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Purpose and organization of the special edition on cluttering
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PURPOSE AND ORGANIZATION OF THE SPECIAL EDITION ON CLUTTERING KENNETH O. ST. L O U I S , G u e s t Editor West Virginia University, Morgantown, West Virginia, U.S.A.
The collective wisdom that provides the basis for the practice of speech-language pathology, logopedics, or phoniatrics is similar to that of any other clinical or educational field. Such collective wisdom is a mixture of principles derived from clinical successes and failures, scientific investigations, and timehonored traditions. Thus, the mixture is composed variously of proven facts-new and old, conceptualizations presumed to be true, opinions, hunches, and guesses. Moreover, the entire mixture is in a constant state of flux. Quite obviously, we strive for changes derived from objective science and proven fact as we continue to manage our speech- and language-impaired individuals. But it seems to be the case that a great deal more of the collective wisdom for certain disorders or impairments can be considered scientific fact than for others. For example, many practitioners believe that fluency disorders are among the least well understood of the various disorders we treat (e.g., St. Louis & Durrenberger, 1993). This special edition of the Journal of Fluency Disorders deals with a communication disorder for which traditions, opinions, and guesses predominate and for which objective data are very limited. We consider here the disorder called "cluttering." The name itself is a little bothersome. In English at least, it rhymes with the well-known problem of stuttering, and it seems likely that the person was originally responsible for the name may have had that fact in mind. The name too reminds us of messy spaces, disorganized individuals, or ramblings in the mind. Perhaps "cluttering" and "clutterer" are not the best names we might develop, but our purpose here is not to rename. That would no doubt simply add to the existing confusion. Instead, the purpose of this edition is to shed light on this poorly understood "orphan of speech pathology" (Daly, 1986;
Address correspondence to Kenneth O. St. Louis, Department of Speech Pathology and Audiology, West Virginia University, 805 Allen Hall, P.O. Box 6122, Morgantown, WV 26506-6122. J. FLUENCY DISORD. 21 (1996), 171-173 © 1996 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
0094-730X/96/$15.00 Pll S0094-730X(96)00020-1
172
K.O. ST. LOUIS
Weiss, 1964). The title of the special edition suggests that the interested reader can acquire a good sense of the state of the art and science in the disorder of cluttering in the mid-1990s. Importantly, the edition reflects an international effort, with contributions from three continents and seven countries. My hope is that, after reading and reflecting on the contributions contained herein, practitioners and scientists will follow promising leads and hypotheses and contribute to further progress toward scientifically defining, understanding, and treating cluttering. The special edition as a whole was designed and intended to be read much as a typical scientific article, which begins with an "introduction" and "review" of the relevant literature. This special edition commences with a thoughtful introduction to the problem of cluttering and an annotated bibliography of literature on the disorder since the seminal textbook on cluttering by Deso Weiss in 1964. Both beginning contributions were written by Florence Myers, a well-known specialist in cluttering. The ensuing case studies and research investigations might be viewed as the "method" and "results" sections of a typical article. These 13 contributions provide much needed, real "data" regarding cluttering. The contributions are classified according to the degree to which guidelines generally accepted by reviewers of the Journal for scientific investigations are met. Two articles are assigned to the category of group research studies. Groups of clutterers are generally very difficult to find, and this is one reason group studies are quite rare. There is one contribution in the second category, single-subject research studies. To be listed as one of these two types of research investigations, the studies must have been designed before data gathering, and appropriate measures applied to assure valid, reliable measures. The remainder of the studies are termed post hoc case studies and are subdivided into two further groups. The first subgroup, identified as "data-based," refers to investigations of clutterers for whom standard data were available, generally as part of a larger study of stutterers. There are two such studies herein comparing the results of a small group of clutterers (in one article, just one clutterer) with standard results obtained in ongoing clinical research with stutterers. Implications or conclusions from the five studies in these three categories are no doubt the most solid and least likely to be artifactual or erroneous. Identified by the term, "clinical impressions," the second subgroup of post hoc case studies, and largest number of contributions to the special edition, refers to reports of actual cluttering cases to which authors had access. Most of the latter group are diagnostic descriptions, but there are summaries of therapeutic interventions as well. Post hoc case studies that contain clinical impressions along with test results were sought for the special edition precisely because so few group studies are available. The information presented in these case studies can best be interpreted as tentative and in need of verification by more carefully controlled research. (For the sake of coherence and ease of reading, the contributions are presented
