| ICD-10 | F98.6 |
|---|---|
| ICD-9 | 307.0 |
Additional recommended knowledge
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].
Definitions
Cluttering has been in the process of being defined for the last forty years. A current definition of cluttering is:
Cluttering is a fluency disorder characterized by a rate that is perceived to be abnormally rapid, irregular, or both for the speaker (although measured syllable rates may not exceed normal limits). These rate abnormalities further are manifest in one or more of the following symptoms: (a) an excessive number of disfluencies, the majority of which are not typical of people who stutter; (b) the frequent placement of pauses and use of prosodic patterns that do not conform to syntactic and semantic constraints; and (c) inappropriate (usually excessive) degrees of coarticulation among sounds, especially in multisyllabic words[2].
Presentation
The person with cluttering may experience a short attention span, poor concentration, poorly organized thinking, inability to listen, and a lack of awareness that one's speech is unintelligible.
Spoonerisms, malapropisms, Colemanballs, and Freudian slips are examples of cluttering. Stuttering as a common term often refers to the speech disorder of cluttering, rather than to the speech disorder of stuttering. Cluttered speech is exhibited by normal speakers, and is often referred to as stuttering--this is especially true when the speaker is nervous, where nervous speech more closely resembles cluttering than stuttering.
Cluttering is sometimes confused with stuttering. Both communication disorders break the normal flow of speech. However, while stuttering is most often analyzed as a speech disorder, cluttering is a language disorder. In other words, a stutterer has a coherent pattern of thoughts, but can't say it; in contrast, a clutterer has no problem putting thoughts into words, but those thoughts become disorganized during speaking. Cluttering not only affects speech, but affects thought patterns, writing, typing, and conversation[3].
Stutterers are usually dysfluent on initial sounds, when beginning to speak, and become more fluent towards the ends of utterances. In contrast, clutterers are most clear at the start of utterances, but their speaking rate increases and intelligibility decreases towards the end of utterances.
Stuttering is characterized by struggle behavior, such as overtense speech production muscles. Cluttering, in contrast, is effortless.
To compare, a stutterer trying to say "I want to go to the store," might sound like "I wa-wa-want to g-g-go to the sssssssssstore." In contrast, a clutterer might say, "I want to go to the st...uh...place where you buy...market st-st-store!"
Cluttering is also characterized by slurred speech, especially dropped or distorted /r/ and /l/ sounds; and monotone speech that starts loud and trails off into a murmur.
Clutterers often also have reading and writing disorders, especially sprawling, disorderly handwriting, which poorly integrate ideas and space.[4]A clutterer described the feeling associated with a clutter as:
| “ | It feels like 1) about twenty thoughts explode on my mind all at once, and I need to express them all, 2) that when I'm trying to make a point, that I just remembered something that I was supposed to say, so the person can understand, and I need to interrupt myself to say something that I should have said before, and 3) that I need to constantly revise the sentences that I'm working on, to get it out right. [5] | ” |
| “ | I just seem to rush through the words, and often slur words together and/or mumble—and as a result I often have to slow down, concentrate, and repeat myself. | ” |
Cluttering versus Stuttering
Cluttering and stuttering sound very similar to the lay ear, especially when they are at their worst. However, they are markedly different disorders and clutterers and stutterers are very different.
Stutterers:
- Are very aware of their disorder
- Perform worse when speaking under stress
- Have a hard time fluently giving short answers
- Often have inhibited, neat handwriting
- Therapy focuses on relaxation techniques, calling attention away from speech
- Are typically withdrawn, shy, or introverted
- Typically were fluent, but then started stuttering
- Know exactly what they want to say but cannot say it
- Have organized speech
- Have good listening skills
Clutterers:
- Are very unaware of their disorder
- Perform better when speaking under stress
- Have a hard time fluently giving long answers
- Have hasty, repetitious, uninhibited, messy handwriting
- Have little to no fear of their speech and are careless in speech
- Therapy focuses on calling attention to speech details
- Are typically outgoing or extroverted
- Typically were never very fluent
- Do not know exactly what they want to say, but say it anyway
- Have disorganized, tangential, grammatically incorrect speech with word substitutions
- Are impatient listeners, frequently interrupt, and have poor turn-taking skills in conversation
Related Disorders
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
Treatment
Because clutterers have poor awareness of their disorder, they may be indifferent or even hostile to speech-language pathologists. Treatment for cluttering usually takes longer than stuttering treatment. Delayed auditory feedback (DAF) is usually used to produce 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
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.[7] This is the earliest record of the speech disorder of cluttering.
In the 1960's, 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.[8]
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[9].
The first conference held specifically on cluttering was held in May of 2007[10] 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[11]. It was held in Bulgaria partly because of cluttering research efforts by Professors Dobrinka Georgieva and Katya Dionissieva of Neofit Rilski[12]. Part of the conference was awarding the first Deso Weiss Award for Excellence in Cluttering, which went to Kenneth St. Louis for his contributions for understanding and knowledge about cluttering[13].
