MASTERCLASS VERWORVEN SPRAAK, TAAL,
EN COGNITIE
INHOUD
1. Spraakapraxie – intro ..............................................................................................................................5
Normale spraakproductie ........................................................................................................................5
Fonematische parafasieën .......................................................................................................................5
Definitie spraakapraxie ............................................................................................................................6
Andere vormen van apraxie .....................................................................................................................6
Diagnostiek...............................................................................................................................................7
Diagnostische testen ..............................................................................................................................10
Assessment in functie van behandelplan ..............................................................................................12
2. Spraakapraxie – behandeling ................................................................................................................14
Doelstellingen v behandeling .................................................................................................................14
Principes van motorisch leren................................................................................................................15
Integrale stimulatie ................................................................................................................................15
Therapiemethodes .................................................................................................................................16
Factoren die therapiekeuze bepalen .....................................................................................................20
Niet-stoornisgerichte interventies .........................................................................................................21
Speech entrainment...............................................................................................................................21
3. Extralinguïstische cognitieve aspecten bij afasie ..................................................................................22
Neurale netwerk taal – cognitie.............................................................................................................22
Overlap taal – cognitie ...........................................................................................................................26
Cognitieve domeinen en begrippen.......................................................................................................26
Extralinguïstische cognitieve problemen bij afasie................................................................................29
1
, Assessment ............................................................................................................................................30
Interventie..............................................................................................................................................36
4. Natuurlijke spraak bij neurogene communicatiestoornissen ...............................................................42
Natuurlijke spraak ..................................................................................................................................42
Natuurlijke spraak – pathologisch .........................................................................................................44
Assessment v natuurlijke spraak ............................................................................................................48
Behandeling v natuurlijke spraak ...........................................................................................................53
5. Cognitief-communicatieve problemen na Traumatic Brain Injury (TBI) ..............................................55
Definitie en terminologie .......................................................................................................................55
Oorzaken van TBI ...................................................................................................................................55
Prevalentie TBI .......................................................................................................................................55
Neuropathologie TBI ..............................................................................................................................56
Ernst TBI .................................................................................................................................................57
Soorten bewustzijnstoestanden ............................................................................................................58
Overgang tussen bewustzijnsniveaus ....................................................................................................59
Herstelverloop bij TBI: evolutie na coma ...............................................................................................60
Logopedische problemen bij TBI ............................................................................................................60
Taalstoornissen ten gevolge van TBI......................................................................................................60
Aard van taalstoornissen ten gevolge van TBI .......................................................................................61
Cognitieve stoornissen ten gevolge van TBI ..........................................................................................61
6. Diagnositek van cognitief-communicatieve stoornissen bij TBI ...........................................................62
Assessment ............................................................................................................................................62
Diagnostiek algemene bewustzijnstoestand .........................................................................................62
Diagnostiek taal en cognitief-communicatieve skills .............................................................................63
7. Behandeling van cognitief-communicatieve stoornissen bij TBI ..........................................................65
Indirecte/ omgevingsgerichte therapie .................................................................................................65
Directe therapie .....................................................................................................................................67
Principes directe cognitief-communicatieve therapie ...........................................................................68
2
, INCOG Recommendations .....................................................................................................................69
8. Dementie ...............................................................................................................................................70
Dementie................................................................................................................................................70
Dementie types ......................................................................................................................................71
Specifieke logopedische instrumenten ..................................................................................................74
Behandeling ...........................................................................................................................................74
9. Primaire progressieve afasie .................................................................................................................77
Dementie en PPA ...................................................................................................................................77
Primaire progressieve afasie: definitie ..................................................................................................77
Definiëren van PPA en 3 varianten ........................................................................................................77
Semantische PPA....................................................................................................................................78
Niet-vloeiende PPA ................................................................................................................................80
Logopene PPA ........................................................................................................................................81
Differentiaal diagnostiek ........................................................................................................................83
Kritiek consensuscriteria Gorno-Tempini et al (2011) ...........................................................................85
Rol voor de logopedist in PPA ................................................................................................................85
Best principles when working with PPA.................................................................................................85
Assessment: klinisch-logopedische benadering PPA .............................................................................85
Behandeling en begeleiding ...................................................................................................................88
10. Ernstige afasie .....................................................................................................................................92
Gekende Assessment .............................................................................................................................92
Nieuwe assessment: Specifiek gericht op ernstige afasie .....................................................................94
Assessment: Ondersteunende communicatie .......................................................................................96
Assessment: Conversatie-analyse ........................................................................................................101
Behandeling .........................................................................................................................................102
Behandeling: ondersteunende communicatie ....................................................................................102
Behandeling: Conversatietraining........................................................................................................107
11. Communicatiestoornissen bij rechter hemisfeerletsels ...................................................................110
3
, Definitie, terminologie en etiologie .....................................................................................................110
Symptomen ..........................................................................................................................................112
Verklarende theroieën voor cognitief-communicatieve RH-stoornissen ............................................114
Assessment ..........................................................................................................................................116
Behandeling .........................................................................................................................................117
12. Info uit de practica “Klinisch Redeneren” .........................................................................................118
Algemeen .............................................................................................................................................118
Tips .......................................................................................................................................................119
4
EN COGNITIE
