Assignment Speech Disorder - I Topic Cluttering (Symptoms, Eitology, and Treatment Apporaches)

ASSIGNMENT
SPEECH DISORDER_I
TOPIC
CLUTTERING(SYMPTOMS, EITOLOGY, AND TREATMENT
APPORACHES)
ADEEBA RAMZAN
23563
MS (SLP)
DEFINITION OF CLUTTERING
St. Louis and Schulte define cluttering as a perceived rapid and irregular speech
rate, which results in breakdowns in clarity of speech and fluency.
Cluttering is a fluency disorder characterized by a rapid and irregular speaking rate,
excessive disfluencies, and often other symptoms such as language or phonological errors and
attention deficits.
Cluttering is a speech problem in which a person’s speech too fast or irregular.
Symptoms of cluttering include:
 Rapid rate of speech.

 Omitting and deletion of sound and syllables.
 Collapsing of syllables
 Omission of word endings
 Unusual prosody due to unexpected pauses
 Leaving off the ends of words.
 Words sound as if they are running into each other.
 Lots of starts and stops in speaking.
 Use of disfluencies such as “um”, “uh”, repeating or revising phrases, or repeating words
or sentences.
 Difficulty organizing thoughts and getting to the point.
 Limited awareness of how one’s speech sounds to others.
 Face difficulties in slowing down of speech.
 The tendency to interrupt the conversation.
 Words or ideas come out differently than intended.
 Also face difficulties with handwriting.
 Face difficulty in sustaining attention for such type of activities like reading or small talk.
 Difficulty in typing words accurately.
 Speech is usually best in a structured or controlled situation in which the person is
actively monitoring it. Speech is usually at its worst when the person is more relaxed.
Symptoms of cluttering ACCORDING TO DALY 1994:

Obligatory Symptoms
 Excessive repetitions
 Poorly organized thinking
 Short attention span and poor concentration
 Lack of awareness of cluttering problem
Facultative Symptoms
 Excessive speech rate
 Grammatical Mistakes
 Delayed speech and language development
 Auditory problems.
 Writing problems
 Difficulties in oral reading.
Other Facultative Symptoms

 Abnormal respiration
 Monotony
 Motor problems
 Family history of disfluency
 Academically weak in reading, writing or language arts
 Volume problems (explosive speech)
 Personality factors (aggressive, untidy, impulsive)
 Articulation problems
 Lack of rhythm
 Small for age
 Academically strong in math
 Dysphonia
 Language or grammar difficulties (word retrieval; word order; simplification of sentence;
uses of verb; uses of prepositions; pronoun reference.
Symptoms of cluttering ACCORDING TO (Weiss, 1968)
Obligatory Symptoms
 Excessive repetitions (8-10)
 Short attention span and poor concentration
 Lack of awareness of the problem
 Perceptual weakness
 Poorly organized thinking
Facultative Symptoms
 Excessive speech rate
 Interjections
 Vowel stops
 Articulatory and motor disabilities
 Grammatical difficulties
 Vocal monotony
 Respiratory dysrhythmia
 Delayed speech development
Associated Symptoms
 Reading disorder
 Writing disorder
 Lack of rhythmical and musical ability
 Restlessness and hyperactivity
 EEG findings
 Lag in maturation
 Heredity
ETIOLOGY OF CLUTTERING
 Causes of cluttering are currently unknown.
 Difficulty of isolating group; there is clear difference between cluttering and stuttering,
and some individuals face both conditions.
 Caused by abnormal development of the different parts of brain.
 Caused by rate of speech control
 Caused by speech language planning and execution of other fluency disorders.
Cluttering also caused due to some neurological conditions:
 In early studies, over 90% of clutterers showed abnormal functioning of EEG (Luchsinger &
Landholt, 1951).
 According to other early studies, cluttering caused by using drugs such as chlorpromazine
(tranquilizer) and dexfenmatrazine (amphetamine).
Pathogenesis: The symptoms of cluttering are usually not appear until a person's language is
developed, in late childhood or early adolescence
It is hypothesized that cluttering results when a person tries to speak too quickly.
Risk factors of cluttering:

 Tourette’s syndrome.
 Presence of ADHA(attention deficit hyper activity)
DIAGNOSTIC CONSIDERATIONS:
 Case history, including family and academic history, etc.
 Observe the fluency of speech and reactions to speech
 Spontaneous speech sample
 Oral reading of extended (3-5 minutes) passage 1 year below presumed reading level
 Collect writing sample
 Check rhythm of speech
 Used speech tasks for purpose of assessments
 Also observe when taping is discontinued
 Check auditory memory through sentence repetition
Checklist for Possible Cluttering (Daly, 1991)
 33 items rated on a 4 point scale; 99 possible points.

