Purpose: Cluttering is a fluency disorder characterized by a variety of features such as low speech intelligibility, speed of speech perceived as too fast or irregular, inappropriate prosody and the presence of disfluencies. In this study, the purpose was to synthesize the definition, scope, characteristics, assessment and current information on therapy of cluttering, which is under the umbrella of fluency disorders in the field of speech and language pathology. The aim is also to draw attention to cluttering in terms of clinical practice and research. Method: The traditional compilation method was used in this study. A literature review was conducted on speech fluency, linguistic-motor features, etiology, accompanying disorders, assessment and therapy of cluttering. Results: Beyond the speed of speech, other skills such as disfluencies, language and communication skills are also affected in cluttering. In addition, there have been findings showing that cluttering can be seen in addition to other speech and language disorders and is rarely seen in isolation. It can also be seen together with attention deficit and hyperactivity disorder and specific learning disorder. In addition, auditory processing disorders, apraxia, and autism spectrum disorders are among the disorders that can often coexist with cluttering. It has also been stated that cluttering can be seen together with genetic origin syndromes such as Down syndrome, Tourette's syndrome and Fragile X syndrome. Many different views have been put forward regarding the etiology of cluttering, but it has also been seen that there is a lot of evidence base that the disorder has neurological and genetic bases. It has been determined that the effects of cluttering that occur in various skills of individuals with cluttering may cause this disorder to be one of the difficult disorders to study. Therefore, performing an assessment leading to differential diagnosis also helps to determine the therapy goals. Conclusion: In cluttering, in addition to speed of speech it is recommended to examine a wide variety of skills such as disfluencies in speech, language and pronunciation skills, listening and expression skills, non-verbal communication skills, motor coordination, auditory and visual perception, cognitive and intellectual skills, awareness and self-monitoring while performing the assessment procedures. Cluttering is also a disorder that is difficult to treat because it affects many developmental areas and skills of the individual. Therapy generally consists of identification, awareness, speed-pronunciation-language skills and monitoring-follow-up stages. In addition, cluttering is reffered to as the "orphan" disorder because it is often stated that awareness of cluttering is quite low both in the field of speech and language therapy and among individuals with cluttering.
fluency disorders, disfluent speech, disfluency types, cluttering, speech intelligibility
ASHA (2014). Fluency Disorders. https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/#collapse_0 adresinden alınmıştır (Erişim tarihi: 16.01.2021).
Bakker, K., Myers, F. L., Raphael, L. J., ve St. Louis, K. O. (2011). A preliminary comparison of speech rate, self-evaluation, and disfluency of people who speak exceptionally fast, clutter, or speak normally, D. Ward & K. S. Scott (Ed.), Cluttering: A handbook of research, intervention and education içinde (s. 45–65). Psychology Press.
Becker, K. P., & Grundmann, K. (1970). Investigation on incidence and symp tomatology of cluttering. Folia Phoniatrica et Logopaedica, 22 (4-5), 261–271. https://doi.org/10.1159/000263403
Blood, G. W., Blood, I. M., ve Tellis, G. (2000). Auditory processing and cluttering in young children. Perceptual and Motor Skills, 90(2), 631-639. https://doi.org/10.2466/pms.2000.90.2.631
Bóna, J. (2016). Characteristics of pausing in normal, fast and cluttered speech. Clinical Linguistics & Phonetics, 30(11), 888–898. https://doi.org/10.1080/02699206.2016.1188421
Bóna, J. (2018). Disfluent whole-word repetitions in cluttering: Durational patterns and functions. Clinical linguistics & phonetics, 32(4), 378-391. https://doi.org/10.1080/02699206.2017.1384062
Bretherton-Furness, J., & Ward, D. (2015). Linguistic behaviours in adults who clutter and adults who stutter when reading and speaking. Procedia-Social and Behavioral Sciences, 193, 62-71. https://doi.org/10.1016/j.sbspro.2015.03.245
Cangi, M. E., & Özel, S. B. (2019). Türkçe konuşan hızlı bozuk konuşması olan yetişkinlerin akıcısızlık özelliklerinin ve yaşam kalitelerinin incelenmesi: Ön çalışma. Dil Konuşma ve Yutma Araştırmaları Dergisi, 2(2), 121-145. https://dergipark.org.tr/tr/pub/dkyad/issue/48573/592799
Chudley, A. E., & Hagerman, R. J. (1987). Fragile X syndrome. The Journal of Pediatrics, 110(6), 821–831. https://doi.org/10.1016/S0022-3476(87)80392-X
Craig, A. (1996). Long-term effects of intensive treatment for a client with both a cluttering and stuttering disorder. Journal of Fluency Disorders, 21(3-4), 329-335. https://doi.org/10.1016/S0094-730X(96)00035-6
Daly, D. A., & Burnett, M. L. (1996). Cluttering: Assessment, treatment planning, and case study illustration. Journal of Fluency Disorders, 21(3-4), 239-248. https://doi.org/10.1016/S0094-730X(96)00026-5
Georgieva, D., & Miliev, D. (1996). Differential diagnosis of cluttering and stuttering in Bulgaria. Journal of fluency disorders, 21(3-4), 249-260. https://doi.org/10.1016/S0094-730X(96)00027-7
Gregory, H. H. (1995). Analysis and commentary. Language Speech and Hearing Services in the Schools, 26(2), 196–200. https://doi.org/10.1044/0161-1461.2602.196
Guitar, B. (2014). Stuttering: an integrated approach to its nature and treatment (4. baskı). Lippincott Williams and Wilkins.
