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Childhood Cluttering and Stuttering

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Definition

Cluttering

Cluttering is a fluency disorder, meaning it affects the smooth flow of speech. speakers who clutter tend to produce interjections, revisions, and “false starts” (i.e.,

abandoned segments of speech) more often than other types of disfluency, and the frequency of these disfluency types may be greater than what is observed in the general population. Thus, the disfluency pattern seen in cluttering is, in a sense, the inverse of the pattern seen in stuttering.

Key Characteristics:
  • Rapid and/or Irregular Speech Rate: People with cluttering often speak very quickly or with an uneven rhythm.
  • Excessive Disfluencies: They may exhibit a high number of disfluencies, which are disruptions in the flow of speech, that are not typical of stuttering.
Other Potential Symptoms:
  • Language or phonological errors (difficulty with word order or sound production)
  • Attention difficulties
  • Poor self-awareness of their speech problems
  • Difficulty organizing thoughts and/or expressing them clearly
 Stuttering

 Stuttering is defined as a disorder in the rhythm of speech in which the individual knows precisely what he wishes to say but at the same time he is unable to say it because of involuntary repetition, prolongation, cessation of sound.

Core behaviors:-
  • REPETITIONS:-Repetitions of sounds, syllables, and monosyllabic words. (e.g., “Look at the b-b-baby,”)
  • PROLONGATIONS:-Prolongations of consonants when it isn’t for emphasis (e.g.“Ssssssssometime we stay home”)
  • BLOCKS:- inaudible or silent fixation or inability to initiate sounds
OTHER BEHAVIOURS
Secondary behaviours

●       Interjections

●       Silent pauses

●       Broken words

●       Incomplete phrases

●       Revision

●       Hesitation

●       Dysrhythmic phonation

 

●       Escape:-eye blinks,

head nods, or interjections of extra sounds such as “uh.

●       Avoidance:-change words, pause, postponements, starters, and timing devices, e.g.,) hand movements timed to saying the word) all of this to prevent a stutter from occurring

Key Signs and Symptoms:

  • Visible gap or split: A noticeable gap or split in the upper lip and/or palate.
  • Feeding difficulties: Difficulty with feeding, including latching and sucking.
  • Speech difficulties: Difficulty with speech, including articulation and pronunciation.
  • Hearing difficulties: Difficulty with hearing, including frequent ear infections.

CAUSES

 Stuttering:-
  • Genetics: Stuttering tends to run in families, suggesting a genetic component.
  • Brain Differences: Some research indicates that people who stutter may have subtle differences in brain structure or function related to speech and language.
  • Neurophysiological Factors: Stuttering may involve issues with the coordination of muscles used for speaking.
  • Environmental Factors: Stress, anxiety, and fast-paced lifestyles can exacerbate stuttering.
  • Developmental Factors: Stuttering often emerges during childhood as children develop their speech and language skills.
Types of Stuttering:

Developmental Stuttering: The most common type, typically beginning in childhood.

Neurogenic Stuttering: Caused by damage to the central nervous system.

Psychogenic Stuttering: This may result from psychological disorders or trauma.

 Cluttering
  • Genetics: Some evidence suggests a genetic component to cluttering, but more research is needed.
  • Neurological Factors: Preliminary findings indicate differences in brain activity in individuals with cluttering, but further research is needed.
  • Language Development: Language planning disturbances may contribute to the symptoms of cluttering.
  • Environmental Factors: Stress, anxiety, and fast-paced lifestyles can exacerbate cluttering.
  • Developmental Factors: Cluttering can occur alongside other developmental conditions, such as ADHD or autism.
  • Other Conditions: Cluttering can be associated with auditory processing disorders, learning disabilities, and Tourette syndrome.
ASSESSMENT

In Speech-sy’s, the assessment for Stuttering like this by taking:-

  • Case history:- asking about the current concerns,awareness of the child about stuttering, Stuttering across individual,gender, emotions, language
  • Oral peripheral mechanism examination
  • Language assessment (receptive and expressive language)
  • Speech profile :- assessing speech subsystems(respiration, phonation, articulation, resonance)
  • Fluency profile:-stuttering and cluttering across situations,gender,emotions, language and type of context the moment Stuttering.
  • Dysfluency profile:- assessing core behaviours, secondary and other behaviours, feelings and attitudes of the child
  • Rate of speech
  • Standardized test tools :- SPI,SSI -IV,CPI,DSM-V etc.ised to assess presence and severity.
  • All these are assessed using audio and video recordings of the child being doing carious tasks(story telling, reading conversation).
MANAGEMENT
Speech-sy’s therapy approach for :-
Stuttering
  • Fluency Shaping: Techniques like slowing down speech, using easy onsets (smoothly starting sounds), and practicing pausing and phrasing can help improve fluency.
  • Stuttering Modification: Techniques like cancellations (pausing after a stutter), pull-outs (modifying the stutter in progress), and preparatory sets (anticipating and preparing for potential stutters) are used to manage stuttering.
  • Addressing Anxiety and Stress: proper counseling can help individuals manage the anxiety and emotional challenges associated with stuttering.
  • Parent-Child Interaction: For children, parents can be trained to use strategies that support their child’s speech and create a supportive environment.
  • Electronic Devices: Devices that provide delayed auditory feedback or mimic speech patterns can be used to improve fluency.
 Cluttering
  • Slowing Down Speech: Techniques to reduce the rapid speech rate, such as stretching words or sounds, can help improve clarity and fluency.
  • Pausing and Phrasing: Inserting pauses at natural points in speech and emphasizing syllables can improve speech flow and organization.
  • Self-Monitoring: Learning to recognize cluttering behaviors and patterns is crucial for managing the disorder.
  • Delayed Auditory Feedback (DAF): Using DAF devices can help individuals become more aware of their speech rate and encourage slower, more controlled speech. (Eg:- DAF Jammer)
  • Improving Language Organization: Techniques to help individuals structure their thoughts and sentences more clearly can improve overall communication.
OUTCOMES

Speech-sy’s help the individual with Stuttering by:-

  • Reduced Stuttering Severity:
  • Improved Communication Skills:
  • Reduced Negative Impact:
  • Increased Self-Awareness:
  • Avoidance Reduction:

 Speech-sy’s help the individual with cluttering by:-

  • Improved Speech Rate and Clarity
  • Enhanced Self-Regulation
  • Improved Conversational Skills
  • Increased Awareness of Communication Breakdowns
  • Increased Pausing

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