Talking Mats in Germany is being extended by one of our trainers Professor Norina Lauer.  Here she describes two of her current interesting  projects and we look forward to reading her findings.

The German version of the Talking Mats app will now be tested in two more projects in the west of Germany. As the communication symbols were developed for English-speaking clients six German SLT students of the Hogeschool van Arnhem en Nijmegen (han) in the Netherlands want to find out if the words and symbols fit to German clients and their cultural background. Because of cultural differences between Scotland and Germany it is necessary not only to adapt the language but also check the icons.

One of the projects will be conducted with children between the ages of 8 and 10 years. The children will be asked to classify the symbols from their age-group. The question will be whether the symbols and words are relevant for the situation of German children. If not, they will be asked for possible alternatives.

The other project focuses on adults. One group of people with aphasia and one group of healthy persons will be tested. Every tested person scores the 57 icons concerning their correspondence with the words written down below by using a scale from 0 to 3. In addition, possible graphic alternatives will be enquired and collected. The two groups of adults will be used to determine if there is a significant difference between the obtained results from each group.

Talking Mats were delighted to be involved in the launch of Care Opinion’s Picture Supported stories at the Life Changes Trust Gathering in Perth Scotland this week. We have been working with Care Opinion for the past two years to develop this feature.  This earlier Talking Mats blog describes the development process and this recent Care Opinion blog gives some examples of the feature in use.

However, in this blog,  I want to reflect on two events I went to within a short space of time; the gathering in Perth on Monday and the Royal College of Speech and Language  Therapists study day the previous thursday in Stirling . It felt to me like my two worlds colliding or maybe it was just my stars aligning ! At the RCSLT study there was a session on the public perception of Speech and Language therapy and how there is still much work to do in changing the myths that are spun and repeated about what Speech and Language therapists actually do . For as John F Kennedy said in 1962 ‘ the great enemy of truth is very often not the lie but the myth , persistent, persuasive and unrealistic ´ The  National  Allied Health Professional  children’s lead, Pauline  Beirne suggested to the study day that Care Opinion is a great web site for encouraging that sharing of stories. Then, strangely when I got back into the office there was a story waiting for me in my in box all about the positive experience of a parent involved in a Hanen programme in NHS Lanarkshire  which reinforced that very message.

We know people relate to stories, stories resonate and have impact, they are easy to remember .  Our drive in working in partnership with Care opinion was to support more people to tell their health and care stories  by increasing accessibility . It was designed with and for people with dementia   through funding from Life Changes Trust but anyone can use it and they are! It is great to see the stories coming in.

Through stories let’s celebrate the good, develop and improve practice and let’s use stories to challenge myths and educate. So use Care Opinion and try out the  picture supported stories to share your experiences , tell other people ,spread the word and the picture supported story feature  !

We are delighted that ‘Talking Mats in German’ is now available in the Digital version and includes the latest technical and symbol upgrades. These upgrades are also now included in the English version.

Please click on this link to find out about all the upgrades.

We are very grateful to Prof Norina Lauer for sending us this blog which explains how ‘Talking Mats in German’ has been developed.

In 2016 Prof. Dr. Norina Lauer, a German professor for speech language therapy contacted Joan Murphy from Talking Mats because she was initially interested in the digital version for goal setting with people with aphasia. We found out that it would be interesting to have a German version of the app. So we started a project for translating Talking Mats into German. Prof. Dr. Norina Lauer managed the translation process. The project was financially supported by a German health insurance “BKK Dachverband” in cooperation with the German aphasia self-help organization “Bundesverband für die Rehabilitation der Aphasiker” (www.aphasiker.de). The translations were performed in a special scientific procedure to make sure that they match the English terms.

What did we do?

Norina Lauer and her colleague Holger Grötzbach independently translated the English terms into German. Subsequently these translations were compared and the differing terms were discussed until a consensus was reached. The agreed translations were given to a professional translator who only got the German words and the corresponding pictures. She re-translated the terms into English and these re-translations were checked by Talking Mats if they were in accordance with the original English terms. For those terms that did not match, the process started again until all terms matched the original English terms (figure 1 shows the translation process). This process was performed for all topics of the app. So we have the complete Talking Mats app in German now.

Figure 1

So what’s next?

Norina Lauer completed the foundation training and the accredited training in 2017. In October 2017 she performed her first foundation training for 6 of her SLT students. One of these students will do her bachelor thesis about the German app version in 2018. Under accompanying consultation of Norina Lauer the student will perform two workshops for people with aphasia. In these workshops they will practice doing Talking Mats and afterwards evaluate the app concerning its content and practical use. For the evaluation we are planning a short questionnaire and a focus group.