Hegde, M. N. (2018). Hegde's Pocketguide to treatment in speech-language pathology. Plural Publishing.
Healey, K. T., Nelson, S., ve Scaler Scott, K. S. (2015). A case study of cluttering treatment outcomes in a teen. Procedia–Social and Behavioral Sciences, 193, 141-146. https://doi.org/10.1016/j.sbspro.2015.03.253
Langevin, M., & Boberg, E. (1996). Results of intensive stuttering therapy with adults who clutter and stutter. Journal of Fluency Disorders, 21(3-4), 315-327. https://doi.org/10.1016/S0094-730X(96)00034-4
LaSalle, L. R., & Wolk, L. (2011). Stuttering, cluttering, and phonological complexity: Case studies. Journal of fluency disorders, 36(4), 285-289. https://doi.org/10.1016/j.jfludis.2011.04.003
Molt, L. F. (1996). An examination of various aspects of auditory processing in clutterers. Journal of Fluency Disorders, 21(3-4), 215–223. https://doi.org/10.1016/S0094-730X(96)00024-1
Myers, F. L. & St. Louis, K. O. (1992). Cluttering: Issues and controversies. F. L. Myers, & K. O. St. Louis (Ed.), Cluttering: A clinical perspective içinde (s. 11–22). FAR Communications.
Myers, F. L., & St. Louis, K. O. (1996). Two youths who clutter, but is that the only similarity? Journal of Fluency Disorders, 21(3–4), 297–304. https://doi.org/10.1016/S0094-730X(96)00032-0
Myers, F. L., Bakker, K., St Louis, K. O., ve Raphael, L. J. (2012). Disfluencies in cluttered speech. Journal of Fluency Disorders, 37(1), 9–19. https://doi.org/10.1016/j.jfludis.2011.10.001
Myers, F. L., & Bakker, K. (2014). Experts’ saliency ratings of speech-language dimensions associated with cluttering. Journal of fluency disorders, 42, 35-42. https://doi.org/10.1016/j.jfludis.2013.10.004
Oliveira, C. M. C. D., Bernardes, A. P. L., Broglio, G. A. F., ve Capellini, S. A. (2010). Speech fluency profile in cluttering individuals. Pró-Fono Revista de Atualização Científica, 22(4), 445-450. https://doi.org/10.1590/S0104-56872010000400014
Oliveira, C. M. C. D., Broglio, G. A. F., Bernardes, A. P. L., ve Capellini, S. A. (2013). Relationship between speech rate and speech disruption in cluttering. CoDAS, 25(1), 59-63. https://doi.org/10.1590/s2317-17822013000100011
Op't Hof, J., & Uys, I. C. (1974). A clinical delineation of tachyphemia (cluttering). South African Medical Journal, 47(8), 1624-1628. https://journals.co.za/doi/pdf/10.10520/AJA20785135_27206
Preus, A. (1996). Cluttering upgraded. Journal of Fluency Disorders, 21(3-4), 349-357. https://doi.org/10.1016/S0094-730X(96)00038-1
Scott, K. S. (2020). Cluttering symptoms in school-age children by communicative context: A preliminary investigation. International journal of speech-language pathology, 22(2), 174-183. https://doi.org/10.1080/17549507.2019.1637020
Scott, K. S., & St. Louis, K. O. (2009). A perspective on improving evidence and practice in cluttering. Perspectives on Fluency and Fluency Disorders, 19(2), 46-51. https://doi.org/10.1044/ffd19.2.46
Shipley, K. G., & McAfee, J. G. (2015). Assessment in speech-language pathology: A resource manual. Nelson Education.
