2003 IFA Congress: Montreal, Canada

Diagnostic Criteria Of Determination Of Cluttering In School Children

Yulia 0. Filat Ova, Lidia I. Beliakova
Logopedia Department, Moscow State Pedagogical University, 38-3-406, Akademika Anohina St., Moscow 119602, Russia


The purpose of this study is to determine the diagnostic criteria of cluttering. We have tested 55 subjects between eight and sixteen years of age. We used adapted and modified Daly’s Checklist for Possible Cluttering. The test results have allowed us to divide the children into four groups: pure stuttering, a mixed form with a prevalence of stuttering, a mixed form with a prevalence of cluttering, and pure cluttering. The subjects with pure cluttering and the ones with the mixed form where cluttering dominated were studied more carefully. The results include characteristics of their oral speech, serial organisation of movements and sense of rhythm, intellectual processes and attention.

  1. Introduction
In preschool age children it is possible to observe a great number of types of dysfluency such as pauses, breathing iterations (multiple inhalations and exhalations before the child starts speaking and the same in the middle of a phrase), sound repetitions, part-word and whole word repetitions, revisions, blocking (not often)-. These types of dysfluency are a psychophysiological norm of maturation of speech and language mechanisms.

Research indicates a definite age dynamics of dysfluencies in children with a normal rate of speech development (Aslanova, 2001; Iele, 1995; Myers, 1998; Myers & Wall, 1981). The lack of age dynamics indicates deviation in maturation of the speech functional system. Another parameter of this deviation is a disorder of formation of speech breathing. In senior preschool age such children demonstrate a small volume of inhaled air, irrational using of exhalation, discoordination of exhalation during speech (Beliakova & D’yakoVa, 2000; Schischkova, 2001). Children with these symptoms of deviation in speech ontogenesis are at risk of becoming stutterers.

In Russian speech and language therapy practice a clinical differentiation of stutterers is adopted, including neurotic and pseudo—neurotic forms of disorder (Beliakova & D’yakoVa, 1998). Such clinical differentiation is conditioned by different pathogenetic mechanisms of disorder. Some clinical, pedagogical and psychological characteristics of two forms of stuttering are shown in Table 1.

Some researchers suppose that pseudo—neurotic form of stuttering is not homogeneous (Beliakova, 1998; Leonova, 1995). We analyzed the foreign literature on the problem of cluttering and set up a hypothesis that some persons with pseudo—neurotic form of stuttering besides stuttering have symptoms of cluttering.


Table 1. Clinical, pedagogical and psychological characteristics of neurotic and pseudo-neurotic forms of stuttering.

  1. Method
This research was carried out in unique special boarding school for stuttering children and consisted of several stages.

At the first stage on the basis of the medical and pedagogical documentation the group of children with pseudo-neurotic form of stuttering was selected (55 subjects, aged between 8 and 16). The wide age range was selected for a number of reasons. Firstly, cluttering as an inborn form of pathology may be found in the primary school; secondly, in senior school age in such educational establishment the stuttering may be overcome, revealing the symptoms of cluttering. Moreover, in this age the tempo—rhythmic organisation of speech finally take shape.

At the second stage we tested this group of children using adapted and modified Daly’s Checklist for Possible Cluttering (Daley & Burnett, 1996). According to the test results, we have divided 55 children into four subgroups:
  1. pure stuttering - 26 subjects (47 %);
  2. mixed form of disorder with prevalence of stuttering - 18 subjects (33 %);
  3. mixed form of disorder with prevalence of cluttering — 7 subjects (13 %);
  4. pure cluttering — 4 subjects (7 %).
Figure 1 shows the quantitative data of testing results.


Figure 1. Testing results.

Using the adapted and modified Daly’s Checklist for Possible Cluttering allowed us to consider the group of children with pseudo—neurotic form of stuttering heterogeneous and consisting of 4 subgroups: persons with pure stuttering; persons with stuttering and some characteristics of cluttering; persons with cluttering, complicated by stuttering and ones with pure cluttering.

Subjects of III and IV subgroups made up the experimental group (see in appendix the examples of completed checklists for possible cluttering).

At the third stage persons with pure cluttering and ones with mixed form where cluttering was dominant (experimental group) were studied more carefully.

We have tested zheir family history, their oral speech, serial organization of movements and sense of rhythm, intellectual processes and attention.