It has been a delight to work with Norina and we look forward to hearing the results of her student’s project.

If you already have the Digital Talking Mats make sure you upgrade to get all the new features.  The German version with the upgraded is now available from the App store, Google Play (Free and Lite versions) or purchase the full version from our website .

We are now half way through our project, funded by The Health and Social Care ALLIANCE Scotland, whose overall aim is to empower people with a range of long term conditions, with and without additional communication difficulties, to self-manage their own health and well-being by using Digital Talking Mats.

Participants

We have carried out all the initial visits and 16 follow-up visits and participants are sending in their completed mats, choosing whichever topics they want from the digital Health and Well-being resource. At the time of writing this blog we have received 137 completed mats.

We have received very positive feedback with many examples of how people are using the Digital Talking Mats to self-manage.

Here are 3 examples:

One participant with learning disability has diabetes. Through using the Digital Talking Mats she has stopped buying takeaways every night and is now buying M&S ‘Balanced for You’ meals. This is a huge step forward for her as she refused to discuss healthier eating before.

A man with early onset dementia has identified that he used to enjoy singing and has decided for the first time in his life to join a choir. This is not something that had come up in conversation before. Despite the diagnosis of dementia he has realised that he is still keen to try new things.

 

 

The wife of a man with severe aphasia said ‘This (Leisure away) has highlighted how few things he can do away from home. We discussed this but can’t see how we can change the situation.’ However at the second visit he used the same mat and indicated that he had been thinking about his mobility and was about to start swimming and a fitness class.

We already have an increased awareness of the meaning of self-management as we observe how participants are using the Digital Talking Mats to think about their situation, state their own views and share them with carers/support workers. We are also noticing that there is a shift in some relationships as the carers/support workers realise that the person with the long term conditions can make decisions and express their own views rather than having decisions made for them.

Thanks to Gill Pearl for sending us this information about an international conference for people with aphasia.

Where:  Warwick Conference Centre, Coventry, England

When:  Sunday 5 and Monday 6 March, 2017

Families, friends, aphasia and stroke organisations, and health professionals are also invited. People with aphasia have planned the conference and will chair the sessions.

The information will be presented in a way that is easier for people with aphasia.  There will be support from therapists and students to help people to join in.

The following themes will be discussed

•  technology and aphasia, learn and have a go
• increasing awareness of aphasia, and using social media
• sharing what’s happening about aphasia around the world
• research
• support for carers of people with aphasia
• aphasia and the arts.

There will be an exhibition of products relevant for people living with aphasia

This is a wonderful opportunity to

• Do something new, develop confidence, be inspired
• Learn from each other and share ideas
• Find out about new services and ways to help
• Meet people with aphasia from around the world!

If you want to find out more, contact Gill or Denise at

• info@buryspeakeasy.org.uk
• gill@buryspeakeasy.org.uk
•  01706 825802    (part time office)

Talking Mat would like to wish you all a Happy Christmas

2106 has certainly been a busy year for us at Talking Mats. We have seen some staff changes saying goodbye to Jill hall and welcoming Morag Crawford. We were delighted when we brought Kirsty  onto our staff . Kirsty originally volunteered with us as part of a school transition programme for people with autism. Laura Holmes joined us as a Talking Mats external associate for the North West of England.

If you are interested in what we do and want to see our activity in numbers then have a look at the Talking Mats Year in numbers . Click on image to see the enlarge ! 

At the moment we are busy preparing for 2017 and we are looking forward to

1. The evaluation of our following projects in The New Year

• The National Involvement Network on our partnership with ARC Scotland
• Our programme of service wide training with Central London Community health

2 Continuing to work with

• Patient Opinion
• The Alliance Self-management digital project
• Colleagues in Germany

3 Launching more resources

• Keeping Safe- so far this resource has only been available to people working with people with learning disability in Scotland. We will be holding a specialist seminar about this resource in London on the 17th March so its use can extend south of the border .
• Launching our conversation sets: gardens, holidays, trips out, sports indoor, sports outdoor and football.  These were developed as part of the family training for people with dementia but they have much wider use and will be available  as additional  Talking mats sets

Plus Talking Mat is planning to go to Australia in May!

Nicki and Lois have their flights booked. Agosci here we come ! Then we are over to New Zealand to run foundation training in Christchurch and Auckland before we head back to Melbourne to run the first ever accredited training course in Australia. We will also be running a specialist seminar on Keeping Safe in Melbourne. If you want any details about the trip please get in touch.

