VLOEIENDHEIDSSTOORNISSEN
Behandeling Hoorcolleges
Linda Beijering
,INHOUDSOPGAVE
Hoorcollege 1 week 1..................................................................................................................................... 5
Wat is stotteren ook alweer?................................................................................................................................5
feiten stotteren......................................................................................................................................................5
Uitlokkende factoren:............................................................................................................................................6
Versterkende factoren:.........................................................................................................................................6
In standhoudende factoren:..................................................................................................................................6
Screeningslijst Stotteren........................................................................................................................................6
Secundaire preventie.............................................................................................................................................6
Hoe zit dat met stotteren?................................................................................................................................6
Herstel van stotteren bij jonge, stotterende kinderen..........................................................................................7
Richtlijn voor stotteren..........................................................................................................................................7
aanbevelingen.......................................................................................................................................................7
Aanbeveling 2....................................................................................................................................................7
Aanbeveling 3....................................................................................................................................................7
Aanbeveling 4....................................................................................................................................................7
Aanbeveling 5....................................................................................................................................................8
Verklaringsmodellen.............................................................................................................................................8
Ijsberg................................................................................................................................................................9
Erasmus viercomponentenmodel (Stournaras)................................................................................................9
Klinisch Werkmodel Stotteren (A. bertens)......................................................................................................9
Verwachtingen & mogelijkheden....................................................................................................................10
Wat zegt de NVLF-richtlijn ‘Logopedische dossiervorming 2019)’ over de diagnose, op weg naar therapie?. .10
Gemengde diagnose...........................................................................................................................................12
Behandelmogelijkheden jonge kinderen.............................................................................................................13
Hoorcollege 2............................................................................................................................................... 14
Behandelprogramma’s en aanpakken voor de verschillende doelgroepen:.......................................................14
lidcombe programma..........................................................................................................................................15
SMT (stuttering modification therapie)..............................................................................................................15
MIDVAS............................................................................................................................................................15
SMT opgedeeld in 3 fases:...............................................................................................................................16
FST: Fluency shaping tharapie............................................................................................................................18
Geintegreerde benadering (GUITAR) smt en fst tegelijk of na elkaar. smt en fst tegelijk of na elkaar. ..............................................................18
Niet reguliere, commerciele stotterprogramma’s in nederland:........................................................................19
Enkele voorbeelden:........................................................................................................................................19
casussen..............................................................................................................................................................19
Hoorcollege 3............................................................................................................................................... 20
, Adviezen van ouders...........................................................................................................................................20
RESTART-Dcm & Licombe Programma...............................................................................................................20
Indicaties voor RESTART-DCM:.......................................................................................................................20
Indicaties voor Lidcombe Programma:...........................................................................................................21
Diagnostiek (terugblik)........................................................................................................................................21
Interactie-analyse (terugblik)..............................................................................................................................21
Er zijn drie uitgangspunten voor ouderbegeleiding binnen de logopedie-stottertherapie.................................22
Uitgangspunten RESTART-DCM..........................................................................................................................22
Ontwikkeling van het praten..............................................................................................................................22
Verwachtingen & mogelijkheden........................................................................................................................23
Wat zijn VERWACHTINGEN?...........................................................................................................................23
Wat zijn de MOGELIJKHEDEN?........................................................................................................................23
Rationale RESTART-DCM.................................................................................................................................23
Verwachtingen....................................................................................................................................................24
Mogelijkheden:...................................................................................................................................................24
Overzich behouden.........................................................................................................................................24
Behandelprocedure – algemeen.........................................................................................................................25
Verlagen motorische verwachtingen..............................................................................................................25
Verlagen linguïstische verwachtingen.............................................................................................................26
Verlagen sociaal-emotionele verwachtingen..................................................................................................26
Verlagen cognitieve verwachtingen................................................................................................................27
Volgorde in waar je mee begint en waar je wel of niet mee verder gaat:.........................................................27
Volgende stap in de behandeling........................................................................................................................27
Hoorcollege 4............................................................................................................................................... 28
Wat is een richtlijn?............................................................................................................................................29
Wanneer is EBP ‘EBP’?....................................................................................................................................29
Wie werken mee aan een richtlijn?................................................................................................................29
Casus ‘Pim’..........................................................................................................................................................29
Aanbeveling 1:.................................................................................................................................................30
Aanbeveling 2:.................................................................................................................................................30
Wat is monitoren?..............................................................................................................................................30
Via de achtpuntsschaal van Yairi & Ambrose..................................................................................................30
Of via de tienpuntsschaal van Lidcombe Programma:...................................................................................31
Casus ‘Pim’..........................................................................................................................................................31
Aanbeveling 3:.................................................................................................................................................31
Casus ‘Pim’..........................................................................................................................................................32
Aanbeveling 4:.................................................................................................................................................32
Casus ‘Pim’..........................................................................................................................................................32
Aanbeveling 5:.................................................................................................................................................32
De monitoringsfase is afgerond, nu start het onderzoek voor Pim....................................................................32
Aanbeveling 9:.................................................................................................................................................32
, Aanbeveling 11:...............................................................................................................................................33
Casus ‘Pim’..........................................................................................................................................................33
