SUGGESTIONS FOR TREATING CLUTTERING

 DAVID A. DALY

Weiss (1964) contends that cluttering is the “mother load" of stuttering. He believes that in most cases, the child’s stuttering began with cluttering. Early literature reports a poor prognosis for clutterers, however, success has been reported using various techniques and strategies.

1. Focus on self-awareness. Most clutterers are unaware of their repetitions, deletions, and transpositions. Audiotape and videotape them to teach self monitoring. A patient but direct clinician is needed.

2. Tachylalia is not obligatory for cluttering diagnosis, but it is common. Instructions to “slow down" are worthless. Try finger tapping to teach syllable stress. Model desired behavior. Clinician must slow rate too.

3. Froeschels (1946) recommended reading aloud one word at a time. Placing a cover sheet with a hole over the page to reveal one word at a time is suggested to help the clutterer focus.

4. Test for articulation errors and dyslalia is common. We have used a delayed feedback machine to help cluttering clients "over-articulate" their slower rate of speech. Encourage client to "feel" tactile cues.

5. Poor memory abilities are common in cluttering. Practice telling and retelling stories trying to include more and more details. Use sequence picture cards if necessary. Such abilities can be enhanced.

6. Relaxation and visual imagery exercises may be useful for reducing impulsivity and distractibility. Attention deficits are common.  Auditory comprehension activities found useful for learning disabled students or aphasic adults may be most appropriate for cluttering clients.

7. Some clutterers have motor coordination, rhythm, and speech melody impairments. Exaggerating various rhythmic patterns and speech prosodic patterns may be helpful. E.g., some clutterers show very monotonus voice patterns - vary their prosody - change the stress pattern. We use exaggeration as auditory imperceptiveness is usually present.

8. Reading and writing difficulties are typical.  Authorities recommend teaching cursive writing not printing.  Help clients write a one paragraph story.  Assistance may be needed to follow a train of thought.  Reinforce generously.  Read and discuss the "story."  Then try for one page story.  Patience and persistence are needed.  Examination of written work will help clinicians understand the clutterer's language confusion.

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