INTRODUCTION TO SPECIAL ISSUE
173
in a general order from diagnostic to therapeutic information--according to the above-described categorization.) Most typical research studies contain a summary of the results in tabular form. To derive such a table for this special edition, I mailed a detailed questionnaire to the authors and asked them to identify both documented and undocumented (e.g., suspected) characteristics of the cluttering subjects they presented in their articles. These results were combined into one summary table, juxtaposing all 29 subjects presented in the special edition. A shorter table on therapeutic efforts and results for 15 clutterers is also included. Importantly, the tabular information is not intended to replace, change emphasis, or supersede any of the information presented in the articles, only to supplement such data for the reader looking for general trends, similarities, differences, and generalizations. For example, symptoms or abnormalities reported by authors for the 29 cluttering subjects are rank-ordered in terms of frequency of mention. The last section of a typical article is the discussion. For the special edition, four esteemed clinicians and researchers were asked to review all of the aforementioned material and write a brief but critical summary of what has been learned--and not learned--about cluttering and an opinion of where clinicians and researchers should proceed from here. For the discerning reader, these critical summaries hopefully will assist in deriving a sense of the state of the art and science of cluttering in the mid 1990s.
As Guest Editor, I give my heartfelt thanks to all of the reviewers who gave unselfishly of their time and expertise, and whose reviews reflected a spirit of helping the authors improve their contributions. I also express my sincere gratitude to the authors who diligently modified their manuscripts according to the reviewers' and my suggestions. Finally, I acknowledge the valuable assistance of Renee Jones, my editorial assistant, whose competence and dedication were key factors in bringing this project to fruition.
REFERENCES Daly, D.A. (1986). The clutterer. In K.O. St. Louis (Ed.), The Atypical Stutterer: Principles and Practices of Rehabilitation. New York: Academic Press, pp. 155-192. St. Louis, K.O., & Durrenberger, C.H. (1993). What communication disorders do experienced clinicians prefer to manage? Asha 35, 23-35. Weiss, D.A. (1964). Cluttering. Englewood Cliffs, NJ: Prentice-Hall.
PURPOSE AND ORGANIZATION OF THE SPECIAL EDITION ON CLUTTERING KENNETH O. ST. L O U I S , G u e s t Editor West Virginia University, Morgantown, West Virginia, U.S.A.
The collective wisdom that provides the basis for the practice of speech-language pathology, logopedics, or phoniatrics is similar to that of any other clinical or educational field. Such collective wisdom is a mixture of principles derived from clinical successes and failures, scientific investigations, and timehonored traditions. Thus, the mixture is composed variously of proven facts-new and old, conceptualizations presumed to be true, opinions, hunches, and guesses. Moreover, the entire mixture is in a constant state of flux. Quite obviously, we strive for changes derived from objective science and proven fact as we continue to manage our speech- and language-impaired individuals. But it seems to be the case that a great deal more of the collective wisdom for certain disorders or impairments can be considered scientific fact than for others. For example, many practitioners believe that fluency disorders are among the least well understood of the various disorders we treat (e.g., St. Louis & Durrenberger, 1993). This special edition of the Journal of Fluency Disorders deals with a communication disorder for which traditions, opinions, and guesses predominate and for which objective data are very limited. We consider here the disorder called "cluttering." The name itself is a little bothersome. In English at least, it rhymes with the well-known problem of stuttering, and it seems likely that the person was originally responsible for the name may have had that fact in mind. The name too reminds us of messy spaces, disorganized individuals, or ramblings in the mind. Perhaps "cluttering" and "clutterer" are not the best names we might develop, but our purpose here is not to rename. That would no doubt simply add to the existing confusion. Instead, the purpose of this edition is to shed light on this poorly understood "orphan of speech pathology" (Daly, 1986;
Address correspondence to Kenneth O. St. Louis, Department of Speech Pathology and Audiology, West Virginia University, 805 Allen Hall, P.O. Box 6122, Morgantown, WV 26506-6122. J. FLUENCY DISORD. 21 (1996), 171-173 © 1996 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
0094-730X/96/$15.00 Pll S0094-730X(96)00020-1
172
K.O. ST. LOUIS
