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From: Erika Shira
Date: 19 Oct 2008
Time: 12:50:06 -0500
Remote Name: 66.92.76.147
Oh, this is a great question. I don't actually know much about the neurological bases of cluttering, though I've certainly encountered many people who present with it. Can you tell me more about it? For instance, do you encounter it in people who seem otherwise neurologically typical, as is the case with stuttering? I've only encountered cluttering in people who I have eventually diagnosed with disorders that involve executive functioning, such as AD/HD, psychotic disorders, or PDD. With these folks, I usually will use techniques similar to what I described in the article, where we use as much of the brain as possible to try and sing in an organized and fluent fashion. But I've also done a lot of work around sequencing, self-regulation, self-awareness, etc. with these folks. At least based on the folks I've worked with, I find that people who stutter often have no other difficulties with rhythmic/organizational processes. People who I've seen who clutter usually have executive functioning issues across the board, for instance, not being able to break down the steps needed to complete a task, getting ahead of themselves and coming across as impulsive, difficulty with joint attention, etc. Does this seem pretty accurate to you in terms of all folks who clutter? As in, have I seen a fairly representative sample? [Paragraph goes here] With the folks I've seen who clutter, speech has tended to be more of a minor component of what we're addressing, though it's one of the things that improves with therapy. We've often done more instrument playing than singing, with the aim of addressing sequencing, self-awareness, listening to others, interacting reciprocally, etc. Oh, and certainly a lot of movement; I see one person who clutters whose entire repertoire of behavior seems to be characterized by these sorts of rapid bursts. We've worked on using stretching and slow breathing (with vocalization) as a means of self-soothing and calming his body down. When I first would model how to stretch our arms up high, he would raise his barely above shoulder height and would rapidly flap them up and down. He doesn't have any condition that prevents him from physically stretching his arms up all the way; I can stretch them for him quite easily. We've done a lot of yoga-type movements together with music and vocalization that have helped him to be more fluid in general. It's generalized to his speech as well as to some of his impulsive behaviors. Again, I don't know enough about cluttering to know whether a SLP would characterize him as "a clutterer" versus someone for whom it's part of a bigger picture, but his speech certainly fits the description of cluttered speech.