Cluttering
See also: Speech and Language Disorders GlossaryCluttering is a speech disorder, a bit like stammering. It is also known as ‘speech organisation disorder’. People who clutter tend to be difficult to understand, because they often speak quickly and jerkily or erratically, with pauses in unexpected places. They might also use unrelated words in their sentences, slide words or syllables together, or use odd and unexpected patterns of grammar.
There is much less awareness and understanding of cluttering than of stammering. Most people do not recognise it and may not know how to react if they hear it. This page explains more about this condition, and how to cope with it in yourself, or someone talking to you.
Understanding Cluttering
In cluttering, thoughts seem to become muddled when they are turned into speech.
The mechanism is thought to be that the person is talking too fast for their brain to manage, and their speech system cannot keep up.
This means that people who clutter have unusual speech patterns. For example:
Their speech often appears jerky;
They may repeat whole words or phrases, so that their speech is difficult to follow;
They may inconsistently delete syllables, especially of much longer words (for example, saying ‘puter’ for ‘computer’);
They may use a lot of ‘um’ and ‘er’ noises;
They often revise what they were saying part-way through a sentence, as if their brain has taken a while to catch up with their speech;
They may pause in unusual places;
They may have an unusual rhythm or stress pattern;
They may drop odd unconnected words into a sentence;
They may blur words or syllables together, for example, either sliding two words together, or blurring a longer word into a much shorter form.
People who clutter often have disorganised expressive language and other errors in their speech or language. They may find it hard to read and write, suggesting that this is a language problem (unlike stammering, which seems to be a problem in how speech is produced). However, it may also be an issue of speech regulation. People who clutter may also experience problems with paying attention, like many specific learning difficulties.
The main effect of cluttering is to reduce the effectiveness of communication. In other words, people who clutter are usually harder to understand.
Finally, people who clutter are often not aware that they are doing so. It is therefore very difficult for them to self-regulate.
Cluttering vs stammering
How can you tell the difference between someone who is stammering and someone who is cluttering? There are several very clear distinctions.
Cluttering tends to sound like very fast, disorganised speech. The speaker may talk in spurts, or sound like they don’t know what they want to say. There will be pauses in odd places within sentences, words run together, and syllables elided.
This speed of speech is one of the key diagnostic criteria for cluttering.
Someone who is stammering, however, knows exactly what they want to say, but they cannot get the word out. They often show physical discomfort as they try to speak, which is not seen in cluttering.
Causes of Cluttering
Much less is known about the causes of cluttering than of stammering. However, there seem to be several different factors that can contribute to or cause cluttering. These include:
There seems to be a genetic element to cluttering, as there is with stammering;
Cluttering and stammering often happen together; around one-third of people who stammer also show signs of cluttering. This makes it harder to diagnose cluttering and separate it from stammering (see box);
A problem in disguise
Cluttering is often found alongside stammering.
Under these circumstances, it is often not identified or even noticed until the stammering has reduced (either on its own, or with the assistance of speech therapy). It can therefore seem like a ‘problem in disguise’.
Cluttering is more common in men and boys than in women and girls;
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Cluttering often co-exists with other problems, particularly Tourette’s Syndrome, autism spectrum disorder, and learning disabilities. However, plenty of people show cluttering without any other issues; and
Taking particular medications can cause cluttering as a side effect (note that drinking alcohol has a similar effect).
Treating Cluttering
Speech therapy is an effective way to help people who clutter. Generally, speech therapists will take a holistic approach to cluttering. They will want to understand what is going on in the life of the person who clutters. If the person cluttering is a child, they will liaise closely with school staff to make sure that a consistent approach is being used at home and at school.
The techniques and strategies that they will use to help might include:
Helping the person who clutters to learn to read non-verbal communication to help them to recognise when other people have not understood them;
Encouraging the use of pauses in speech, which is generally more effective than trying to slow down the rate of speech more generally. The use of pauses may need to be taught, but is often enough to allow the ‘system’ to catch up with the speech;
Encouraging the over-articulation of keywords, as a way to increase the chances of being understood;
Some people who clutter benefit from being taught to exaggerate stressed syllables, especially in longer words. They may also need to be reminded to include all the unstressed syllables;
Working on overall communication skills to improve other aspects of communication. This may, in particular, focus on planning both what to say (the content of the message) and how to say it. This might include learning how to structure communication more effectively;
Using video feedback to increase self-awareness and self-monitoring. Self-awareness can also be achieved by encouraging pausing and emphasising stresses, as this raises awareness of what the voice is doing; and
Discussing strategies to ask others to adopt when the person who clutters cannot be understood. For example, it is often not helpful to tell someone to slow down, or just pass over the remark. Instead, the Michael Palin Centre for Stammering suggests that a more helpful strategy for others to adopt is to use phrases like “I’m sorry, I didn’t understand that”, because this is more likely to encourage self-regulation.
A Final Thought
Cluttering can seem extremely challenging to manage, and is a very real barrier to communication.
However, overall, the two most important mechanisms for helping to reduce cluttering seem to be increasing self-awareness, and therefore enabling self-regulation, and slowing down speech.
Once these can be addressed, it is very likely that much of the cluttering will resolve, and the person who clutters will be able to communicate effectively.
Continue to:
Coping with Stammering
Developmental Language Disorder
See also:
Dysarthria
Aphasia
Voice Disorders