We really appreciate all the support we get from everyone involved in Talking Mats and wish you all a happy and peaceful festive season

Delighted to introduce you to ‘The Communication Game’ : a board game for staff to improve their communication skills.

How we  listen, talk and engage with people is fundamental to the quality and effectiveness of health and social care services. Although communication underpins everything we do in a work context, it can be a difficult topic for staff to talk easily about. Add to that the possibility of service users having an additional communication support need, through reasons like stroke, learning disability or dementia, then there is much potential for things to go awry and  unfortunately, they often do. ‘Poor communication’ is cited as the most common cause of frustration in complaints about services.

The Communication Game was developed by Focus Games, NHS Education for Scotland (NES) and Talking Mats. It is a learning tool to help staff working in the health & social care sector increase their knowledge and skills around communication.  The Communication Game is fun and easy to play. It can be played with or without a facilitator, and allows staff groups to have discussions and reflect on their communication skills. It allows them the chance to learn from each other. It will improve knowledge, but more importantly enable them to think about the small steps they can make to improve their interactions.

The project grew out of two previous projects funded by NES: Making Communication Even Better and Through a Different Door. In these projects, it was recognised that the experience of services for people with a communication support need is something of a lottery. For them, there was a considerable difference in the experience of interacting with a staff member who was empathetic and able adapt to their communication, to interacting with a member of staff who was struggling and unable to adapt their interaction. Training and understanding of inclusive communication practice is key. It has been a great privilege for Talking Mats to continue to support the work of the previous 2 projects and work with Focus Games Ltd to develop The Communication Game. Support during the development process from the Stroke Association Scotland, Capability Scotland, RCSLT, Scottish Care, Communication Forum, Queen Margaret University and NHS Ayrshire & Arran SLT Department have been invaluable, and we are very grateful; also to NHS Education for Scotland for their continued input and funding.

If you are working with staff in the health and social care sector, then this will be a great resource for you. You can get The Communication Game from the Focus Games online shop. It is guaranteed to promote laughter learning, and a touch of competitive team spirit. Most importantly, it will be a catalyst to help develop staff communication, making interactions better for people with communication support needs.

You can find out more about the game at www.communicationgame.co.uk

, and follow the game on Twitter on @Comm_Game.

Get your copy at www.focusgames.com.

We are very grateful to Lauren Pettit and her colleagues from Pretoria, South Africa for sending us their published paper on a recent research project which used Talking Mats as a research method.

The study’s aim was to describe and compare the views of adults with aphasia, their significant others and their speech and language pathologists regarding the importance of nine life areas for the rehabilitation of adults with aphasia.

They used Talking Mats to support 15 adults with expressive aphasia to rate 9 life areas in terms of importance to them. The 9 life areas they included were Domestic Life, Relationships, Work and Education, Leisure, Self-care, Learning and Thinking, Coping, Communication and Mobility. These are taken from the World Health Organisation International Classification of Functioning Disability and Health (WHO-ICF). The researchers also obtained the ratings of 15 significant others and the 15 speech and language pathologists treating them.

They found that most life areas were rated as important to work on in rehabilitation by most participants. However, there were some discrepancies between the views of the adults with aphasia and the other 2 groups in the study and significant discrepancies were noted for 3 of the 9 life areas.

The graphs below show the comparisons of the 3 groups of participants. Click on graphs to enlarge

Fig1. People with aphasia

Fig2. Significant others

Fig3. Speech and language pathologists

The researchers suggest that ‘These life areas can provide the ‘common language’ for team members to engage in dialogue and identify problem areas related to the daily life functioning of people with expressive aphasia. By simplifying some of the labels of the activities and participation dimensions of the WHO-ICF and pairing these labels with pictures and the interactive Talking Mats interview procedure, adults with expressive aphasia (who often have difficulty participating in the selection of rehabilitation priorities) were able to express their own views. This may be a first step in assisting the adult with aphasia to advocate for themselves and to exercise their right to identify the activities and participation opportunities which they would like to access, and to set rehabilitation priorities based on their choice. While the overlap in priorities among the three groups as found in this study is encouraging, the presence of some significant differences underlines the importance of the voice of adults with aphasia themselves. This ensures truly client-centred rehabilitation that underscores the principles of human rights and a focus on competence rather than deficits’.