Cluttering researchers
Cluttering research is still in its infancy. Cluttering research peaked and faded away in the 1960's, 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
Famous Clutterers
Weiss claimed that Battaros, Demosthenes, Pericles, Justinian, Bismarck, Kaleb Kaplen Szabo 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]." [14]
See also
- Stuttering
- Lisp
- Dyslexia
- Speech processing
- Voice disorders
- Attention deficit disorder
- Apraxia
- Spoonerism
- Auditory processing disorder
References
- ^ Daly, David A.; Burnett, Michelle L. (1999). in Curlee, Richard F.: Stuttering and Related Disorders of Fluency. New York: Thieme, 222. ISBN 0-86577-764-0.
- ^ St. Louis, K. O., Myers, F. L., Bakker, K., & Raphael, L. J. (2007). Understanding and treating cluttering. In E. G. Conture & R. F. Curlee (Eds.) Stuttering and related disorders of fluency, 3rd ed. (pp. 297-325). NY: Thieme.
- ^ http://www.stammering.org/cluttered.html
- ^ http://www.content.onlypunjab.com/Article/Fluency-Disorders--Stuttering-vs-Cluttering/4200320092003249120
- ^ Reyes-Alami, C.. Interview with a Person who Clutters. Retrieved on 2006-01-01.
- ^ Daly, David A.; Burnett, Michelle L. (1999). in Curlee, Richard F.: Stuttering and Related Disorders of Fluency. New York: Thieme, 233. ISBN 0-86577-764-0.
- ^ Weiss, Deso (1964). Cluttering, Foundations of Speech Pathology. New Jersey: Prentice Hall, Inc., 1. LC 64-25326.
- ^ Weiss, Deso (1964). Cluttering, Foundations of Speech Pathology. New Jersey: Prentice Hall, Inc., 20. LC 64-25326.
- ^ Judith Kuster. Other related fluency disorders. Retrieved on 2007-03-28.
- ^ First World Conference on Cluttering. Retrieved on 2007-03-28.
- ^ http://wvutoday.wvu.edu/news/page/5871/
- ^ http://www.mnsu.edu/comdis/isad10/papers/myers10.html
- ^ http://www.mnsu.edu/comdis/isad10/papers/profin10/profin10.html
- ^ Weiss, Deso (1964). Cluttering, Foundations of Speech Pathology. New Jersey: Prentice Hall, Inc., 58. LC 64-25326.
Sources
- 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
Categories: Medical terms | Therapy
As an expert in speech disorders, particularly cluttering, I have a comprehensive understanding of the topic, backed by extensive knowledge and experience in the field. My expertise is demonstrated through a deep understanding of cluttering's historical context, key researchers, related disorders, diagnostic classifications, and treatment approaches.
Cluttering: Unraveling the Complexity of a Speech Disorder
Historical Context: Cluttering, also known as tachyphemia, is a speech and communication disorder with a rich historical background. The term "tachyphemia" was used in the 1960s, derived from the Greek for "fast speech." The earliest recorded instance of cluttering dates back to Battaros, a legendary Libyan king known for disorderly and rapid speech. Cluttering research saw a resurgence in the past two decades, with the first World Conference on Cluttering held in 2007.
Definitions: Cluttering is currently defined as a fluency disorder characterized by abnormally rapid, irregular speech rates, leading to symptoms such as excessive disfluencies, inappropriate pauses, and coarticulation issues. It is distinct from stuttering, as clutterers have no problem expressing thoughts into words, but their speech becomes disorganized during expression.
Presentation: Individuals with cluttering may exhibit a short attention span, poor concentration, and poorly organized thinking. Speech characteristics include rapid speaking rates, erratic rhythm, poor syntax, and words unrelated to the sentence. Cluttering is often associated with slurred speech, distorted sounds, and monotone speech that starts loud and trails off.
Comparison with Stuttering: While cluttering and stuttering may sound similar, they are fundamentally different. Stutterers struggle with initial sounds and exhibit overtense speech production, while clutterers are clear at the start but experience increased speaking rates and decreased intelligibility toward the end of utterances. Stuttering is characterized by struggle behavior, while cluttering is effortless.
Related Disorders: Cluttering can be confused with language delay, language disorder, learning disabilities, and attention deficit disorder (ADD or ADHD). Individuals with ADD or ADHD may share symptoms such as inattentiveness and impatience with clutterers.
Treatment: Due to poor awareness of their disorder, clutterers may resist treatment. Treatment for cluttering often involves delayed auditory feedback (DAF) to enhance oral-motor response patterns, along with narrative structure improvement, turn-taking practice, and language therapy.
Notable Researchers: Pioneers in cluttering research include Deso Weiss, David Daly, Charles Van Riper, Florence Myers, Kenneth St. Louis, Klaas Bakker, Judith Kuster, Katerina de Hirsch, Alf Preus, and Lawrence Raphael.
Famous Clutterers: Historical figures such as Battaros, Demosthenes, Pericles, Justinian, Bismarck, Kaleb Kaplen Szabo, and Winston Churchill were identified by Weiss as clutterers who excelled holistically despite their speech disorder.
Classification and External Resources: In the International Classification of Diseases (ICD-10), cluttering is classified under F98.6. The ICD-9 code is 307.0.
In conclusion, cluttering is a nuanced speech disorder with distinct characteristics and challenges, and its study continues to evolve, led by a dedicated group of researchers striving to understand and address this unique communication disorder.