  1. Results
Subjects with pseudo—neurotic form of stuttering and ones with cluttering have a number of similar characteristics. These are:
  • slight speech and psychomotor delay of formation in childhood;
  • low level of tempo-rhythrnical organization of movements development and speech development;
  • peculiarities in oral speech such as different kinds of repetitions and language disorders (programming of utterance).
Along with similarities there are a number of differences.

First of all, in case of cluttering a speech disinhibition, verbalization of activities are registrated. Persons with stuttering, on the contrary, limit their speech contact using monosyllabic and stereotype words and constructions, not to verbalize their actions, hardly combine actions with speech.

Persons with cluttering have disturbances in attention and memory; their thought processes have no expressed deviations. Children with cluttering are busily sociable, not critical both their speech and their "actions. The disinhibition of behavior and the lack of criticality combine with the disinhibition of inclination. Such persons, apparently, quite often involve in asocial groups (2 subjects in our study), i.e. their social adaptation is lowered. Both behavior and the peculiarities of motor functions and speech of persons with cluttering are the evidences of weakening of regulation from the highest parts of central nervous system. From our point of view, speech disorders of such children finally may rate as the disturbance of speech and language coordination.

  1. Conclusions
The results of this study have allowed us to draw the following conclusions:
  1. The analysis of a literature on the problem of cluttering shows that the diagnostic symptoms of cluttering marked out by different authors are similar to the characteristics of pseudo-neurotic form of stuttering in Russia.
  2. Using the adapted and modified Daly’s Checklist for Possible Cluttering allows us to divide group of subjects with pseudo-neurotic form of stuttering into four subgroups:
    1. persons with pure stuttering;
    2. persons with stuttering and some characteristics of cluttering;
    3. persons with cluttering, complicated by stuttering;
    4. persons with pure cluttering.
  3. The basic characteristic of cluttering includes the following symptoms:
    1. fast speech with a significant amount of different types of dysfluency;
    2. disturbances in sequence of programming of speech;
    3. attention span problems;
    4. memory problems of different modality (locomotor, visual and auditory); - behavioral features (impulsiveness, motor and speech disinhibition);
    5. indifference to their own speech and behavior.
  4. Tempo—rhythrnical disorganization of psychomotor activity underlies of a structure of speech defect and behavior features of a children with cluttering due to disturbances of functioning of structures of the brain determining and controlling space—time characteristics of various functional systems — from motor up to behavioral.
  5. Characteristic symptoms of persons with cluttering testify the necessity of realization of the special therapy directed to development of different psychic functions, the tempo- rhythmical organization of movements and sequence of utterance.

We suppose that persons with cluttering can be revealed not only among children with pseudo- neurotic form of stuttering as the closest under the description but also among pupils with learning difficulties in mass, schools.

Aslanova, S. R. (2001). Types of dysfluency of speech in preschool children as a factor of risk of stuttering. Ph.D. thesis..Moscow (in Russian).

Beliakova, L. 1., & D’yakova, E. A. (1998). Stuttering. Moscow (in Russian).

Beliakova, L. 1., & D’yal<ova, E. A. (2000). Stuttering.( 2”“ ed.). Moscow (in Russian).

Daly, D., & Burnett, M.L. (1966). Cluttering: assessment, treatment planning, and case study illustration. Journal of Fluency Disorders, 21, 3/4,  239-248.

Iele, I. (1995). Diagnostics of stuttering in early ontogenesis. Foreign Psychology, 5.

Leonova, S. V. (1995). Psychological and pedagogical characteristics of stuttering school children studied in the first grade in special boarding school for children with severe speech and language disorders. Ph.D. thesis. Moscow (in Russian).

Myers, F. (1998). Dysfluency and Child language. In K. Grundy (Ed.), Linguistics in clinical practice, 293-312.

Myers, F., & Wall, H. (1981). Issues to consider in the differential diagnosis of normal childhood nonfluency and stuttering. Journal of Fluency Disorders, 6, 189-195.

Schischkova, T. G. (2001). Development of speech breathing in stuttering preschoolers in the system of correctional and pedagogical work. Ph.D. thesis. Moscow (in Russian).

Completed Daly’s checklists for possible cluttering

Example 1. Subject from the III subgroup.


Example 2. Subject from the IV subgroup.


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