|About the presenter: Carla Di Domenicantonio is a registered speech-language pathologist in Ontario, Canada. She has worked in the field of stuttering and fluency disorders for over 25 years serving preschool, school-aged and adult populations in hospital and private clinic settings. Eager to support the advancement of cluttering amongst colleagues and the general population, Carla became the Canadian SLP representative for the International Cluttering Association (ICA) in 2007.
In January 2009, Francis Duldulao, also International Cluttering Association (ICA) representative for Canada, and I set out to find out whether and how Canadian speech-language pathology Master level university programs prepare prospective clinicians for work with clients who clutter. Secondary objectives were to raise awareness of the ICA in Canadian speech-language pathology training programs; to recruit new Canadian membership to the ICA; and, to stimulate research interest on the topic of cluttering. We presented the results in poster format at the Annual Conference of the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) in the spring of 2009.
The survey was designed to capture information on classroom teaching, resources used, clinical hours, research/student projects on cluttering and expected impact of the ICA on student training.
Surveys were mailed to Canadian university programs offering Master level training in speech-language pathology. All nine programs responded.
Classroom Teaching: All Canadian Master level speech-language pathology university programs reported including cluttering in the classroom curriculum. Eight programs discussed cluttering as part of a fluency disorders course; one included it as a topic in a seminars course. Time allotted to cluttering ranged from 1 to 3 hours, with an average of 2.1 hours spent on the subject.
Clinical Hours: None of the programs required that students complete a specified number of hours assessing or treating cluttering as part of their training. Respondents estimated that 0-3 students per year graduate having had some "hands-on" exposure to cluttering in clinical placements.
Teaching Resources: Programs utilized a variety of teaching resources including assigned readings in combination with video and/or audio recordings. Internet resources were used by some programs.
Research/Special Projects: None of the programs had faculty/staff with a special interest in cluttering or anyone on staff who was conducting research on cluttering. One faculty member had published a research paper on cluttering in the past. One program reported that ten students had completed some form of project on cluttering in the past five years as part of the seminars course.
Expected impact of the ICA: Instructors regarded the formation of the ICA as a positive and helpful development. Eight of nine respondents knew about the ICA but none was a member. Most indicated an interest in joining. All envisioned using the ICA website as an educational tool for themselves and students. Respondents indicated a need and desire for more, new and current information and material on cluttering, including case studies, audiovisual samples of cluttered speech with and without stuttering in several languages, and even virtual clients.
Discussion: Cluttering receives considerably less classroom time than most other communication disorders, including stuttering (See Kroll & Klassen, 2007) in the Canadian speech-language pathology curriculum. The apportioned time may be explained by the seemingly low incidence of the disorder. Students are unlikely to encounter cluttering during clinical placements diminishing its relevance, and therefore importance. Instructors themselves may have little to no direct clinical experience with cluttering making it challenging to present extensively on the subject. It is interesting to note that none of the Canadian programs provides a separate course, required or elective, on cluttering as is the case in some European countries (Scaler Scott et al., 2007). Separate courses allow a comparatively generous 15-21 hours of classroom time on the subject.
It would be extremely challenging to require a specified number of clinical hours in cluttering for all Canadian students because of its virtual absence on speech-language pathology caseloads. It is not surprising that a very small number of students (0-3 per year across programs) graduate having had direct experience with cluttering in clinical placements, or having completed a special project or research study on the subject.
The low profile of cluttering within the field is further reflected in our Canadian professional organization. Cluttering is conspicuously absent from a list of Interest/Preferred Practice choices for speech-language pathologists on CASLPA's National Find a Professional Data Base. There is no Fact Sheet on cluttering and there are no consumer links to information about the disorder.
Conclusion: We were able to safely conclude that Canadian-trained Master level speech-language pathologists are at least aware of cluttering as another fluency disorder. The relatively small number of classroom hours devoted to cluttering and the virtual absence of clinical experience within training programs raise the question of how adequately prepared Canadian-trained speech-language pathologists would rate themselves in assessing and treating cluttering. It would be unfair to base any reported inadequacies on educational programs. We need to consider that we are still working towards a validated definition for cluttering and gathering new information on which to build effective assessment and treatment procedures. It is our hope that renewed international interest and collaboration in the area of cluttering, facilitated by the ICA, will raise the profile of the disorder within the field of speech-language pathology, stimulate research interest, and advance our understanding and clinical practices. This activity may in turn foster greater interest from speech-language pathology students and advance the presence of cluttering in academic curriculums.
Kroll, R.M. & Klassen, T. R. (2007). Perspectives on the Academic and Clinical Education in Stuttering. Canadian Journal of Speech-Language Pathology and Audiology, 31(2), 94-99.
Scaler Scott, K., Grossman, H.L. & Tetnowski, J.A. (2007, Nov.). Cluttering Education in Fluency Courses: A Survey of Faculty. A poster presentation at the annual convention of the ASHA, Boston, MA.
SUBMITTED: March 6, 2010