeners to understand due to rapid speaking rate, erratic rhythm, poor syntax or grammar, and words or groups of words unrelated to the sentence. Cluttering has in the past been viewed as a fluency disorder^[1].

Definition[link]

There is not currently a definition of cluttering which is generally accepted by the research or clinical community. The list of suggested characteristics is so broad that it becomes difficult to distinguish it from separate communication disorders. ^[2] However, the American Speech-Language-Hearing Association uses the following working definition: Cluttering is a syndrome characterized by a speech delivery rate, which is either abnormally fast, irregular, or both. In cluttered speech, the person’s speech is affected by one or more of the following: (1) failure to maintain normally expected sound, syllable, phrase, and pausing patterns; (2) evidence of greater than expected incidents of disfluency, the majority of which are unlike those typical of people who stutter. ^[3]

Characteristics[link]

Contributing to the ambiguity of its definition, when reviewing previously written texts on cluttering, researchers noted sixty-five different associated symptoms.^[4] However, researchers have been working to narrow down the most common characteristics and currently believe that problems concerning rate of speech are central to cluttering. An example would be trying to talk so fast that speech intermittently breaks down. Clutterers also tend to slur or omit syllables of longer words, which compromises intelligibility during spurts of rapid speech. Other symptoms include:

• lack of awareness of the problem
• family history of fluency disorders
• confusing, disorganized language or conversational skills
• temporary improvement when asked to "slow down" or "pay attention" to speech
• misarticulations
• poor intelligibility
• social or vocational problems
• distractibility
• hyperactivity
• auditory perceptual difficulties
• learning disabilities
• apraxia.^[3]

Clutterers often have reading disorders and writing disorders as well. This additional disorders include symptoms such as sprawling and disorderly handwriting, which poorly integrate ideas and space.^[5]

Related disorders[link]

Because of similar characteristics, cluttering can often be confused with language delay, language disorder, learning disabilities, and attention deficit disorder^[6]. People with ADD or ADHD may have many of the same symptoms as clutterers, including being inattentive, restless, short tempered, and impatient. In fact, many of these overlapping symptoms occur so often that several of the suggested definitions of cluttering include them. This has led some researchers to classify cluttering as a constitutional disorder, rather than the more common category of a fluency disorder. A constitution disorder would allow cluttering to affect more than just fluency, and address the learning disabilities and behavioral issues that some researchers believe may underlie cluttering. ^[7]

Cluttering versus Stuttering[link]

Cluttering and stuttering are related, but two distinct disorders. While they are both fluency disorders, they manifest themselves differently. While a person who stutters usually knows exactly what they want to say but are temporarily unable to say it, cluttering involves breaks in speech flow that stem from a disorganized speech planning or rate, or being unsure of exactly what one wants to say. ^[8] While stuttering is sometimes described as struggling, cluttering is effortless, and most clutterers seem uninhibited even while their speech is unintelligible. Also, a person who stutters lacks the ability to smoothly transition from one sound or syllable to the next, whereas in the case of cluttering, the person lacks the ability to transition from one syntactical unit to the next. ^[4] While they are separate disorders, stuttering and cluttering are related, and research has shown that more individuals suffer from both stuttering and cluttering simultaneously than from “pure” cluttering, without any signs of stuttering. ^[4] When both disorders are present, it is often difficult to observe the cluttering until after the stuttering has remitted. ^[3]

Diagnosis[link]

The diagnosis may be made by one of two ways. A Speech Language Pathologist could make the diagnosis on their own after an evaluation is done. Or, the diagnosis can be made by a treatment team, which could include a Speech Language Pathologist, as well as an audiologist, classroom teacher, special educator, psychologist, and occasionally a neuropsychologist. ^[3] One or more sessions may be required to properly diagnose cluttering. The evaluation should include any existing oral-motor, language, pronunciation, learning, or social problems, in addition to the fluency problems, as any of these can be contributing symptoms of cluttering. The diagnosis should include whether “pure” cluttering is present, or whether the cluttering is present in addition to another disorder.^[8]

Treatment[link]

Since research is limited, there is no standard course of treatment. Treatment currently is tailored to the individual’s specific needs and symptoms. One specific technique that has been effective in some cases is Delayed auditory feedback. Delayed auditory feedback (DAF) is a device which allows the user to speak into a microphone and hear his or her own voice through headphones afterwords. DAF allows clutterers to observe their own speech and time themselves, with the goal of producing a more deliberate, exaggerated oral-motor response pattern . Other treatment components include improving narrative structure with story-telling picture books, turn-taking practice, pausing practice, and language therapy.

