Cluttering overview

These web pages provide information for the public about cluttering in children, young people and adults. The views of people with lived experience of cluttering have been sought and used when writing them.

You may previously have heard ‘cluttering’ or ‘stammering’ referred to as ‘stuttering’ or ‘dysfluency’

You may also be interested in our overview of Stammering

For clinical level information on Cluttering and Stammering, see our Clinical Guidance

 

What is cluttering?

 

Research about cluttering is limited, which means there are still aspects of it that we are yet to find out about. However, we know that cluttering is linked to the ways brains function. This neurological variation or neurodivergence means that individuals who clutter may organise their ideas and the words they say in a different way and sometimes may speak at a faster speed. This faster rate may make speech less clear as syllables or words may run into each other. People who clutter may not be able to adjust their rate of speech. Cluttering varies across time and speaking situations. Individuals who clutter may also:

  • pause in unusual places
  • use lots of filler words such as “like”, “um”, “and”
  • have difficulty in telling a story about something that has happened, losing the thread of what they are trying to convey and having to stop and start again
  • make some errors with words such as saying “Saturday” when meaning Sunday”
  • have some difficulty sticking to the topic of conversation or making clear when they are changing topic.

Cluttering starts in childhood but is not usually diagnosed until children are at least 8 years old. During the early years, it can be hard to differentiate cluttering from typical speech and language development. Cluttering becomes more apparent at this age as children are using more complex language and more sophisticated vocabulary.

How are people affected by cluttering?

People who clutter typically do not notice that they are speaking quickly. However, they may realise that the listener is not able to understand them and this can lead to them feeling frustrated, anxious or upset.

Cluttering and other differences

Cluttering may be the only presenting difference someone is experiencing. However, this is quite rare. Typically, cluttering presents alongside one or more of the following:

  • stammering
  • dyslexia
  • dyspraxia
  • ADHD
  • developmental language disorder
  • autism

How can speech and language therapy help?

 

What is speech and language therapy?

Speech and language therapists provide support, therapy and care for people of all ages who are experiencing difficulties resulting from speech, language or communication, differences. SLTs often work in the public sector or independent practice and in a range of settings such as schools, clinics and hospitals. Many therapists who work in private practice are also members of the Association of Speech and Language Therapists in Independent Practice.

All speech and language therapists must be registered with the Health and Care Professions Council. This registration ensures they adhere to established codes of ethics and practice, guaranteeing that the services they provide are safe and of high quality.

The ways speech and language therapy is provided may differ across the four nations of the UK. However, the overall aim remains the same: to support people who clutter to live fulfilling lives.

 

How do speech and language therapists support people who clutter?

Speech and language therapists play a key role in supporting children, young people and adults who clutter. Using specialist skills, they work directly with the individual client and with others in their life to ensure that the speaking environment is as supportive as possible. For children this involves working with parents, carers and school. Speech and language therapists support young people and adults to be able to understand more about cluttering and what is happening when they talk and to be able to advocate for themselves. Therapy can include using strategies to increase speech intelligibility. These strategies can be effortful and may only be used some of the time.

 

What to expect from speech and language therapy

Referral / Requests for assistance is when someone wishes to seek support and advice for a child, young person or adult as there is concern about how their speech, language or communication is affecting their everyday life.

 

You can access speech and language therapy in the following ways:

For children

  • A referral / request for assistance by a Health professional including GP or Health Visitor
  • A referral / request for assistance by nursery or school
  • A direct referral / request for assistance by the parent to the local speech and language therapy service may be possible
  • Parents can ask school to make referral/ request for assistance
  • Direct contact with a private speech and language therapist to request assistance

For young people

  • A referral / request for assistance by a GP or by the school
  • Parents can ask the school to make a referral / request for assistance
  • A direct referral / request for assistance by the parent to the local speech and language therapy service may be possible
  • Direct contact with a private speech and language therapist to request assistance

For adults

  • A referral by your GP
  • A self-referral to the local speech and language therapy service
  • Direct contact with a private speech and language therapist to request assistance

What happens next?

When someone who clutters has been referred to speech and language therapy, they should expect confirmation that the referral has been received and that:

  • The referral has not been accepted and a referral needs to be made to another service

OR

  • The referral has been accepted

The waiting time for assessment will be confirmed. You will be offered some general advice while you are waiting and be given information about other organisations that can offer support.

