I work with a 9 year-old girl who has a diagnosis of ADD and global dyspraxia. She displays a severe language disorder affecting her receptive and expressive skills at all levels. Her main area of strength are her receptive and expressive vocabulary (but not semantic) skills. Her intelligibility is low due to a rapid rate of speech, phonological simplifications such as final consonant omission (especially in final blends), syllable reduction, assimilation + metathesis. She also leaves out little words, and displays many revisions and hesitations, often producing words with phonological transformations or that are semantic substitutions. Her language is often confused and disorganized. She also has severe difficulties with reading and writing, as well as dyscalculia (I’ve been working on conservation of quantity).

A year ago, I diagnosed moderate verbal dyspraxia because she found it easier to name images automatically/in sentence completion tasks than in repetition tasks, and had specific difficulties with sequencing sounds in complex words. She also demonstrated difficulties with sequencing oral-motor movements. Over the course of the past year, she has made good progress in slowing down her pace and improving the production of complex words. This has helped me to realize that she has many of the symptoms of cluttering.

My question is – can cluttering also exist in parallel with a phonological disorder and verbal dyspraxia or was I just not properly interpreting symptoms?

My Thoughts:

• Cluttering can and often does come along with other conditions.
• Verbal dyspraxia can and often does come along with global dyspraxia.
• ADD and cluttering often go together.
• There are ALWAYS kids who don’t fit the mold, especially when neurological conditions are at play.
• It may not be possible to completely tease out exactly what conditions are affecting her.  Treat the symptoms, modify based on what’s working and what’s not working in therapy.