Condition: Cluttering

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Cluttering, another fluency disorder, is characterized by a perceived rapid and/or irregular speech rate, atypical pauses, maze behaviors, pragmatic issues, decreased awareness of fluency problems or moments of disfluency, excessive disfluencies, collapsing or omitting syllables, and language formulation issues, which result in breakdowns in speech clarity and/or fluency (St. Louis & Schulte, 2011; van Zaalen-Opt Hof & Reichel, 2014). Individuals may exhibit pure cluttering or cluttering with stuttering (van Zaalen-Op’t Hof et al., 2009).

Breakdowns in fluency and clarity can result from

  • atypical pauses within sentences that are not expected syntactically (e.g., “I will go to the / store and buy apples”; St. Louis & Schulte, 2011),
  • deletion and/or collapsing of syllables (e.g., “I wanwatevision”),
  • excessive levels of typical disfluencies (e.g., revisions, interjections),
  • maze behaviors or frequent topic shifting (e.g., “I need to go to…I mean I’m out of cheese. I ran out of cheese and bread the other day while making sandwiches and now I’m out so I need to go to the store”), and/or
  • omission of word endings (e.g., “Turn the televisoff”).

Cluttering may have an effect on pragmatic communication skills and awareness of moments of disruption (Teigland, 1996). For example, individuals who clutter may not be aware of communication breakdowns and, therefore, do not attempt to repair them. This results in less effective social interactions.

There are limited data on the age of onset of cluttering; however, the age of onset of cluttering appears to be similar to that of stuttering (Howell & Davis, 2011). Individuals typically aren’t diagnosed or do not start treatment until 8 years of age or into adolescence/adulthood (Ward & Scaler Scott, 2011).

Cluttering can co-occur with other disorders, including

  • learning disabilities (Wiig & Semel, 1984),
  • auditory processing disorders (Molt, 1996),
  • Tourette’s syndrome (see Van Borsel, 2011, for a review),
  • autism (see Scaler Scott, 2011, for a review),
  • word-finding/language organization difficulties (Myers, 1992), and
  • attention-deficit/hyperactivity disorder (Alm, 2011).

Speech clarity and fluency may temporarily improve when the person is asked to slow down or pay attention to their speech. These should be considered during differential diagnosis but should not be the sole therapeutic strategies.


Signs and Symptoms:

Signs and symptoms of cluttering include

  • excessive coarticulation resulting in the collapsing and/or deletion of syllables and/or word endings;
  • excessive disfluencies, which are usually of the more nonstuttering type (e.g., excessive revisions and/or use of filler words, such as “um”);
  • pauses in places typically not expected syntactically;
  • rapid and/or irregular speech rate; and
  • unusual prosody (often due to the atypical placement of pauses rather than a “pedantic” speaking style, as observed in many with autism spectrum disorder).

The speaker’s measured speech rate is not always greater than average, but the listener perceives it as rapid. This perceived rapid rate—and the resulting breakdown in speech clarity—is thought to be because speakers with cluttering speak at a rate that is too fast for their systems to handle (Myers, 1992; St. Louis et al., 2007; Ward, 2006).

Persons who clutter can experience the same affective, behavioral, and cognitive reactions as those with stuttering, including communication avoidance, anxiety, and negative attitudes toward communication (Scaler Scott & St. Louis, 2011). Although some people with cluttering are not aware of their communication difficulties, many are aware that others have difficulty understanding them.



**NOTE:  Although cluttering and stuttering can co-occur, there are some important distinctions between the two (see Scaler Scott, 2010). Individuals who stutter are more likely to be self-aware about their disfluencies and communication, and they may exhibit more physical tension, secondary behaviors, and negative reactions to communication. Individuals who clutter may exhibit more errors related to reduced speech intelligibility secondary to rapid rate of speech.


Individuals are referred to a speech-language pathologist (SLP) for a comprehensive assessment when disfluencies are noted and when one or more of the factors listed below are observed along with the disfluencies.

This list is not exhaustive, and not all factors need to be present for a referral to an SLP (e.g., Guitar, 2019; Yaruss et al., 1998).

