Cluttering is a speech and communication disorder characterized by a rapid rate of speech, erratic rhythm, and poor syntax or grammar, making speech difficult to understand. Classification Cluttering is a speech and communication disorder that has also been described as a fluency disorder. It is defined as: Signs and symptoms Stuttering is often misapplied as a common term referring to any dysfluency. It is also often incorrectly applied to normal dysfluency rather than dysfluency from a disorder. Cluttered speech is exhibited by normal speakers, and is often referred to as stuttering. This is especially true when the speaker is nervous, where nervous speech more closely resembles cluttering than stuttering. Cluttering is sometimes confused with stuttering. Both communication disorders break the normal flow of speech, but they are distinct. A stutterer has a coherent pattern of thoughts, but may have a difficult time vocally expressing those thoughts; in contrast, a clutterer has no problem putting thoughts into words, but those thoughts become disorganized during speaking. Cluttering affects not only speech, but also thought patterns, writing, typing, and conversation. Stutterers are usually dysfluent on initial sounds, when beginning to speak, and become more fluent towards the ends of utterances. In contrast, clutterers are most clear at the start of utterances, but their speaking rate increases and intelligibility decreases towards the end of utterances. Stuttering is characterized by struggle behavior, such as overtense speech production muscles. Cluttering, in contrast, is effortless. Cluttering is also characterized by slurred speech, especially dropped or distorted /r/ and /l/ sounds; and monotone speech that starts loud and trails off into a murmur. A clutterer described the feeling associated with a clutter as: Differential diagnosis Cluttering can often be confused with various language disorders, learning disabilities, and attention deficit hyperactivity disorder (ADHD). Clutterers often have reading and writing disabilities, especially sprawling, disorderly handwriting, which poorly integrate ideas and space. Treatment The common goals of treatment for cluttering include slowing the rate of speech, heightening monitoring, using clear articulation, using acceptable and organized language, interacting with listeners, speaking naturally, and reducing excessive disfluencies. Slowing the rate of speech can help many of the symptoms of cluttering, and can be achieved in a couple of different ways, though it is very important that speech language pathologists do not nag their clients to "slow down" incessantly, as this does not help and can actually hinder progress. Additionally, it is important to