Cluttering framed: An historical overview

BACKGROUND: Cluttering has been described in the literature on speech disorders for over 300 years. Despite this, it remains a poorly understood condition whose history has not been analyzed as a whole to identify common themes and underlying frameworks. OBJECTIVE: The purpose of this review is to identify thematic questions and frameworks contained within the literature on cluttering since the earliest found reference in 1717. METHODS: Information from influential historical and contemporary documents were analyzed. Particular attention was paid to the types of questions, both implicit and explicit, that were posed in these materials. This information was ultimately organized into five thematic strands, presented here in the form of key questions. RESULTS: Five questions were derived from our historical analysis: (1) What should the problem be called? (2) What kind of problem is it? (3) What are its defining features? (4) What are its causes? and (5) How should it be treated? The first four questions are discussed in this review. The fifth question will be addressed in a forthcoming paper. CONCLUSIONS: Consensus has been achieved on what to call the disorder (cluttering) and in what domain it should be placed (fluency). Less agreement exists regarding its defining features, causes, and treatment. We propose that alternative conceptual frameworks may be useful in breaking new ground in our understanding and management of this complex condition.