Chair of Health Care & Technology for Quality of Life

Cluttering, stuttering, reading and writing

Dr. Yvonne van Zaalen

Fontys University of Applied Sciences,

Institute of Allied Health Professions

Chair of Health Care & Technology for Quality of Life

Cluttering is a fluency disorder characterized

by a rate that is perceived to be

abnormally rapid, irregular or both for the

speaker (although measured syllable rates

may not exceed normal limits). These rate

abnormalities further are manifest in one

or more of the following symptoms:

Cluttering

……

a) an excessive number of disfluencies, the majority of which are not typical of people who stutter

b) the frequent placement of pauses and use of prosodic patterns that do not conform to syntactic and semantic constraints; and

c) inappropriate (usually excessive) degrees of coarticulation among sounds, especially in multisyllabic words.

(St. Louis et al, 2007).

Chair of Health Care & Technology for Quality of Life

Chair of Health Care & Technology for Quality of Life

• Cluttering is a disorder of speech fluency,

in which a person is not capable enough to

adjust his/her speech rate to the

syntactical or phonological demands of the

moment. (Van Zaalen, 2009)

Cluttering

Chair of Health Care & Technology for Quality of Life Main characteristics

A fast and or irregular articulatory rate

combined with:

a. A higher than normal frequency of normal

disfluencies and pausing errors (too short and

on linguistical wrong places)

b. Errors in word structures (syllable sequencing

errors, overcoarticulation).

Chair of Health Care & Technology for Quality of Life

Levelt, 1

989 languageproduction

Articulatory rate

Cluttering and stuttering

Chair of Health Care & Technology for Quality of Life

33-55% Cluttering-

stuttering

8-15% Cluttering

30% Stuttering

Chair of Health Care & Technology for Quality of Life

Levelt, 1

989 languageproduction

Stuttering

Cluttering

Speech and writing

Model

van Ellis

& Young

Video cluttering

Peter Kissagizlis †

• A sample of Peter’s handwriting,

(phonological cluttering):

A sample of Peter's "unguarded" typing, telling some of his personal story: I have had problems for many years, which started when I was at schol as far as I can remember, reading out in calss was one ot the problems, teacxhers would riducoue me for speaking funy, one wuol,d ay to me "speak ip

bioy don't mumble", felow puoils woueld taunt me, no one understod me properly, I msde freinds but don't nkwohow myana.

I woked hard, I was quiet, and fiound it hadr to tlak to people about some thisnhgs, adn this has hapend al mylife and has held up my ecducation and employemnt. Even wehn I statred work people used to taunt me becasue

I taklekd funny! I wa sbulied at scgol and at work, no one seemded to care. Life was so frustrating and intimidating, I had no idea that I had a porblem tlike \I know today, if I as awatre of tnis and the teacjhers ot mypartent had adddressed this, i could myabwe had some help, hmmm, maybe not, no one knwe about clutering in

those days, but it oculd have ben found that I had a comunication pronb;lem. I have treid al my life to please peole, I was told thaty I would never do any god in life and I tried to probve

evrybody worng, I ewnt into busines in the 1970's and I struggeld to hold run a business sucsesfuly, I was notharfd enought to condunt a bisusiness proplery, nad fater mnay eyars I had to amdnit defeat, I packed it al up

and went back to working fro zomseone else. At least I got pasid on a Friday every week. Whne working in the garages I was a motoer vehicle techniician and was god at my job, it would have been

goukd ofr promotion, but each time I apliead for poromotion I was told dthat my spech was not suiyatbale forspeaing to customomers and for teh many aplications I made in fiddefernt companies thaye gave me the sdame

story. After years of feeling insecure, differnt, isolated and excluded, I know Kknow the comndition I have, which is

clutteroimng, although it is not cured and nebver can be as fra as I am aware, at lwast I am aware of the conditini aadn people wil learn from tihs, and poepke who sufer as I do wil be able t undrestand what they ahve, the amin thinsg is, peiopokle worlkd wide awil be able to reecognise the condition and maybe the ptofessionals

can impement a suitable treainhg/teacjhing athen evebntaualy a treatment regime. Ok, nuffs. enough! eh? the above sentences were typed as I type, I have made no attempt to delibertaly slow

down or edit the text, this sentence is deliberately typed slow (waht a difficult job!) and aslo I have edited someof it, as even when typing slowly, I make mistakes.

Writing, syntactical cluttering

Man, 34 jr, MBO, 7:36 min

Writing, stuttering

• Man,

36 jr,

MBO, 1:50 min

Boy, 9;6 yrs, cluttering

Writing

• Handwriting Speech rate

• Sentence structure Spontaneous

Retelling

Writing

Reading development

Fonemic awareness

Sound- letter-association

Correct and fast reading

Reading strategies

Fluent reading

Understanding reading

Monitoring

Did I read what I wanted to read?

necessary:

• AC

• Auditory skills

• Lexicon

….

Heightened audition

• Defstut / speech easy DAF/FAF/AAF

• AC => speech

R., cluttering-stuttering

• Without auditory feedback:

• With auditory feedback (wispher phone):

5 minutes later

without therapy

Cluttering and reading

• Errors in or omission of small words

• Fast and/or irregulare rate

• Prosodic errors

• Telescoping

• /b/ - /d/ substitutions

• Guessed reading

• Error rate reduces in slow speech

• HAF positive effect

Stuttering and reading

• Sound or word fear influences stuttering

severity

• Outside time limitations

• Errors: type and number normal

• Benefit from whispered or coral reading

• Negative response to HAF