Cluttering Treatment: Theoretical Considerations and Intervention Planning

Abstract

This article presents a variety of treatment approaches based on an understanding of four components of communication, and describes cluttering intervention focusing on problem identification, speech rate reduction, appropriate pausing, appropriate monitoring, and addressing story narrating skills. Therapeutic considerations, taking into account the specific characteristics of cluttering, will also be presented. Finally, building clients' confidence, emotional skills, and sense of accomplishment will turn the therapeutic process into awareness of realistic expectations and motivation to pursue challenging goals.

Efeito da retroalimentação auditiva atrasada na fala e leitura de taquifêmicos

“…In the intergroup comparison of spontaneous speech, there were more differences in Non-Altered Auditory Feedback condition than in the delayed one (Tables 2). This result was already expected, once the main characteristic of cluttering is the increase in speech rate and the number of common disfluencies (2,6,7,8,9,10) . It is worth highlining that in the spontaneous speech under the DAF, the groups differed in the number of common disfluencies (Table 2).…”

“…In the description of the cluttering neurological foundations, a study concluded that the disorder may be explained by imbalance in the anterior cingulate cortex circuit and the supplementary motor area (5) . The main characteristics of cluttering are increased speech rate and excessive disfluencies (2,6,7,8,9,10) . Fast speech was reported both by studies that assessed speech rate (8,9) and compared it with normative standard (11) , as well as by reports of the own adults who clutter (1) .…”

“…The results showed that all participants had a fast speech complaint (1) . One of the most important goals in the cluttering treatment is to reduce the speech rate (10,12,13) and to reduce the excess of common disfluencies (12,13) . It is worth mentioning that the goal of reducing speech rate is also indicated to improve the broad spectrum of cluttering clinical manifestations (13) .…”

“…It is worth mentioning that the goal of reducing speech rate is also indicated to improve the broad spectrum of cluttering clinical manifestations (13) . A central aspect of cluttering therapy is speech monitoring (4,10,12) , which provides control of speech rate. In order to obtain this domain of oral production, the speaker uses auditory feedback (14) , which also assists in the maintenance of speech fluency (15) .…”

Diagnosing Cluttering

“…No large normative studies have been completed that reliably identify a specific number that defines “excessive” normal disfluencies and/or moments of over-coarticulation. In terms of abnormal pauses, two studies identified shorter mean pause duration in persons who cluttered (Rieber et al, 1972; van Zaaelen & Reichel, 2015). No work to date has been done examining the frequency of pauses in unexpected places in the speech of school-age children who clutter.…”