INHOUD
1. Spraakapraxie – intro ..............................................................................................................................5
Normale spraakproductie ........................................................................................................................5
Fonematische parafasieën .......................................................................................................................5
Definitie spraakapraxie ............................................................................................................................6
Andere vormen van apraxie .....................................................................................................................6
Diagnostiek...............................................................................................................................................7
Diagnostische testen ..............................................................................................................................10
Assessment in functie van behandelplan ..............................................................................................12
2. Spraakapraxie – behandeling ................................................................................................................14
Doelstellingen v behandeling .................................................................................................................14
Principes van motorisch leren................................................................................................................15
Integrale stimulatie ................................................................................................................................15
Therapiemethodes .................................................................................................................................16
Factoren die therapiekeuze bepalen .....................................................................................................20
Niet-stoornisgerichte interventies .........................................................................................................21
Speech entrainment...............................................................................................................................21
3. Extralinguïstische cognitieve aspecten bij afasie ..................................................................................22
Neurale netwerk taal – cognitie.............................................................................................................22
Overlap taal – cognitie ...........................................................................................................................26
Cognitieve domeinen en begrippen.......................................................................................................26
Extralinguïstische cognitieve problemen bij afasie................................................................................29
1
, Assessment ............................................................................................................................................30
Interventie..............................................................................................................................................36
4. Natuurlijke spraak bij neurogene communicatiestoornissen ...............................................................42
Natuurlijke spraak ..................................................................................................................................42
Natuurlijke spraak – pathologisch .........................................................................................................44
Assessment v natuurlijke spraak ............................................................................................................48
Behandeling v natuurlijke spraak ...........................................................................................................53
5. Cognitief-communicatieve problemen na Traumatic Brain Injury (TBI) ..............................................55
Definitie en terminologie .......................................................................................................................55
Oorzaken van TBI ...................................................................................................................................55
Prevalentie TBI .......................................................................................................................................55
Neuropathologie TBI ..............................................................................................................................56
Ernst TBI .................................................................................................................................................57
Soorten bewustzijnstoestanden ............................................................................................................58
Overgang tussen bewustzijnsniveaus ....................................................................................................59
Herstelverloop bij TBI: evolutie na coma ...............................................................................................60
Logopedische problemen bij TBI ............................................................................................................60
Taalstoornissen ten gevolge van TBI......................................................................................................60
Aard van taalstoornissen ten gevolge van TBI .......................................................................................61
Cognitieve stoornissen ten gevolge van TBI ..........................................................................................61
6. Diagnositek van cognitief-communicatieve stoornissen bij TBI ...........................................................62
Assessment ............................................................................................................................................62
Diagnostiek algemene bewustzijnstoestand .........................................................................................62
Diagnostiek taal en cognitief-communicatieve skills .............................................................................63
7. Behandeling van cognitief-communicatieve stoornissen bij TBI ..........................................................65
Indirecte/ omgevingsgerichte therapie .................................................................................................65
Directe therapie .....................................................................................................................................67
Principes directe cognitief-communicatieve therapie ...........................................................................68
2
, INCOG Recommendations .....................................................................................................................69
8. Dementie ...............................................................................................................................................70
Dementie................................................................................................................................................70
Dementie types ......................................................................................................................................71
Specifieke logopedische instrumenten ..................................................................................................74
Behandeling ...........................................................................................................................................74
9. Primaire progressieve afasie .................................................................................................................77
Dementie en PPA ...................................................................................................................................77
Primaire progressieve afasie: definitie ..................................................................................................77
Definiëren van PPA en 3 varianten ........................................................................................................77
Semantische PPA....................................................................................................................................78
Niet-vloeiende PPA ................................................................................................................................80
Logopene PPA ........................................................................................................................................81
Differentiaal diagnostiek ........................................................................................................................83
Kritiek consensuscriteria Gorno-Tempini et al (2011) ...........................................................................85
Rol voor de logopedist in PPA ................................................................................................................85
Best principles when working with PPA.................................................................................................85
Assessment: klinisch-logopedische benadering PPA .............................................................................85
Behandeling en begeleiding ...................................................................................................................88
10. Ernstige afasie .....................................................................................................................................92
Gekende Assessment .............................................................................................................................92
Nieuwe assessment: Specifiek gericht op ernstige afasie .....................................................................94
Assessment: Ondersteunende communicatie .......................................................................................96
Assessment: Conversatie-analyse ........................................................................................................101
Behandeling .........................................................................................................................................102
Behandeling: ondersteunende communicatie ....................................................................................102
Behandeling: Conversatietraining........................................................................................................107
11. Communicatiestoornissen bij rechter hemisfeerletsels ...................................................................110
3
, Definitie, terminologie en etiologie .....................................................................................................110
Symptomen ..........................................................................................................................................112
Verklarende theroieën voor cognitief-communicatieve RH-stoornissen ............................................114
Assessment ..........................................................................................................................................116
Behandeling .........................................................................................................................................117
12. Info uit de practica “Klinisch Redeneren” .........................................................................................118
Algemeen .............................................................................................................................................118
Tips .......................................................................................................................................................119
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