Assessment

Speech and language therapists assess the needs of children, young people and adults who clutter. This involves gathering background information about the client and their speech as well as listening to how they are communicating.

In collaborative discussion with the adult client or parent and child, the speech and language therapist establishes if support for cluttering is the individual’s main need. When it is, the speech and language therapist will offer information and guidance to help clients understand more about cluttering and the things that may help or not. The therapist will ask the client about their best hopes for therapy and discuss realistic expectations. They will also signpost people to other available support and opportunities to be a part of the cluttering community.

 

Therapy

The SLT will explain the different options for therapy and support the client to select the best option for their needs and preferences. These options will be based on what research has shown to be an effective therapy or on information that has been gathered by SLTs through their practice. The SLT will explain what the realistic/ outcome of this therapy will be and how many therapy sessions will be offered. Enough sessions should be offered to ensure that the therapy is effective.

Therapy for cluttering

For people who clutter, research suggests the main areas in therapy are:

  • understanding cluttering and own speech patterns
  • informing others in regular communication environments
  • self-advocacy skills
  • practising putting pauses in speech to slow it down overall, make it easier to understand and to give more time to organise what is being said
  • working on awareness of speech and awareness of listener reactions to make it easier to recognise when speech is not easy to understand
  • recognising when speech is too fast
  • working on organising how and when things are said to make speech easier for others to follow and understand

Advice

As part of their role, SLTs can offer general advice about cluttering. This includes giving advice to:

  • parents about how to support their child whilst they are waiting for an appointment
  • other professionals (e.g. GP, Health Visitor, teacher) about whether to refer to speech and language therapy
  • school and nursery staff about how to create a cluttering friendly environment
  • schools, colleges and universities about seeking reasonable adjustments for certain activities such as oral exams and presentation assessments
  • people who clutter about how to find organisations such as charities that offer support and community

Training

Speech and language therapists can provide training about cluttering to ensure the creation of a supportive speaking environments. This training can be offered to:

  • school staff
  • health professionals
  • employers

Information for health professionals including GPs and health visitors

 

Health professionals including general practitioners and health visitors play a vital role in referring children, young people and adults to speech and language therapy. Delayed referral can have negative impact on therapy outcomes and the individual’s emotional wellbeing. Cluttering is highly variable and so you may not necessarily hear a representative sample of an individual’s overall speech when you speak to them.  If this is the case, it is important to still make a referral / request for assistance, based on the information someone shares about the difficulties they are experiencing related to their speech.

Referral is required when:

  • a child is cluttering beyond the age of 7 or 8 years old as it may impact on their communication, learning and social interaction
  • cluttering is affecting daily life, employment or social relationships

 

NOTE: If cluttering is accompanied by other neurological symptoms (e.g. sudden onset, cognitive changes), consider further investigation for acquired causes.

Information for education professionals including early years practitioners, teachers, lecturers

 

Within the education setting, some speaking activities may be particularly challenging for students who clutter. There are several useful resources available to support students who clutter and education staff.

A referral to or request for assistance from speech and language therapy is indicated when:

  • cluttering is impacting learning or social interaction
  • the student is also experiencing anxiety or other mental health condition
  • the child, young person or adult is requesting support

NB: speech and language therapists can offer training to help you to support students who clutter.

Resources

 

RCSLT resources

 

Organisations and networks

These organisations provide support to people who clutter as well as opportunities to network.

International Cluttering Association

  • International organisation whose primary mission is to increase awareness and understanding of cluttering, and to improve treatment and quality of life for people who clutter.
  • Website: https://sites.google.com/view/icacluttering

 

STAMMA

  • This UK charity is primarily focused on stammering, but provides some limited information about cluttering, and people who clutter may find many of the resources for people who stammer are relevant and useful for them. Website: www.stamma.org
  • Freephone helpline: 0808 802 0002
  • Webchat service
  • Email support at help@stamma.org

 

Action for stammering children

  • This UK charity focuses on supporting children and young people and offers resources for SLTs, parents, and schools.
  • Website: actionforstammeringchildren.org

 

Specialist therapy organisations

The following organisations provide specialist therapy for people who clutter:

The Michael Palin Centre for Stammering

City Lit

  • This Adult Education college offers in person and online therapy courses for people 18+.
  • Website: ac.uk