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Is there a gold standard for treating cluttering — 5 Comments

  1. Dr. Onslow,
    I have taken some medications that has been prescribed to me as for an “off label use.”
    I could see using some of the elements of a Lidcombe like regimen to be very useful. For example, the slowing speech rate… I could also recommend that the mother or other primary caretaker: 1) allocates at least one half-an-hour one on one time where there is no urgency and the little one can talk to her heart’s content; 2) any suggestions for change have to be preceded with at least four compliments on her speech or her effort to speak; 3) silences can be welcomed, not only impatiently tolerated; 4) the home environment be examined for pressures, like homework, mandatory tasks, etc.; 5) be on lookout for teasing and bullying; 6) sibling rivalry should be handled with most delicate, but firm and fair approaches; and in general 7) the speech should be accepted with grace, the child should be valued for who they are now…
    Maybe the use of term Lidcombe was superfluous and any well designed childhood speech disorder could benefit from the above suggestions. On the other hand, stuttering and cluttering are both fluency disorders and I would have assumed that at least some commonality exists…

  2. May I suggest you take a look at the International Cluttering Association site:
    http://associations.missouristate.edu/ica/

    Dr Yvonne Van Zaalen is the chair and a specialist on cluttering. I have no doubt she can tackle any query on cluttering with all the latest research on the area. Trust me 🙂
    regards
    Joseph Agius

  3. Gunars, The elements of Lidcombe that you suggest might be applied to a child who clutters are, for the most part, unlikely to be relevant. I agree with Mark’s comment that the Lidcombe program is appropriate as a treatment for children who stutter. Cluttering is similar to stuttering only in that fluency is disrupted. The disfluencies that may be present in children who clutter tend to be typical disfluencies as opposed to stuttering-like disfluencies. Joseph suggested that you look at the ICA website, which should give you a better understanding of cluttering. The focus in helping a person manage cluttering is more likely to be on increasing speech intelligibility through a variety of means that may include being sure to say words in their entirety, inclusion of all words in sentences, especially function words if they are deleted by the speaker, tolerating a slower rate of speaking, maintaining a regular rhythm of speaking with pauses in typical locations, keeping the voice going throughout a speaking turn, and so forth. With regard, Lynne

  4. I agree with Lynne. The current thinking regarding the theory behind why cluttering happens is that the speaker is speaking at a rate too fast for their system to handle, resulting in breakdowns in intelligibility and/or disfluencies (as Lynne mentions, typically of the non-stuttering type). Much of the work that has been successful with cluttering has been that focusing on self-regulation: i.e., watching your listener’s face to see when there is a communication breakdown, repairing that communication breakdown by either reducing your rate, emphasizing all sounds/syllables in your words, etc. The ICA site, as mentioned, is a great source of information on cluttering, as is the archives of the Online conference on cluttering that took place through this forum in 2010. Kathy Scaler Scott