Weiss, 1964). The title of the special edition suggests that the interested reader can acquire a good sense of the state of the art and science in the disorder of cluttering in the mid-1990s. Importantly, the edition reflects an international effort, with contributions from three continents and seven countries. My hope is that, after reading and reflecting on the contributions contained herein, practitioners and scientists will follow promising leads and hypotheses and contribute to further progress toward scientifically defining, understanding, and treating cluttering. The special edition as a whole was designed and intended to be read much as a typical scientific article, which begins with an "introduction" and "review" of the relevant literature. This special edition commences with a thoughtful introduction to the problem of cluttering and an annotated bibliography of literature on the disorder since the seminal textbook on cluttering by Deso Weiss in 1964. Both beginning contributions were written by Florence Myers, a well-known specialist in cluttering. The ensuing case studies and research investigations might be viewed as the "method" and "results" sections of a typical article. These 13 contributions provide much needed, real "data" regarding cluttering. The contributions are classified according to the degree to which guidelines generally accepted by reviewers of the Journal for scientific investigations are met. Two articles are assigned to the category of group research studies. Groups of clutterers are generally very difficult to find, and this is one reason group studies are quite rare. There is one contribution in the second category, single-subject research studies. To be listed as one of these two types of research investigations, the studies must have been designed before data gathering, and appropriate measures applied to assure valid, reliable measures. The remainder of the studies are termed post hoc case studies and are subdivided into two further groups. The first subgroup, identified as "data-based," refers to investigations of clutterers for whom standard data were available, generally as part of a larger study of stutterers. There are two such studies herein comparing the results of a small group of clutterers (in one article, just one clutterer) with standard results obtained in ongoing clinical research with stutterers. Implications or conclusions from the five studies in these three categories are no doubt the most solid and least likely to be artifactual or erroneous. Identified by the term, "clinical impressions," the second subgroup of post hoc case studies, and largest number of contributions to the special edition, refers to reports of actual cluttering cases to which authors had access. Most of the latter group are diagnostic descriptions, but there are summaries of therapeutic interventions as well. Post hoc case studies that contain clinical impressions along with test results were sought for the special edition precisely because so few group studies are available. The information presented in these case studies can best be interpreted as tentative and in need of verification by more carefully controlled research. (For the sake of coherence and ease of reading, the contributions are presented
INTRODUCTION TO SPECIAL ISSUE
173
in a general order from diagnostic to therapeutic information--according to the above-described categorization.) Most typical research studies contain a summary of the results in tabular form. To derive such a table for this special edition, I mailed a detailed questionnaire to the authors and asked them to identify both documented and undocumented (e.g., suspected) characteristics of the cluttering subjects they presented in their articles. These results were combined into one summary table, juxtaposing all 29 subjects presented in the special edition. A shorter table on therapeutic efforts and results for 15 clutterers is also included. Importantly, the tabular information is not intended to replace, change emphasis, or supersede any of the information presented in the articles, only to supplement such data for the reader looking for general trends, similarities, differences, and generalizations. For example, symptoms or abnormalities reported by authors for the 29 cluttering subjects are rank-ordered in terms of frequency of mention. The last section of a typical article is the discussion. For the special edition, four esteemed clinicians and researchers were asked to review all of the aforementioned material and write a brief but critical summary of what has been learned--and not learned--about cluttering and an opinion of where clinicians and researchers should proceed from here. For the discerning reader, these critical summaries hopefully will assist in deriving a sense of the state of the art and science of cluttering in the mid 1990s.
As Guest Editor, I give my heartfelt thanks to all of the reviewers who gave unselfishly of their time and expertise, and whose reviews reflected a spirit of helping the authors improve their contributions. I also express my sincere gratitude to the authors who diligently modified their manuscripts according to the reviewers' and my suggestions. Finally, I acknowledge the valuable assistance of Renee Jones, my editorial assistant, whose competence and dedication were key factors in bringing this project to fruition.
REFERENCES Daly, D.A. (1986). The clutterer. In K.O. St. Louis (Ed.), The Atypical Stutterer: Principles and Practices of Rehabilitation. New York: Academic Press, pp. 155-192. St. Louis, K.O., & Durrenberger, C.H. (1993). What communication disorders do experienced clinicians prefer to manage? Asha 35, 23-35. Weiss, D.A. (1964). Cluttering. Englewood Cliffs, NJ: Prentice-Hall.