Aanbeveling 22:...............................................................................................................................................33
Casus ‘Pim’..........................................................................................................................................................33
Aanbeveling 8:.................................................................................................................................................34
Aanbeveling 12:...............................................................................................................................................34
Aanbeveling 13:...............................................................................................................................................34
Aanbeveling 21:...............................................................................................................................................34
Aanbeveling 23:...............................................................................................................................................34
Aanbeveling 18:...............................................................................................................................................35
Hoorcollege 5............................................................................................................................................... 35
Hoe werkt dat met stotteren?.............................................................................................................................35
Wat zegt de richtlijn over cognities en emoties bij stotteren?...........................................................................36
Aanbeveling 14................................................................................................................................................36
Aanbeveling 15................................................................................................................................................36
Aanbeveling 19................................................................................................................................................37
MIDVAS...............................................................................................................................................................37
Identificatie en desensitisatie..............................................................................................................................37
Hoe kom je achter de cognities van de client?...............................................................................................38
Cognitieve gedragstherapie................................................................................................................................38
Stappen CGT....................................................................................................................................................39
Helpende schema’s.............................................................................................................................................39
ABCDE-schema................................................................................................................................................40
GGGG-model...................................................................................................................................................40
Gedragsbehandeling bij CGT...............................................................................................................................40
Exposure in-vitro en exposure in vivo.................................................................................................................41
Wat ga je toepassen?......................................................................................................................................41
Hoorcollege 6: Broddelen............................................................................................................................. 42
Wat is broddelen?...............................................................................................................................................42
Diagnose broddelen............................................................................................................................................42
Twee typen broddelen.........................................................................................................................................42
Stotteren vs broddelen........................................................................................................................................42
Factoren bij broddelen........................................................................................................................................43
Uitlokkende factoren broddelen.....................................................................................................................43
Versterkende factoren broddelen...................................................................................................................43
Instanthoudende factoren broddelen.............................................................................................................43
4-componenten model bij broddelen..................................................................................................................43
Veraalmotorische component........................................................................................................................44
sociale component..........................................................................................................................................44
Emotionele component...................................................................................................................................44
Cognitieve component....................................................................................................................................45
Behandeling Hoorcolleges
Linda Beijering
,INHOUDSOPGAVE
Hoorcollege 1 week 1..................................................................................................................................... 5
Wat is stotteren ook alweer?................................................................................................................................5
feiten stotteren......................................................................................................................................................5
Uitlokkende factoren:............................................................................................................................................6
Versterkende factoren:.........................................................................................................................................6
In standhoudende factoren:..................................................................................................................................6
Screeningslijst Stotteren........................................................................................................................................6
Secundaire preventie.............................................................................................................................................6
Hoe zit dat met stotteren?................................................................................................................................6
Herstel van stotteren bij jonge, stotterende kinderen..........................................................................................7
Richtlijn voor stotteren..........................................................................................................................................7
aanbevelingen.......................................................................................................................................................7
Aanbeveling 2....................................................................................................................................................7
Aanbeveling 3....................................................................................................................................................7
Aanbeveling 4....................................................................................................................................................7
Aanbeveling 5....................................................................................................................................................8
Verklaringsmodellen.............................................................................................................................................8
Ijsberg................................................................................................................................................................9
Erasmus viercomponentenmodel (Stournaras)................................................................................................9
Klinisch Werkmodel Stotteren (A. bertens)......................................................................................................9
Verwachtingen & mogelijkheden....................................................................................................................10
Wat zegt de NVLF-richtlijn ‘Logopedische dossiervorming 2019)’ over de diagnose, op weg naar therapie?. .10
Gemengde diagnose...........................................................................................................................................12
Behandelmogelijkheden jonge kinderen.............................................................................................................13
Hoorcollege 2............................................................................................................................................... 14
Behandelprogramma’s en aanpakken voor de verschillende doelgroepen:.......................................................14
lidcombe programma..........................................................................................................................................15
SMT (stuttering modification therapie)..............................................................................................................15
MIDVAS............................................................................................................................................................15
SMT opgedeeld in 3 fases:...............................................................................................................................16
FST: Fluency shaping tharapie............................................................................................................................18
Geintegreerde benadering (GUITAR) smt en fst tegelijk of na elkaar. smt en fst tegelijk of na elkaar. ..............................................................18
Niet reguliere, commerciele stotterprogramma’s in nederland:........................................................................19
Enkele voorbeelden:........................................................................................................................................19
casussen..............................................................................................................................................................19
Hoorcollege 3............................................................................................................................................... 20
, Adviezen van ouders...........................................................................................................................................20
RESTART-Dcm & Licombe Programma...............................................................................................................20
Indicaties voor RESTART-DCM:.......................................................................................................................20
