J.D. is a 32-year-old male who exhibits characteristics of a person who clutters, including short attention span, inability to listen, and difficulties with syntax. The latter three characteristics, according to J.D., are not as evident as the symptoms of his speech output. He stated that although he does not remember the exact age of when his cluttering became evident, he noticed while looking back at old journals, his handwriting changed at approximately age nine (which showed similarities to a handwriting sample of a clutterer in Weiss' (1964) book). It was around that time when family problems arose, and his mother began to excessively control her children.
As a child, his mother was very adamant about specific syntax. He gave an apologizing example, where she demanded that he repeat verbatim "I'm sorry that I didn't take out the trash and that I threw the cat out the window." Even if the apology consisted the overall gist, thus missing a few words (e.g. "I'm sorry that I didn't take out the trash and that I threw the cat out."), he was still required to repeat the sentence as she stated it. Such demands may have caused much stress and anxiety on J.D. being able to use proper planning for speech output that he reportedly was not able to go through the developmental process of learning to pre-plan speech/language.
When asked what if feel like to clutter, his response went as follows:
"It feels like 1) about twenty thoughts explode on my mind all at once, and I need to express them all, 2) that when I'm trying to make a point, that I just remembered something that I as supposed to say, so the person can understand, and I need to interrupt myself to say something that I should have said before, and 3) that I need to constantly revise the sentences that I'm working on, to get it out right."
He mentioned a speech he gave recently, where he froze for approximately thirty seconds and was not able to say a word. As he mapped out his thought process later, he counted sixteen separate thoughts he was trying to keep in mind, though he normally tries to hold five to eight thoughts at once while speaking. He believes that such 'banks' could be a part of cluttering. He hypothesizes that fluent speakers hold only about two to three thoughts in their minds, before they simply "shut down, and do something about it." Although with J.D., there is no limit of thoughts, nothing is done about it, and therefore, he either freezes or begins to express all the thoughts at once. Therefore, one of his self-remediation techniques is to simply focus on one central theme as he speaks.
He used to avoid speaking with people who are 'power figures' or had status, talking on the phone, and also avoided speaking with people who would have difficulties understanding his speech, such as those who are hard of hearing, or those who do not understand English well (i.e. native speakers of another language). He prefers e-mail as the main mode of communicating/exchanging ideas, since he is able to revise easily. He stated that he probably would not be as functional without e-mail/computer access.
The interview process consisted of questions sent to him via email. J.D. acknowledged an interesting aspect of his cluttering and organization process. He mentioned how the majority of people would have most likely read and answered the questions one at a time, perhaps starting from easiest to most difficult, then proofreading and turning in the answers. However, he felt as if he was answering the questions by jumping from one to another, rewording and revising, changing answers, etc., simultaneously.
In addition, although clutterers don't exhibit escape or avoidance behaviors as stutterers do, he stated how at times when he becomes overwhelmed with the myriad of thoughts in his head, the conversational partner will usually notice his frustration, and move on to another topic. Such acts by other people, although perhaps done with good intentions, are not to his liking.
Since reading disabilities are corresponding symptoms of a clutterer, J.D. graduated from college by basically skimming textbooks, not exactly reading them and imbibing all the necessary information. He has excelled vocationally, with database development, and has voiced how such a career would be ideal for clutterers, since they learn organizational skills at a high level.
He was asked how his relationships with other people have been affected by his cluttering. To which he replied:
"I really have a hard time telling storiesŠI avoid telling stories, because I can't get them out rightŠI lack the organization to tell what happened yesterday, etc. My wife has a hard time with that because I never talk about how my day went at workŠI don't remember a sequence of events of what happened at workŠbut I spend time mulling over certain events or conversations that I think are significant."
While conversing, he prefers to ask questions rather than answer them, since questions are easier for him to produce fluently. Because of his preference to ask rather than answer, he has come across to many as cold and `interviewing.' He has also been mocked about his "deer in the headlights" reaction when asked a question, and tends to avoid those individuals who are less than understanding about his reaction, and contribute unnecessary opinions about his speech.
Keeping all this in mind, J.D. did not realize he cluttered until the age of twenty-six, when a college teacher brought to his attention that he had a speech disorder. This also coincides with one of the obligatory symptoms of cluttering; the "lack of (complete) awareness of the problem" (Daly, 1985). He then received speech therapy for about a year, which he did not find to be helpful.
His suggestions to me for therapy/remediation ideas included the following: integrating elements and pointers used in public speaking training and thespian voice lessons, allowing the client to either talk freely or read aloud out of picture books, and learning how to become comfortable with talking to other individuals. He believes that reducing speaking rate should not be the focus of therapy. Although clutterers do exhibit tachylalia, it should be kept in mind that it is a symptom, and not the cause of cluttering. Focusing on delivery of speech (which includes prosody and suprasegmentals), rather than speech rate would aid the clutterer to obtain fluent speech production. Another technique he suggested included the videotaping of clutterer while speaking. This would allow the client to observe his/her own production of speech, as well as note on the appropriate/inappropriate characteristics of their speech. The client would then be videotaped once more trying new techniques for improvement. This allows the clutterer to become self-aware of his/her speech, try new approaches, and have the Speech-Language Pathologist as a guide.
While conducting research for educational and personal purposes, I was quite surprised to find the lack of current research on this disorder. Even looking through databases, it was difficult to obtain a journal article published within the last five years containing helpful information on cluttering. Research must be imperative in order for future clinicians to be able to make educated and competent decisions about therapy techniques, should we encounter a client who clutters later on in our careers. This interview has allowed me to gain much more insight on the disorder than by simply reading the few pages in the textbook, as well as the required article about cluttering. The impact this disorder has on an individual's life varies, though I am grateful to have come across J.D., who has helped me become aware of the caliber of this disorder, and the overall lack of awareness most people have. Like stuttering, future research on cluttering should focus on possible etiologies and proven therapy techniques to allow the client to become a fluent speaker. The increase of awareness of cluttering should also be evident in schools, thus allowing the teachers to notice the characteristics easily, refer to an SLP, and have the child not fall through the cracks (since, reading and writing disabilities, and language difficulties are symptoms/characteristics of cluttering). J.D. has made some great strides to improve his speech and increase cluttering awareness. SLP's should equally aware that there are two forms of fluency disorders, and that cluttering, though not as prevalent, should not be ignored.
Daly, D.A. (1986). The clutterer. In K. O. St. Louis (Ed.), The atypical stutterer: Principles and practices of rehabilitation (pp. 155-192). Orlando, FL: Academic Press.
Weiss, D.A. (1964). Cluttering. Englewood Cliffs, NJ: Prentice-Hall.