A Comparative study between different methods in treatment of cluttering

Abstract

Cluttering is one of the controversial diseases, it is recently defined as a fluency disorder characterized by a rate that is perceived to be abnormally rapid, irregular or both for the speaker (although measured syllable rates may not exceed normal limits). These rate abnormalities further are manifest in one or more of the following symptoms: a) an excessive number of disfluencies, the majority of which are not typical of people who stutter b) the frequent placement of pauses and use of prosodic patterns that do not conform to syntactic and semantic constraints; and c) inappropriate (usually excessive) degrees of coarticulaion among sounds, especially in multisyllabic words. Clinicians around the world are challenged by the dysfluent patients known as clutterers. Treating cluttering is complicated not only by the wide variety of possible coexisting disabilities, but also by the unique personality or attitude of the clutterer. The clinician without a clear plan for diagnosis and treatment is likely to fail in his or her effort to treat cluttering.

The therapy of cluttering varies according to the clinician belief. Three main lines of therapy are used empirically in practice; namely the Accent Method, the Coarticulation technique of Stromesta and the Daly’s cluttering therapy program.

This study was conducted on 30 patients diagnosed as having a Cluttering disorder, 27 males and 3 females. Those patients had an average age of 28.6 years old (range 15 to 60 years). Those clutterers were classified into three groups each group comprised of 10 patients, and each group received a different therapy program respectively: The Accent Method, the Coarticulation technique of Stromesta and Daly’s cluttering treatment program, and for a period of 16 weeks. These patients were assessed before therapy, at 8 weeks and 16 weeks post therapy.

Each patient was assessed using the Cluttering assessment protocol assumed by the Phoniatric Unit, Ain Shams University for communication disorders includes: elementary diagnostic procedures [personal interview, auditory perceptual assessment, visual perceptual assessment], clinical diagnostic aids [speech recording, formal testing, the Checklist for Identification of Cluttering-Revised, Predictive Cluttering Inventory (PCI)] and additional instrumental measures [visi-pitch (diadochokinetic rate)].

The results obtained from this study showed that two of the three therapy regimens; namely the Accent Method and the Daly’s cluttering therapy program, were reasonably successful for adolescent and adult clutterers, there were no significant differences between the two therapy regimens in most of the parameters investigated. The Accent Method had a significant percent change in total some parameters while the Daly’s cluttering therapy program had highly significant differences in other parameters as well. So each therapy regimen proved to be more effective in dealing with some of the aspects of the cluttering syndrome. Thus indicating that each therapy regimen has a different point of view.