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From: Ken St. Louis
Date: 19 Apr 2010
Time: 16:02:34 -0500
Remote Name: 157.182.15.121
Renita and others, I suppose I should weigh in here, although the others have covered the issues very well. Let me first try to answer Renita's questions. Yes, the boundaries are subjective. That should not bother us too much unless we are equally bothered by the questions of when a person has a "language disorder," a "voice disorder," a "swallowing disorder," etc. We deal with shades or gray rather than categories of black and white in most areas of SLP practice. My contribution to the rest of this excellent discussion is the following. If we define "language" as most linguists do, then all the disorders involving speaking and communicating are "language disorders." Of course, we don't do that; we have traditionally differentiated "language" from "speech," and "(dis)fluency" and/or "stuttering" have classically been regarded as "speech" disorders. My guess is that the origin or "motor" versus "linguistic" distinctions for such categories as stuttering, articulation disorders, cluttering, etc. comes from the original, and somewhat arbitrary, "language" and "speech" division. The bottom line is that we have the categories we have. Thus, we must try to work within them. My position has been that we should not worry at this point whether or not cluttering is a "language" or a "motor" problem (although I would vote for the latter) so much as to develop a definition (that uses the very subjective distinctions that bother Renita) and get to work on a research agenda wherein all the key players use the same definition. If we did that, we would soon learn who falls through the cracks, e.g., people who very rarely demonstrate clear cluttering such as David, perhaps. We'd no doubt come up with subtypes for such groups. More likely as Flo here and Klaas in other places have argued, the data would eventually sort themselves out. I would not be surprised if we don't end up with several subtypes, as Yvonne suggests. My reason for arguing for an LCD definition is that our current state of ignorance renders arguments about what the REAL problem most clutterers have to premature at this point. I submit that developing consensus on a definition that contains not all but the necessary elements of a definition offers the potential for generating an objective, systematic body of research that major funders will respect. After than happens, it is likely that grant money will be forthcoming for systematic investigations of the epidemiology, nature, diagnosis, and treatment of this vastly neglected problem. More than my two bits worth perhaps. <smile> Ken