on self-awareness. Most clutterers are unaware of their
repetitions, deletions, and transpositions. Audiotape and
videotape them to teach self monitoring. A patient but direct
clinician is needed.
Tachylalia is not obligatory for cluttering diagnosis, but it
is common. Instructions to “slow down" are worthless. Try
finger tapping to teach syllable stress. Model desired behavior.
Clinician must slow rate too.
Froeschels (1946) recommended
reading aloud one word at a time. Placing a cover sheet with a
hole over the page to reveal one word at a time is suggested to
help the clutterer focus.
articulation errors and dyslalia is common. We have used a delayed
feedback machine to help cluttering clients "over-articulate"
their slower rate of speech. Encourage client to "feel"
Poor memory abilities are common in
cluttering. Practice telling and retelling stories trying to
include more and more details. Use sequence picture cards if
necessary. Such abilities can be enhanced.
Relaxation and visual imagery
exercises may be useful for reducing impulsivity and
distractibility. Attention deficits are common. Auditory
comprehension activities found useful for learning disabled
students or aphasic adults may be most appropriate for cluttering
Some clutterers have motor
coordination, rhythm, and speech melody impairments. Exaggerating
various rhythmic patterns and speech prosodic patterns may be
helpful. E.g., some clutterers show very monotonus voice patterns
- vary their prosody - change the stress pattern. We use
exaggeration as auditory imperceptiveness is usually present.
and writing difficulties are typical. Authorities recommend
teaching cursive writing not printing. Help clients write a
one paragraph story. Assistance may be needed to follow a
train of thought. Reinforce generously. Read and
discuss the "story." Then try for one page
story. Patience and persistence are needed.
Examination of written work will help clinicians understand the
clutterer's language confusion.