Indicaties voor Lidcombe Programma:...........................................................................................................21
Diagnostiek (terugblik)........................................................................................................................................21
Interactie-analyse (terugblik)..............................................................................................................................21
Er zijn drie uitgangspunten voor ouderbegeleiding binnen de logopedie-stottertherapie.................................22
Uitgangspunten RESTART-DCM..........................................................................................................................22
Ontwikkeling van het praten..............................................................................................................................22
Verwachtingen & mogelijkheden........................................................................................................................23
Wat zijn VERWACHTINGEN?...........................................................................................................................23
Wat zijn de MOGELIJKHEDEN?........................................................................................................................23
Rationale RESTART-DCM.................................................................................................................................23
Verwachtingen....................................................................................................................................................24
Mogelijkheden:...................................................................................................................................................24
Overzich behouden.........................................................................................................................................24
Behandelprocedure – algemeen.........................................................................................................................25
Verlagen motorische verwachtingen..............................................................................................................25
Verlagen linguïstische verwachtingen.............................................................................................................26
Verlagen sociaal-emotionele verwachtingen..................................................................................................26
Verlagen cognitieve verwachtingen................................................................................................................27
Volgorde in waar je mee begint en waar je wel of niet mee verder gaat:.........................................................27
Volgende stap in de behandeling........................................................................................................................27
Hoorcollege 4............................................................................................................................................... 28
Wat is een richtlijn?............................................................................................................................................29
Wanneer is EBP ‘EBP’?....................................................................................................................................29
Wie werken mee aan een richtlijn?................................................................................................................29
Casus ‘Pim’..........................................................................................................................................................29
Aanbeveling 1:.................................................................................................................................................30
Aanbeveling 2:.................................................................................................................................................30
Wat is monitoren?..............................................................................................................................................30
Via de achtpuntsschaal van Yairi & Ambrose..................................................................................................30
Of via de tienpuntsschaal van Lidcombe Programma:...................................................................................31
Casus ‘Pim’..........................................................................................................................................................31
Aanbeveling 3:.................................................................................................................................................31
Casus ‘Pim’..........................................................................................................................................................32
Aanbeveling 4:.................................................................................................................................................32
Casus ‘Pim’..........................................................................................................................................................32
Aanbeveling 5:.................................................................................................................................................32
De monitoringsfase is afgerond, nu start het onderzoek voor Pim....................................................................32
Aanbeveling 9:.................................................................................................................................................32
, Aanbeveling 11:...............................................................................................................................................33
Casus ‘Pim’..........................................................................................................................................................33
Aanbeveling 22:...............................................................................................................................................33
Casus ‘Pim’..........................................................................................................................................................33
Aanbeveling 8:.................................................................................................................................................34
Aanbeveling 12:...............................................................................................................................................34
Aanbeveling 13:...............................................................................................................................................34
Aanbeveling 21:...............................................................................................................................................34
Aanbeveling 23:...............................................................................................................................................34
Aanbeveling 18:...............................................................................................................................................35
Hoorcollege 5............................................................................................................................................... 35
Hoe werkt dat met stotteren?.............................................................................................................................35
Wat zegt de richtlijn over cognities en emoties bij stotteren?...........................................................................36
Aanbeveling 14................................................................................................................................................36
Aanbeveling 15................................................................................................................................................36
Aanbeveling 19................................................................................................................................................37
MIDVAS...............................................................................................................................................................37
Identificatie en desensitisatie..............................................................................................................................37
Hoe kom je achter de cognities van de client?...............................................................................................38
Cognitieve gedragstherapie................................................................................................................................38
Stappen CGT....................................................................................................................................................39
Helpende schema’s.............................................................................................................................................39
ABCDE-schema................................................................................................................................................40
GGGG-model...................................................................................................................................................40
Gedragsbehandeling bij CGT...............................................................................................................................40
Exposure in-vitro en exposure in vivo.................................................................................................................41
Wat ga je toepassen?......................................................................................................................................41
Hoorcollege 6: Broddelen............................................................................................................................. 42
Wat is broddelen?...............................................................................................................................................42
Diagnose broddelen............................................................................................................................................42
Twee typen broddelen.........................................................................................................................................42
Stotteren vs broddelen........................................................................................................................................42
Factoren bij broddelen........................................................................................................................................43
Uitlokkende factoren broddelen.....................................................................................................................43
Versterkende factoren broddelen...................................................................................................................43
Instanthoudende factoren broddelen.............................................................................................................43
4-componenten model bij broddelen..................................................................................................................43
Veraalmotorische component........................................................................................................................44
sociale component..........................................................................................................................................44
Emotionele component...................................................................................................................................44
Cognitieve component....................................................................................................................................45
