Cluttering
Hello professionals,
What are your thoughts on cluttering being labeled as the “Orphan of Speech Language Pathology?”
Research has shown that cluttering is actually more prevalent than we think.
Why do you think we unaware of its incidence?
What a great question, and a difficult one to answer. I agree that it is probably more common than we realize, and there are several possible reasons for this. First of all, unlike stutterers, clutterers are often unaware that they clutter, most likely due to neurological reasons related to the dopaminergic system. This is similar to the “sensory calibration” issues that Parkinson’s patients exhibit, wherein they have difficulty perceiving how low their vocal loudness is.
Also, some of my research has suggested that some listeners mislabel “fast talking” as cluttering or vice versa, as rapid speech is usually a component of definitions of cluttering. Speaking of which, our field can’t seem to agree on a definition of cluttering, which doesn’t help the issue. Lastly, cluttering has not been featured in film and T.V. nearly to the extent that stuttering has. In the International Cluttering Association, we are working to increase public awareness of cluttering, which is sorely needed. Obviously, there is much work to be done related to this fascinating disorder. Thanks for the question!
Dear Jennifer,
I don’t believe most people would regard cluttering as the “orphan” anymore. It was so designated by Deso Weiss in 1964 and than later by David Daly. Cluttering, as you indicate, is clearly on the fluency disorders “map” now.
In my view, we are unaware of cluttering’s incidence and prevalence because sufficient careful epidemiological studies have not yet been done. I was involved in a few plans to carry out some preliminary studies, but to date they have not been completed. Hopefully, someone will take on this important task.
I was involved in two studies that explored attitude toward cluttering (and stuttering) that also involved respondents’ indicating how many clutterers, stutterers, and clutterer-stutterers they knew. From a JFD publication in 2014, we wrote, “From these comparisons, it is reasonable to conclude that, when provided a lay definition of cluttering, one-third to one-half of adults can identify at least one person they know who clutters. Moreover, they clearly can differentiate such known individuals from others known to stutter and, also can likely differentiate them from a few known people who clutter and stutter. Together with the earlier results, these results are robust for different countries, cultures, and languages (regardless of traditional, new, or coined words for “cluttering.””
Steen Fibiger and colleagues in Denmark has done some preliminary epidemiology of cluttering (although the individuals involved may have included persons who might not be diagnosed as cluttering. Their heritability estimates were:
1. Cluttering: .53/.65 M/F
2. Stuttering: .78/.80 M/F
3. Childhood speech disorders: .71/.87 M/F
Perhaps this begins to address your important question.
Ken
Hi.
Thanks for your question! I agree with Dr. St. Louis that the orphan status may be fading due to increased awareness movements. However, even though many more have now heard of cluttering, there is so much more that needs to be investigated about cluttering. Including prevalence and incidence. Before that step, however, we need to firm up evidence supporting an accepted definition of cluttering. That is our first step. We are progressing, but much work is ahead of us! By using a tighter definition of cluttering, we can be more sure that those we believe are diagnosed with cluttering in our studies truly are people with cluttering.
Yes, and luckily; I totally agree with previous statements above that cluttering is NOT defined as an orphan any more; thanks to individual professional work (articles, books, public interviews etc.), the very important and worldwide collaboration within the ICA (the International Cluttering Association), and collaboration with other international and national organizations (ref IFA2018 in Hiroshima). I assume that the level of cluttering awareness is differing in different countries. Nevertheless, even though cluttering is well-known for the the majority of the SLPs, the knowledge of cluttering still remains limited among the general population, as already stated. Several initiatives have been introduced to address this. For example, by including cluttering in the name of the Norwegian Stuttering and Cluttering Association, we believe that cluttering have been even more visible in Norway. By well-driven work of the board in the association and close collaboration with the SLPs in Norway, I believe that cluttering is now a beloved “cluttering sister” to the solid and well-known “stuttering brother”(for more information; see ICA’s Newsletter, volume 7, issue 1).
Since the Norwegian population is only slightly above 5 millions in total, it was not realistic to build a national association exclusive to cluttering.
Regarding definitions; I support my colleagues’ statement above that a common definition will help for increasing awareness or consciousness even more. There is ongoing collaborative work in the ICA (chaired by Florence Myers), which might bring us closer to a joint and new cluttering definition. Anyhow, in my work so far, I have had great support by using the working definition of St. Louis and colleagues (Lowest common denominator, LCD definition), but I am looking forward to know more about how this work is proceeding:-).
Even though we need more information on cluttering prevalence in different populations; we do have access to information/research which tell that there probably is at least just as many people with cluttering as people with stuttering. Hence, I think that the research can be even more improved when we have access to a more specific definition, and if we are more clear about what kind of people in the cohort/population we are actually evaluating.
At last; just a comment regarding sex ratio. So far in my clinical work and research related to cluttering, I have had nearly just as many females than males who are cluttering. I am therefore tempted to believe that this is not only a coincidence, and that the ratio of females to males is therefore much closer to 1:1 than previously believed. This information might be in opposite to the information we find in the cluttering literature, but it would be interesting to know others’ reflections upon this. This comment was much longer than I planned to, but hopefully it can address some of the questions which still exist regarding cluttering, and that it can be one contribution to a continuing dialogue.