Cluttering (also called tachyphemia) is a speech disorder and a communication disorder characterized by speech that is difficult for listeners to understand due to rapid speaking rate, erratic rhythm, poor syntax or grammar, and words or groups of words unrelated to the sentence. Cluttering has in the past been viewed as a fluency disorder


ymptoms such as language or phonological errors and attention deficits. To identify cluttering, you must listen to nonstuttered speech of the speaker. Evidence for a fluency disorder (one that is not stuttering) and excessive disfluencies, would be present in a speaker who meets all of the following: * Does not sound "fluent," that is, does not seem to be clear about what he or she wants to say or how to say it. * Has excessive levels of "normal disfluencies," such as interjections and revisions. * Has little or no apparent physical struggle in speaking. * Has few if any accessory (secondary) behaviors.


Before getting treatment, it is important that someone suspected of cluttering be diagnosed accurately. It is advisable to consult a speech-language pathologist to make the diagnosis. The assessment process is often quite extensive and may require two or more sessions. It may also require contributions or reports from other professionals, such as classroom teachers, special educators, psychologists, or (possibly) neuro-psychologists. The evaluation should obviously include consideration of the fluency problem, but also any co-existing oral-motor, language, pronunciation, learning, or social problems. If the suspected clutterer is in school, it may be a good idea to get a comprehensive academic achievement test (e.g., mathe-matics, writing, and reading) and even an intelligence test. The diagnosis should specify whether or not cluttering is present and also what other problems are present, such as stuttering, a language disorder, or a learning disability. It is important to note that if a stutterer also clutters, sometimes the cluttering will not be noticed until the stuttering diminishes, either on its own or from speech therapy.


Because clutterers have poor awareness of their disorder, they may be indifferent or even hostile to speech-language pathologists. Treatment for cluttering usually takes longer than stuttering treatment. Delayed auditory feedback (DAF) is usually used to produce a more deliberate, exaggerated oral-motor response pattern. Other treatment components include improving narrative structure with story-telling picture books, turn-taking practice, pausing practice, and language therapy.