What is cluttering?

Like stuttering, cluttering is a fluency disorder, but the two disorders are not the same. Cluttering involves excessive breaks in the normal flow of speech that seem to result from disorganized speech planning, talking too fast or in spurts, or simply being unsure of what one wants to say. By contrast, the person who stutters typically knows exactly what he or she wants to say but is temporarily unable to say it. To make matters even more confusing, since cluttering is not well known, many who clutter are described by themselves or others as "stuttering." Also, and equally confusing, cluttering often occurs along with stuttering.

The definition of cluttering adopted by the fluency disorders division of the American Speech-Language-Hearing Association is: 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. To identify cluttering, you must listen to nonstuttered speech of the speaker. Evidence for a fluency disorder (one that is not stuttering) and excessive disfluencies, would be present in a speaker who meets the all of the following:

Does not sound "fluent," that is, does not seem to be clear about what he or she wants to say or how to say it.
Has excessive levels of "normal disfluencies," such as interjections and revisions.
Has little or no apparent physical struggle in speaking.
Has few if any accessory (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 an overall impression or actual syllable per minute counts.
Sounds "jerky."
Has pauses that are too short, too long, or improperly placed.

These fluency and rate deviations are the essential symptoms of cluttering. In addition, however, there are a number of symptoms suggested in the latter part of the above definition that may or may not be present but add support to the impression that a person is cluttering. Accordingly, 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 her fluency and rate problems.
Temporary improvement when asked to "slow down" or "pay attention" to speech (or when being tape recorded).
Mispronunciation or slurrring of speech sounds or deleting non-stressed syllables in longer words (e.g., "ferchly" for "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.

Until recently, most of what we knew of cluttering came from Europe. Except for one book in 1964, cluttering was essentially ignored in North America from the 1930s to the mid-1980s. Since that time, however, considerable research and attention is now being devoted to the problem.

How is cluttering diagnosed?

Before getting treatment, it is important that someone suspected of cluttering be diagnosed accurately. It is advisable to consult a speech-language pathologist to make the diagnosis. The assessment process is often quite extensive and may require two or more sessions. It may also require contributions or reports from other professionals, such as classroom teachers, special educators, psychologists, or (possibly) neuro-psychologists. The evaluation should obviously include consideration of the fluency problem, but also any co-existing oral-motor, language, pronunciation, learning, or social problems. If the suspected clutterer is in school, it may be a good idea to read more