 | This article needs more reliable medical references for verification or relies too heavily on primary sources .(December 2012) |  |
| Cluttering | |
|---|---|
| Other names | Tachyphemia, tachyphrasia |
| Specialty | Pediatrics, Psychiatry |
Cluttering is a speech and communication disorder characterized by a rapid rate of speech, erratic rhythm, and poor syntax or grammar, making speech difficult to understand.
Cluttering is a speech and communication disorder that has also been described as a fluency disorder. [1]
It is defined as:
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 words. [2]
Cluttering is sometimes confused with stuttering. Both communication disorders break the normal flow of speech, but they are distinct. A stutterer has a coherent pattern of thoughts, but may have a difficult time vocally expressing those thoughts; in contrast, a clutterer has no problem putting thoughts into words, but those thoughts become disorganized during speaking. Cluttering affects not only speech, but also 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. 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.
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. [4]
Cluttering can often be confused with various language disorders, learning disabilities, and attention deficit hyperactivity disorder (ADHD). [5] Clutterers often have reading and writing disabilities, especially sprawling, disorderly handwriting, which poorly integrate ideas and space. [6] It can occur with Parkinson's disease. [7]
The common goals of treatment for cluttering include slowing the rate of speech, heightening monitoring, using clear articulation, using acceptable and organized language, interacting with listeners, speaking naturally, and reducing excessive disfluencies. [8]
Slowing the rate of speech can help many of the symptoms of cluttering, and can be achieved in a couple of different ways. It is important that speech language pathologists do not nag their clients to "slow down" incessantly, as this does not help and can actually hinder progress. Additionally, it is important to remember that speech rate often increases when emotional arousal or stress increases. Instead of constant verbal reminders, clinicians may use a combination of delayed auditory feedback (DAF), giving out "speeding tickets" (written reminders to slow down speech), or recording speech and having clients transcribe it, writing in where there is need for spaces and pauses. [8]
Many people who clutter are either unable or unwilling to think about their speech, particularly in casual speech. The strategies to slow speech down all require careful monitoring of speech, which can be very difficult for those who clutter. Imagination and careful observation are used to increase monitoring. For instance, an adult who clutters may be asked to visualize themselves speaking slowly and clearly before they actually speak. Additionally, video and audio recordings may be used to show those who clutter where communication starts to break down in their speech. [8]
In general, slowing the rate of speech and/or monitoring speech more effectively should lead to clearer articulation. However, if they do not, additional treatment is needed. These articulation treatment strategies include practicing short sentences with "over-articulated", unnatural but technically correct, speech. Reading multisyllabic words and focusing on including each of the sounds is another strategy to enhance articulation. [8]
Some individuals who clutter will need help learning to tell stories logically and sequentially. This can be aided by learning how to begin narratives with simple, short sentences, and slowly building to longer, more complex ones. Additionally, clinicians may transcribe cluttered speech to clients to show them run-ons and ramblings, and then ask them to just state the necessary, most important information in the utterance. [8]
Additional strategies that may help people who clutter include checking in, ensuring that they've understood any non-verbal or turn-taking cues in the conversation, imitating clinician models of speech to improve natural speech, and treating any stuttering that may be co-occurring with cluttering. The two are separate disorders, but many people who clutter also stutter. [8]
Battaros[ citation needed ] was a legendary Libyan king who spoke quickly and in a disorderly fashion. Others who spoke as he did were said to have battarismus. [9] 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 no longer 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". [10]
The First World Conference on Cluttering was held in May 2007 in Razlog, Bulgaria. [11] It had over 60 participants from North America, Europe, the Middle East and Asia. [12]
Weiss claimed that Battaros, Demosthenes, Pericles, Justinian, Otto von 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]." [13]
Stuttering, also known as stammering, is a speech disorder characterized externally by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds.
A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. This also encompasses deficiencies in verbal and non-verbal communication styles. The delays and disorders can range from simple sound substitution to the inability to understand or use one's native language. This article covers subjects such as diagnosis, the DSM-IV, the DSM-V, and examples like sensory impairments, aphasia, learning disabilities, and speech disorders.
Speech disorders, impairments, or impediments, are a type of communication disorder in which normal speech is disrupted. This can mean fluency disorders like stuttering, cluttering or lisps. Someone who is unable to speak due to a speech disorder is considered mute. Speech skills are vital to social relationships and learning, and delays or disorders that relate to developing these skills can impact individuals function. For many children and adolescents, this can present as issues with academics. Speech disorders affect roughly 11.5% of the US population, and 5% of the primary school population. Speech is a complex process that requires precise timing, nerve and muscle control, and as a result is susceptible to impairments. A person who has a stroke, an accident or birth defect may have speech and language problems.
A speech disfluency, also spelled speech dysfluency, is any of various breaks, irregularities, or non-lexical vocables which occur within the flow of otherwise fluent speech. These include "false starts", i.e. words and sentences that are cut off mid-utterance; phrases that are restarted or repeated, and repeated syllables; "fillers", i.e. grunts, and non-lexical or semiarticulate utterances such as huh, uh, erm, um, and hmm, and, in English, well, so, I mean, and like; and "repaired" utterances, i.e. instances of speakers correcting their own slips of the tongue or mispronunciations. Huh is claimed to be a universal syllable.
