Cluttering

What is cluttering?

Cluttering is a type of fluency disorder that affects the rate and rhythm of your speech. Fluency disorders— which include cluttering and stuttering — involve interruptions to speech flow. With cluttering, you may speak so fast that your words run together. To help the words fit, you may drop syllables or merge words. You may pause in unexpected places and speak in what listeners hear as disorganized language “spurts.”

Cluttering can feel especially frustrating because, usually, everything makes sense from the perspective of the speaker. But it gets lost in translation with listeners. With cluttering, it’s not uncommon for others to continually ask you to slow down or repeat yourself.

How common is this condition?

Experts estimate that cluttering affects about 1.1% to 1.2% of school-age children. About 1 out of every 3 people who stutter also show some signs of cluttering.

It’s more common in children assigned male at birth (AMAB). Healthcare providers don’t usually diagnose it until a child is 8 years old or older. At this point, speech is complex enough to show signs of cluttering.

What are the symptoms of cluttering?

Cluttering involves characteristics like talking too fast and using filler words (like “um”). The occasional “um” or “ah” are common hiccups in otherwise coherent speech. But with this condition, these characteristics are more of a feature than an exception. They frequently prevent others from understanding you.

Common signs of cluttering include:

• Rapid speech. The most common sign of cluttering is talking so fast that others have trouble following what you’re saying. The rhythm of your speech may sound irregular or “jerky” to others.
• Collapsing words and phrases. You may leave out syllables of a longer word (“commcation” instead of “communication”) or jam several words together while omitting certain parts (“Iwango” instead of “I want to go.”)
• Out-of-place pauses in a sentence. You may insert pauses where listeners don’t expect them. For example, you may say, “I want to go to the [pause] movies.”
• Frequent filler words. This involves overusing words like “um,” “ah,” or “you know” that interrupt the flow of what you’re saying.
• “Maze patterns” of speech. You may shift topics so that it’s hard for listeners to follow your train of thought. For example, you might say, “I need to finish — I don’t want to get in trouble. My report was late last time. I need to turn in my report on time or else I’ll get in trouble.”
• Revising what you’re saying mid-thought. For example, you might say, “I want to spend … can I spend … the afternoon with you?”

Other signs of cluttering include:

• Sloppy handwriting.
• Attention difficulties.
• Moving or gesturing a lot when talking.
• Having trouble learning (unrelated to intelligence).
• Avoiding eye contact when speaking.
• Talking over others, interrupting or not taking turns during conversations.

What causes cluttering?

Medical experts don’t know what causes cluttering. But it’s more common in people with specific conditions, including:

• Auditory processing disorder.
• Attention-deficit/hyperactivity disorder (ADHD).
• Autism spectrum disorder.
• Learning disabilities.
• Tourette syndrome.

Some studies suggest that cluttering may run in families, but researchers need to study this more to be sure.

What are complications of cluttering?

The frequent communication breakdowns that keep you from connecting with others can take a toll on your mental health. Children who clutter may feel ashamed, doubt their intelligence and put distance between themselves and their peers. They may learn to talk less to keep from being misunderstood.

This is why diagnosis and treatment are so important. Being a confident and effective communicator positively impacts almost every part of a person’s life.

How is cluttering diagnosed?

A speech-language pathologist (SLP) can diagnose cluttering by listening to your speech and ruling out other types of speech disorders.

During your visit, the SLP will review your symptoms and health history. For example, an important part of diagnosis involves determining whether cluttering is happening alongside a related condition, like ADHD or a learning disability. They’ll listen for signs of cluttering. This involves some back and forth with the SLP, which may include:

• Having a conversation.
• Reading aloud.
• Recounting a story or memory.
• Taking reading, writing or intelligence tests.

Diagnosis may require a team lift if your child is showing signs of cluttering. The SLP may need to hear from their teachers or school counselors. They can shed light on whether your child has language, learning or socialization difficulties other than cluttering. Clearly defining all issues is essential to finding the right treatment.

How is cluttering treated?

Speech therapy can help you reduce cluttering in your speech. During sessions, your SLP will make you aware of how you’re cluttering, so you can be more mindful about speaking more clearly. They may video record you so that you get a sense of what others are hearing and seeing when you talk.

Depending on the characteristics of your speech, an SLP may teach you how to:

• Control your breathing so you’re speaking in a more natural rhythm.
• Insert pauses at the right time and place, so that speech flows more smoothly.
• Emphasize syllables so that words and phrases don’t run together.
• Structure a story you’re sharing so that it follows a logical progression for listeners.
• Use nonverbal cues, like making eye contact, to communicate better.
• Communicate your needs with others (like asking them to let you complete a sentence you’re struggling with instead of jumping in to help).

Counseling or therapy may also be an important part of treatment. You may need support to manage the stress of learning to speak without cluttering. If your child clutters, family counseling can help reinforce the communication strategies they’re learning in speech therapy.

Can cluttering be prevented?

Cluttering isn’t preventable, but speech therapy can help you manage the condition. It can make you a more confident and effective communicator.

What is the outlook for this condition?

While there isn’t a simple cure for cluttering, speech therapy can help you or your child manage the condition so that speech is more understandable. But the process takes patience and commitment. For example, in certain situations (like stressful times), it may be easy to revert to cluttering. Continuing to practice what you learned in speech therapy can help you speak more clearly, no matter the context.

How can I cope with cluttering?

If your child clutters, there are things you can do to help.

• Reinforce the lessons learned in speech therapy. Keep tabs on what your child is learning in therapy so you can support them. Ask their SLP how you can reinforce their training at home.
• Be patient. It can be tempting to coach or correct someone who’s cluttering. But it’s best to give them time to complete their thoughts.
• Take advantage of resources at school. Your child may be eligible for additional help and accommodations at school that can help set them up for success.
• Connect with support groups. Ask your child’s SLP about ways to connect with other parents whose children have difficulties with cluttering. You can help each other become better equipped at attending to your children’s needs.

When should I see my healthcare provider?

Contact a healthcare provider if you or your child demonstrates signs of cluttering. One of the biggest challenges is recognizing these signs in yourself. If others are often asking you to slow down or repeat yourself, you may benefit from speaking with an SLP.

Is cluttering a neurological disorder?

Although cluttering is a fluency disorder, some research suggests that there are neurological (brain-related) factors at play. For example, a study tracking the brain activities of people with speech cluttering identified abnormalities in the basal ganglia and prefrontal cortex.

Still, speech-language pathologists are continuing to study all the factors at play in fluency disorders.