To link to the full article:  http://dx.doi.org/10.1080/10749357.2016.1207148aphasia

Please contact info@talkingmats if you would like to discuss using Talking Mats in research

What are the top 10 blogs for using Talking Mats with adults? Over the years we have posted lots of blogs on different aspects of our framework . If you are working with adults with communication disability these blogs maybe particularly helpful

1. Where is the best place to start using the Talking Mats health and well-being resource? 
2. A blog from Denmark which highlights the effectiveness of using Talking Mats with people with dementia
3. Goal setting with a woman with Multiple sclerosis  
4. Using the  app with someone with aphasia 
5. The development of a resource to help people with learning disability raise concerns 
6. How can Talking Mats support Capacity to make decisions
7.  Involving  people in their decisions about eating and drinking 
8. Thoughts on using Talking Mats with people with dementia to explore mealtimes 
9. Using Talking Mats with someone with a learning disability and dementia
10. Use  in a rehab setting in South Africa 

If you want to explore our  resource and training more  please visit our shop

We are very grateful to Anna Volkmer for sending us this blog, Lets Talk about Capacity…
She has just had an excellent book published –  Dealing with Capacity and Other Legal Issues with Adults with Acquired Neurological Conditions http://www.jr-press.co.uk/dealing-capacity-legal-issues.html. In it she describes how AAC methods, including Talking Mats, can be used to support people in expressing their decisions.

Prior to 1959 people who were considered “non-compus mentis” were cared for under the “parens patriae” principle. Literally translated this meant that they were ‘parents of the country’ and decisions to protect them and their property were made by the Crown (the Lord Chancellor). These people were often described as “Chancery Lunatics”. In 1959 the “parens patriae” jurisdiction gave way to the Mental Health Act. This Act instructed that “the judge may, with respect to the property and affairs of a patient, do or secure the doing of all such things as appear necessary or expedient…for making provision for other persons or purposes for whom or which the patient might be expected to provide were he not mentally disordered” (section 102 (1)(c)). Unfortunately, this Act did not make adequate provision for non-financial decisions such as medical decisions. During this period it was case law that guided professionals in supporting their patients who lacked capacity in medical decision making. It was not until 2005 that the first Mental Capacity Act was given Royal Assent, accompanied by the Mental Capacity Act Code of Practice in 2007.

I returned to the UK from a 5-year stint working in Melbourne, Australia, just after the Mental Capacity Act had been published. Mental capacity was on the tip of everyone’s tongues and as the speech and language therapist working on a multi-disciplinary team I became an integral part of this process. Patients I was seeing, often people with primary progressive aphasia or other types of dementia, were asking about how to make future decisions. They and their families were keen to understand how the mental capacity act worked, how to prepare for the future and how to have their voices heard. On the other side of the coin I was working on an inpatient ward where staff were concerned about ensuring we were fully assessing the decision making capacity of people with cognitive and communication difficulties, often holding best interest discussion to plan for the future of these individuals. Many of these decisions related to dysphagia, but others related to accommodation and finances.

What concerned me was the lack of evidence available across the speech and language therapy arena in this area. There was little to none in terms of written research, let alone written advice or even examples of good practice tailored to speech and language therapy clinicians. As I asked around I found an enormous disparity in the services that speech and language therapy clinicians were providing across different trusts. I had previously written a book on dementia, and had included a chapter on assessments of decision-making. At this stage some of the only research related to communication and decision-making had come from Talking Mats. This had demonstrated that using the talking mats tools can support families and caregivers in conversations with their loved ones when discussing decisions to be made. They found that conversation enabled people in understanding, retaining and expressing themselves in decision-making discussions.

Following a particular stimulating discussion with the publishers at J&R press, they invited me to submit a book proposal on this topic. As I was developing this idea I found the topic of mental capacity was raised more and more often at study days and seminars I attended. At these study days I started linking in with more like minded speech and language therapists such as Mark Jayes, Hannah Luff and Claire Devereux. These were clinicians who all agreed on the diversity of our potential role in supporting our patients around mental capacity issues. These common interests enabled a collaboration. Our book is now published.

Through these connections I became aware of other work being done; Mark Jayes holds a NIHR doctoral fellowship award and is conducting research in the development of a communication and capacity assessment tool kit. Claire Devereux is the chair of the Southern Psychiatry of Old Age Clinical Excellence Network, together we have held a workshop with the clinical specialists where we developed a consensus document on role of the speech and language therapist in capacity assessment. This is to be published in Bulletin magazine later this year. Hannah Luff is a clinical lead speech and language therapist at South London and the Maudsley NHS Trust and is currently a member of the review panel looking at the NICE SCIE dementia guidelines.

The wonders and value of networking never ceases to delight, enthuse and inspire me! And you can purchase our book at the following website (there is currently a discount rate until 21^st February):

http://www.jr-press.co.uk/dealing-capacity-legal-issues.html

You can follow me on my blog https://annavolkmersbigphdadventure.wordpress.com/ or on twitter @volkmer_anna