Subvocalization, or silent speech, is the internal speech typically made when reading; it provides the sound of the word as it is read. This is a natural process when reading, and it helps the mind to access meanings to comprehend and remember what is read, potentially reducing cognitive load.
Palilalia, a complex tic, is a language disorder characterized by the involuntary repetition of syllables, words, or phrases. It has features resembling other complex tics such as echolalia or coprolalia, but, unlike other aphasias, palilalia is based upon contextually correct speech.
Formulaic language is a linguistic term for verbal expressions that are fixed in form, often non-literal in meaning with attitudinal nuances, and closely related to communicative-pragmatic context. Along with idioms, expletives and proverbs. Formulaic language includes pause fillers and conversational speech formulas.
Speech–language pathology (a.k.a. speech and language pathology or logopedics) is a healthcare and academic discipline concerning the evaluation, treatment, and prevention of communication disorders, including expressive and mixed receptive-expressive language disorders, voice disorders, speech sound disorders, speech disfluency, pragmatic language impairments, and social communication difficulties, as well as swallowing disorders across the lifespan. It is an allied health profession regulated by professional bodies including the American Speech-Language-Hearing Association (ASHA) and Speech Pathology Australia. The field of speech-language pathology is practiced by a clinician known as a speech-language pathologist (SLP) or a speech and language therapist (SLT). SLPs also play an important role in the screening, diagnosis, and treatment of autism spectrum disorder (ASD), often in collaboration with pediatricians and psychologists.
Dysprosody, which may manifest as pseudo-foreign accent syndrome, refers to a disorder in which one or more of the prosodic functions are either compromised or eliminated.
Language production is the production of spoken or written language. In psycholinguistics, it describes all of the stages between having a concept to express and translating that concept into linguistic forms. These stages have been described in two types of processing models: the lexical access models and the serial models. Through these models, psycholinguists can look into how speeches are produced in different ways, such as when the speaker is bilingual. Psycholinguists learn more about these models and different kinds of speech by using language production research methods that include collecting speech errors and elicited production tasks.
Delayed Auditory Feedback (DAF), also called delayed sidetone, is a type of altered auditory feedback that consists of extending the time between speech and auditory perception. It can consist of a device that enables a user to speak into a microphone and then hear their voice in headphones a fraction of a second later. Some DAF devices are hardware; DAF computer software is also available. Most delays that produce a noticeable effect are between 50–200 milliseconds (ms). DAF usage has been shown to induce mental stress.
Speech production is the process by which thoughts are translated into speech. This includes the selection of words, the organization of relevant grammatical forms, and then the articulation of the resulting sounds by the motor system using the vocal apparatus. Speech production can be spontaneous such as when a person creates the words of a conversation, reactive such as when they name a picture or read aloud a written word, or imitative, such as in speech repetition. Speech production is not the same as language production since language can also be produced manually by signs.
The Monster Study was a non-consensual experiment performed on 22 orphan children in Davenport, Iowa in 1939 about stuttering. It was conducted by Wendell Johnson, University of Iowa, with the physical experiment being performed by his graduate student Mary Tudor.
Electronic fluency devices are electronic devices intended to improve the fluency of persons who stutter. Most electronic fluency devices change the sound of the user's voice in his or her ear.
There are many references to stuttering in popular culture. Because of the unusual-sounding speech that is produced, as well as the behaviors and attitudes that accompany a stutter, stuttering has been a subject of scientific interest, curiosity, discrimination, and ridicule.
Fluency refers to continuity, smoothness, rate, and effort in speech production. It is also used to characterize language production, language ability or language proficiency.
Stuttering therapy is any of the various treatment methods that attempt to reduce stuttering to some degree in an individual. Stuttering can be seen as a challenge to treat because there is a lack of consensus about therapy.
Apraxia of speech (AOS), also called verbal apraxia, is a speech sound disorder affecting an individual's ability to translate conscious speech plans into motor plans, which results in limited and difficult speech ability. By the definition of apraxia, AOS affects volitional movement pattern. However, AOS usually also affects automatic speech.
Speech and language impairment are basic categories that might be drawn in issues of communication involve hearing, speech, language, and fluency.
Auditory feedback (AF) is an aid used by humans to control speech production and singing by helping the individual verify whether the current production of speech or singing is in accordance with his acoustic-auditory intention. This process is possible through what is known as the auditory feedback loop, a three-part cycle that allows individuals to first speak, then listen to what they have said, and lastly, correct it when necessary. From the viewpoint of movement sciences and neurosciences, the acoustic-auditory speech signal can be interpreted as the result of movements of speech articulators. Auditory feedback can hence be inferred as a feedback mechanism controlling skilled actions in the same way that visual feedback controls limb movements.
