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07-SEPTEMBER-2008 03:17:44 - Cluttering This article is about the speech disorder. For other uses, see Cluttering disambiguation. Cluttering Classification and external resources ICD-10 F98.6 ICD-9 307.0 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 disorder1. 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 with stuttering; 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 words2. Presentation Those 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 conversation3. 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 Another clutterer wrote on an Internet support group: 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 know exactly what they want to say, but it becomes disorganized while actually speaking 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 disorder6. 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 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.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 Homepage9. The first conference held specifically on cluttering was held in May 200710 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 Asia11. It was held in Bulgaria partly because of cluttering research efforts by Professors Dobrinka Georgieva and Katya Dionissieva of Neofit Rilski12. 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 cluttering13. Cluttering researchers 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 Famous clutterers Weiss claimed that Battaros, Demosthenes, Pericles, Justinian, 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. The animated character Porky Pig, who has often been described as a stutterer, also a style of speech, which is similar to cluttering in some ways. 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. ^ When speech is too cluttered - British Stammering Association ^ Fluency Disorders: Stuttering vs Cluttering ^ 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. ^ News and Information Services - WVU Today » Press Release ^ myers ^ Office Hours ^ 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 External links 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 v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Elopement, Sundowning, Wandering · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering Retrieved from http://en..org/wiki/Cluttering Categories: Communication disorders | Sociolinguistics | Human voice | Oral communication | Human communication | Linguistics | Speech impediments | Medical terms | Therapy | Speech and language pathology Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page This page was last modified on 23 July 2008, at 05:49
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