Cluttering is a fluency disorder marked by an abnormally rapid and/or irregular rate of speech, often accompanied by disorganized language formulation and reduced intelligibility. Speakers who clutter produce excessive speech dysfluencies that are not typical of stuttering (e.g. mazes, filler words, word and phrase repetitions), and they frequently omit or slur sounds in longer words.
Unlike stuttering, cluttering is characterized by a lack of awareness of the speech disruptions; the speaker’s thoughts are intact, but their verbal expression becomes tangential or jumbled as utterances progress. Because of these rate and clarity issues, listeners may have difficulty understanding cluttered speech, especially as the individual talks in spurts or accelerates mid-utterance. Diagnosis is typically made by a speech-language pathologist (SLP) in adolescence or adulthood, since cluttering often isn’t recognized until a person’s rapid, unorganized speech hinders effective communication in academic, social, or work settings.
1. Genetic Predispositions: Evidence suggests a hereditary component in cluttering, with familial speech-language patterns often noted. For example, studies have shown that approximately half of young males with Fragile X syndrome meet cluttering criteria, indicating that specific gene mutations may elevate risk.
2. Neurological Factors: Cluttering is associated with atypical development in brain regions responsible for speech timing and coordination, such as the basal ganglia and prefrontal cortex. These differences are congenital and affect the smooth integration of linguistic and motor processes, even in the absence of focal brain lesions.
3. Developmental and Co-Occurring Conditions: Cluttering often coexists with other developmental disorders like ADHD, learning disabilities, or stuttering. These comorbidities suggest overlapping disruptions in attention, executive functioning, and language organization, which may contribute to cluttered speech patterns.
For speech-language pathologists, recognizing cluttering is crucial because it requires different management than stuttering or other fluency issues. Clinically, an SLP will assess a suspected clutterer’s speaking rate, fluency patterns, and clarity of speech across tasks (such as spontaneous speech vs. reading) to confirm the characteristic profile of normal speech starting out, devolving into rapid, unintelligible output. Treatment focuses on improving the speaker’s self-monitoring and control of speech rate.
Techniques like deliberate pausing, pacing (e.g. tapping or using a metronome), and over-articulation are employed to help the person insert appropriate pauses and pronounce all sounds in words. Increasing the client’s awareness of their communication is often a first step – for instance, playing recorded samples of their cluttered speech or teaching them to signal each word boundary with a hand movement can highlight where rate reduction is needed. With consistent intervention, people who clutter can significantly improve their understandability and communication effectiveness, though they must continue to apply strategies in daily speaking situations.
Bangert, K., Scott, K. S., Adams, C., et al. “Cluttering in the Speech of Young Men With Fragile X Syndrome.” Journal of Speech, Language, and Hearing Research 65, no. 3 (2022): 954–969.
Ward, D., Connally, E. L., Pliatsikas, C., et al. “The Neurological Underpinnings of Cluttering: Some Initial Findings.” Journal of Fluency Disorders 43 (2015): 1–16.
St. Louis, K. O., Myers, F. L., Bakker, K., & Raphael, L. J. “Understanding and Treating Cluttering.” In Stuttering and Related Disorders of Fluency, 3rd ed., edited by E. G. Conture & R. F. Curlee, 297–325. New York: Thieme, (2007).