Souza, J. B. D., Paschoalino, F. C., Cardoso, V. M., ve Oliveira, C. M. C. D. (2013). Frequency and typology of disfluencies: comparative analysis between clutterers and stutterers. Revista CEFAC, 15(4), 857-863. https://doi.org/10.1590/S1516-18462013000400014
St. Louis, K. O. S., Hinzman, A. R., ve Hull, F. M. (1985). Studies of cluttering: Disfluency and language measures in young possible clutterers and stutterers. Journal of Fluency Disorders, 10(3), 151-172. https://doi.org/10.1016/0094-730X(85)90008-7
St. Louis, K. O., & Myers, F. L. (1995). Clinical management of cluttering. Language, Speech, and Hearing Services in Schools, 26(2), 187-195. https://doi.org/10.1044/0161-1461.2602.187
St. Louis, K. O., Raphael, L. J., Myers, F. L., ve Bakker, K. (2003). Cluttering updated. The ASHA Leader, 8(21), 4-22. https://doi.org/10.1044/leader.FTR1.08212003.4
St. Louis, K. O., Myers, F. L., Faragasso, K., Townsend, P. S., ve Gallaher, A. J. (2004). Perceptual aspects of cluttered speech. Journal of Fluency Disorders, 29(3), 213–235. https://doi.org/10.1016/j.jfludis.2004.07.002
St. Louis, K. O., & Schulte, K. (2011). Defining cluttering: The lowest common denominator. D. Ward & K. S. Scott (Ed.), Cluttering. A handbook of research, intervention and education içinde (s.233–253). Psychology Press.
Thacker, R., & De Nil, L. (1996). Neurogenic cluttering. Journal of Fluency Disorders, 21(3-4), 227–238. https://doi.org/10.1016/S0094-730X(96)00025-3
Tiger, R. J., Irvine, T. L., ve Reis, R. P. (1980). Cluttering as a complex of learning disabilities. Language, Speech, and Hearing Services in Schools, 11(1), 3-14. https://doi.org/10.1044/0161-1461.1101.03
van Borsel, J., & Vandermeulen, A. (2008). Cluttering in Down syndrome. Folia Phoniatrica et Logopaedica, 60(6), 312–317. https://doi.org/10.1159/000170081
van Zaalen-op’t Hof, Y., Wijnen, F., ve Dejonckere, P. H. (2009a). Differential diagnostic characteristics between cluttering and stuttering: Part one. Journal of Fluency Disorders, 34(3), 137–154. https://doi.org/10.1016/j.jfludis.2009.07.001
van Zaalen-op’t Hof, Y., Wijnen, F., ve Dejonckere, P. (2009b). Language planning disturbances in children who clutter or have learning disabilities. International Journal of Speech-Language Pathology, 11(6), 496–508. https://doi.org/10.3109/17549500903137249
van Zaalen-op’t Hof, Y., & Dejonckere, P. H. (2010). Cluttering: A language-based fluency disorder. Paper presented on the First Online Cluttering Conference. https://www.mnsu.edu/comdis/ica1/papers/yvonne1c.html alınmıştır (Erişim tarihi: 16.01.2021).
van Zaalen, Y., & Reichel, I. K. (2014). Cluttering treatment: Theoretical considerations and intervention planning. Perspectives on Global Issues in Communication Sciences and Related Disorders, 4(2), 57-62. https://doi.org/10.1044/gics4.2.57
Ward, D. (2006). Stuttering and cluttering: frameworks for understanding and treatment. Psychology Press.
Ward, D., & Scott, K. S. (2011). Cluttering: A handbook of research, intervention and education. Psychology Press.
Ward, D., Connally, E. L., Pliatsikas, C., Bretherton-Furness, J., ve Watkins, K. E. (2015). The neurological underpinnings of cluttering: Some initial findings. Journal of fluency disorders, 43, 1-16. https://doi.org/10.1016/j.jfludis.2014.12.003
Weiss, D. (1964). Cluttering. Prentice-Hall.
Weiss, D. A. (1968). Cluttering: Central language imbalance. Pediatric Clinics of North America, 15(3), 705–720. https://doi.org/10.1016/S0031-3955(16)32171-X