History[link]

Battaros was a legendary Libyan king who spoke quickly and in a disorderly fashion. Others who spoke as he did were said to suffer from battarismus.^[9] This is the earliest record of the speech disorder of cluttering.

In the 1960s, cluttering was called tachyphemia, a word derived from the Greek for "fast speech." This word is currently not used to describe cluttering because fast speech is not a required element of cluttering.

Deso Weiss described cluttering as the outward manifestation of a "central language imbalance." In Weiss's book on cluttering, he used Central Language Imbalance or CLI as synonymous with what cluttering is described as today.^[9]

Over the past twenty years, Kenneth O. St. Louis, Lawrence J. Raphael, Florence L. Myers, and Klaas Bakker have been working to standardize a definition of cluttering. Judith Kuster maintains a robust section of cluttering resources and articles in her Stuttering Homepage^[10].

The first conference held specifically on cluttering took place in May 2007 in Razlog, Bulgaria. It was called, "The First World Conference on Cluttering," and had over 60 participants from across North America, Europe, the Middle East and Asia. During the conference, the International Cluttering Association (ICA) was founded. Also, the first Deso Weiss Award for Excellence in Cluttering was given to Kenneth St. Louis for his contributions for understanding and knowledge about cluttering. ^[11]

Cluttering researchers[link]

Cluttering research is still in its infancy. Cluttering research peaked and faded away in the 1960s, but interest in cluttering research has drastically increased and there are numerous books on cluttering that are currently being written. Because of this renewed interest in cluttering, the current cluttering researchers are pioneers in this speech disorder. Most of the cluttering researchers were stuttering researchers who studied cluttering as a secondary behavior, however there are a few dedicated cluttering researchers. The most notable of the cluttering researchers are:

• Deso Weiss
• David Daly
• Charles Van Riper
• Florence Myers
• Kenneth St. Louis
• Klaas Bakker
• Judith Kuster
• Katerina de Hirsch
• Alf Preus
• Lawrence Raphael
• Yvonne van Zaalen

Famous clutterers[link]

Weiss claimed that Battaros, Demosthenes, Pericles, Justinian, Otto von Bismarck, and Winston Churchill were clutterers. He says about these people, "Each of these contributors to world history viewed his world holistically, and was not deflected by exaggerated attention to small details. Perhaps then, they excelled because of, rather than in spite of, their [cluttering]."^[9] The animated character Porky Pig, who has often been described as a stutterer, has a style of speech similar to cluttering in some ways.

See also[link]

• Stuttering
• Lisp
• Dyslexia
• Speech processing
• Voice disorders
• Attention deficit disorder
• Apraxia
• Spoonerism
• Auditory processing disorder
• Autism

References[link]

Sources[link]

• St. Louis, K. O., Raphael, L. J., Myers, F. L., & Bakker, K. (2003, Nov. 18). Cluttering updated. The ASHA Leader, pp. 4–5, 20-22.
• Studies in Tachyphemia, An Investigation of Cluttering and General Language Disability. Speech Rehabilitation Institute. New York, 1963.
• Daly, D. A. (1996). The source for stuttering and cluttering. East Moline, IL: LinguiSystems.
• Myers, F. and K. St. Louis, (1992) Cluttering: A Clinical Perspective, Leicester, England: Far Communications

External links[link]

• Cluttering: Some Guidelines
• Overview of Cluttering
• International Cluttering Association page
• ASHA Cluttering Updated Article
• ISAD presentation on cluttering experience
• Computer Aided Assessment of Cluttering Severity
• Understanding Cluttering-The British Stammering Association