  • There is a family history of stuttering or cluttering.
  • There is parent/individual concern.
  • The person exhibits negative reactions (e.g., affective, behavioral, or cognitive reactions) to their disfluency.
  • The person is experiencing negative reactions from others (e.g., peers, classmates, coworkers, family members).
  • The person exhibits physical tension or secondary behaviors (e.g., eye blinking, head nodding) associated with the disfluency.
  • The person is having difficulty communicating messages in an efficient, effective manner.
  • Other speech or language concerns are also present.

Consistent with the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework (ASHA, 2016a; Coleman & Yaruss, 2014; Vanryckeghem & Kawai, 2015; WHO, 2001; Yaruss, 2007; Yaruss & Quesal, 2004, 2006), a comprehensive fluency assessment is conducted to identify and describe

  • impairments in body structure and function, including frequency and severity of disfluencies, presence of physical concomitant behaviors and learned avoidance behaviors, and presence of tension and effort while communicating;
  • comorbid deficits or conditions, such as speech sound disorders and language disorders;
  • limitations in activity and participation, including functional communication and interpersonal interactions at home, in social settings, at school, or at work;
  • contextual (environmental and personal) factors that serve as barriers to or facilitators of successful communication and life participation; and
  • the impact of communication impairments on quality of life of the individual.

A comprehensive fluency assessment typically includes the following:

  • Relevant case history (as appropriate for age)
  • Consultation with family members, educators, and other professionals regarding fluency variability (when disfluencies are noticed most and least) and the impact of disfluency.
  • Real-time analysis or analysis based on an audiovisual recorded speech sample demonstrating representative disfluencies beyond the clinic setting.
  • Review of previous fluency evaluations and educational records.
  • Assessment of speech fluency (e.g., frequency, type, and duration of disfluencies), speech rate, speech intelligibility, and the presence of secondary behaviors in a variety of speaking tasks (e.g., conversational and narrative contexts).
  • Assessment of awareness in young children of disfluencies and difficulty in speaking.
  • Stimulability testing (e.g., person is asked to increase pausing and/or decrease speech rate in some other way)—a reduction of overall speech rate typically helps in reducing cluttering symptoms.
  • Assessment of the impact of stuttering or cluttering—including assessment of the emotional, cognitive, and attitudinal impact of disfluency.
  • Assessment of other communication dimensions, including speech sound production, receptive and expressive language, pragmatic language, voice, hearing, and oral–motor function/structure.
  • Determination of individual strengths and coping strategies.



Our Resources for Evaluating Stuttering:

Overview of Speech Therapy for Cluttering – Webinar 

This one-hour webinar recording will cover the basics of how to identify cluttering and how to treat it.

Suggested Goals:

The results of the assessment process should help guide what you will target in therapy.  Here are some goals that may need to be addressed in children with this condition.  You can click on one of the goals below to learn more.  Or, scroll down to the therapy section for more in-depth resources and support for treating this condition.


Here are some more resources and information that may help you when it comes to treating this condition.

Overview of Speech Therapy for Cluttering – Webinar 

This one-hour webinar recording will cover the basics of how to identify cluttering and how to treat it.

Cluttering, Phonology, and Dyspraxia Together

This short video gives an answer to a member’s question about what to do for a client who has cluttering, phonological processes, and dyspraxia.

Speeding Ticket Printable

Need a way to slow down a child who clutters?  Try these printable speeding tickets!

Overview of How Breathing Exercises Work into Fluency Therapy

This short video will explain how breathing exercises can be an important part of fluency therapy.

Generalizing Fluency Strategies Outside the Therapy Room

A short video with extra ideas and tips for those children who can use the strategies during therapy but are struggling to generalize them outside the therapy room.

Children Who Use “Like” and “Um” Too Much

This short video shows how children who use filler words, such as “like” and “um”, may be experiencing cluttering as well.

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Resources, Tools, and Training for Speech-Language Professionals

*** The SLP Solution is for informational and educational purposes only and does not provide medical or psychological advice.  We provide general resources but cannot tell you exactly what should be done for a specific client.  Every client is different and your clinical judgement should be used when making decisions about specific individuals.


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