 55+ strongly suggestive of cluttering
 35-55 = stutterer-clutterer
 Items most sensitive to cluttering: 2,3,7,9,10,12,14,20,25,33.
 Perceptions of Speech Communication (Daly, 1978)
 Adapted from Woolf (1967) Perceptions of Stuttering Inventory. Low score indicates
lack of awareness; the average PWS scores ~ 30.
 Articulation and language assessments as appropriate
TREATMENT OF CLUTTERING
Cluttering Therapy
If your child show symptoms of cluttering, it is important to teach him some strategies to
curing for this. There is no “cure” for cluttering but children can be taught some techniques and
strategies that will help them be understood by others. For most of these children, the first step is
making them aware that it is happening. Once they become aware they use these techniques or
strategies to fix the communication breakdown, and for the treatment of cluttering.
Cluttering Strategy #1: Slow Speech

When people clutter, they speak very fast or with an irregular speech rate (adding extra
pauses). This makes it very difficult for the listener to understand. When this happens, speech
therapists can use a strategy called slow speech. In this strategy speech therapists told their
clients to speak slowly or to think about what they had to say before they said it.
Homework: Practice reading sentences or paragraphs from a book while using slow speech
strategy. Think about how it feels when you speak like this and focused on the sounds of words..
Read in front of their parents and then he/she give you feedback on how you sound.
Cluttering Strategy #2: Over-Articulation

When people clutter, they often leave out sounds of different words or mix them all together.
If someone is having trouble understanding you, it is important to try to exaggerate saying every
sound so you know they are all there. This is called over-articulation. You exaggerate each sound
you say to the point that it may sound a little silly to you. This will help your listener understand
what you are saying.
Cluttering Strategy #3: Normal Pitch

When people are cluttering, they often speak with a pitch that is too high or too low. The
pitch of the voice is how high or low it sounds. It is important to find the “Just Right” pitch for
the voice. Practice saying these sentences firstly very high and then very low. After that, use a
normal pitch for reading same sentences. While you’re reading these sentences, think about how
your voice and throat feels while you use a normal pitch and also noticed sounds of the
words. When you use normal pitch will help your therapist in understanding you.
Recommendations from St. Louis & Myers:
 Reduce speaking rate (DAF sometimes helpful)

 Speaking softly to “calm down” speech system.
 Learning to pause at appropriate places
 Via tape review, tapping
 Direct work on articulation
 Beginning with short phrases and moving to lengthier units
 Emphasis on unstressed syllables
 Increased self-monitoring skills and self-awareness
 Teach fluency enhancing skills as necessary to treat stuttering symptoms
Recommendations from Daly & Burnett:

Modify speech rate and regularity through:
 DAF
 Self-monitoring
 Window reading
 Breathing modification
 Oral motor syllable training program
 Over articulation of segments
 Relaxation and mental imagery, including positive self-talk and affirmation
Increased self-awareness through:

 video- and audio- tape
 Vibrotactile feedback
 Counseling and attitude change
 Interpersonal and listening skills
Improving attention span:

 Through Memory games
 Reading story events
 Through Problem-solving tasks
REFERENCES:
 https://www.speechirl.com/what-is-cluttering
 https://www.speechandlanguagekids.com/strategies-for-clutterers/
 https://www.slideshare.net/dennis43/powerpoint-slides-5475596
 https://associations.missouristate.edu/ica/Resources/what_is_cluttering.htm
 https://www.google.com/search?
q=cluttering&source=lnms&tbm=isch&sa=X&ved=2ahUKEwji6
DR47DsAhXMyIUKHVJ2AmMQ_AUoAnoECBYQBA&biw=1366&bih=625#imgrc=9_zFp
BDu16T0EM

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ASSIGNMENT

Cluttering is a speech problem in which a person’s speech too fast or irregular.

Symptoms of cluttering include:

 Rapid rate of speech.

Symptoms of cluttering ACCORDING TO DALY 1994:

Other Facultative Symptoms

Symptoms of cluttering ACCORDING TO (Weiss, 1968)

Risk factors of cluttering:

 33 items rated on a 4 point scale; 99 possible points.

Cluttering Strategy #1: Slow Speech

Cluttering Strategy #2: Over-Articulation

Cluttering Strategy #3: Normal Pitch

Recommendations from St. Louis & Myers:

 Reduce speaking rate (DAF sometimes helpful)

Recommendations from Daly & Burnett:

Increased self-awareness through:

Improving attention span:

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