Cluttering Treatment: Theoretical Considerations and Intervention Planning

This article presents a variety of treatment approaches based on an understanding of four components of communication, and describes cluttering intervention focusing on problem identification, speech rate reduction, appropriate pausing, appropriate monitoring, and addressing story narrating skills. Therapeutic considerations, taking into account the specific characteristics of cluttering, will also be presented. Finally, building clients’ confidence, emotional skills, and sense of accomplishment will turn the therapeutic process into awareness of realistic expectations and motivation to pursue challenging goals. Cluttering is a disorder of speech fluency in which people are not capable of adequately adjusting their speech rate to the syntactical or phonological demands of the moment (van Zaalen, 2009). When language production is relatively easy, people with cluttering (PWC) are capable of producing fluent and intelligible speech. When language production demands are more complex, the speech rate should be adjusted to the language complexity. PWC tend to have difficulties doing so. This reduced ability of PWC to control their speech rate results in either a higher than normal frequency of disfluencies or multiple speech errors. This article presents various intervention approaches based on an understanding of four components of communication: cognitive, emotional, verbal-motor, and communicative. The article focuses on problem identification, speech rate reduction, appropriate pausing, and addressing monitoring and story narrating skills. Therapeutic considerations, taking into account the specific characteristics of cluttering, will also be presented