Children and young people Archives - Page 4 of 9

In this latest blog, our Talking Mats OT Associate, Rachel Woolcomb tells us how Talking Mats can support delivery of Personalised Care:

“Person centred practice”, and “partnership approach” are common phrases heard in health and social care settings but what does this really mean in practice?

How good are we at ensuring our service users are truly heard, and given opportunities to talk about what is important to them?

Recently NHS England set out their ambitions for the delivery of personalised care. This is a commitment to enabling people to have the same choice and control over their mental and physical health that they have come to expect in every other part of their life.

This however requires a shift in culture.

One of the cornerstones of personalised care is shared decision making. This is a collaborative process in which people are supported to understand the options available to them including the various risks, benefits and consequences. A shared decision will have acknowledged personal preferences, circumstances, values and beliefs. This ensures that when a choice is made it is fully informed.

There is substantial literature which demonstrates the usefulness of goal setting as part of the communication and decision making process.

A well written person-centred goal will describe the anticipated achievement of a specific activity. It will be meaningful and help create a common vision within the rehabilitation process.

Talking Mats is an ideal tool to help facilitate these processes. They enable better conversations and provide an interactive thinking space. They have also been demonstrated to be a useful tool in enabling people to think about their rehabilitation goals.

Read more about this in the TMOT Resource 2: How Talking Mats can help facilitate shared decision making and goal setting: Goal setting TMOT 2

If you would like to find out more about the different Talking Mats training options we offer, take a look here: https://www.talkingmats.com/training/

In this latest blog, Laura Holmes (Talking Mats Associate based in Stockport) shares a great example of how Talking Mats can be used by education staff to help children to share their thoughts and feelings:

One of Teaching Assistants I work with at Woodley Primary School in Stockport, Lucie Porteus, attended Talking Mats Foundation Training in December 2018. Since then Lucie has been using Talking Mats with many of the children on our Speech and Language Therapy caseload in school.

Lucie’s use of Talking Mats with a group of Year 6 children is a great example of the benefits of using Talking Mats to help children to share their views and opinions. Lucie had carried out initial Talking Mats sessions with four children, on a one-to-one basis. These sessions had focused on getting a general idea of each child’s thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resources. A common theme had emerged through use of ‘blanks’ – all four children wanted to talk more about their upcoming school residential trip. Here is a picture of one of the mats (click on the picture for a clearer view):

Lucie then planned and prepared options to ‘sub-mat’ the topic ‘PGL’ – the residential school trip, and chose the topline questions ‘happy about/not sure/ not happy about’. She then met with each child individually to complete the mats. Some of the issues/ questions which emerged from the mats were:

‘I don’t know who the people there are’/ meeting new people
‘I don’t know what we will be doing’
‘Do we have a choice about what activities we can or can’t do?’/ ‘I’d like to have a choice’.
Privacy – getting dressed
Will any instructions be written down – do we just listen or will we be shown what to do?
The instructions might be confusing – what will I do?
I don’t like heights – I’m worried about climbing up high
Working in groups – we might all fall out
Sleeping – it might be hard to get to sleep. Sometimes other children talk and I can’t get to sleep.
What will the food be like?
What happens if I don’t feel well?
The journey – I might feel sick if I’m not at the front of the coach/ Do we get to choose who we sit with?

This information was passed on to each child’s Class Teacher and Teaching Assistant. Further conversations then took place to answer/address the above queries and concerns. Using Talking Mats meant that these conversations were personalised and focused. The children’s queries/concerns were listened and responded to well before the school trip itself.

School staff report that all the children had a fantastic time on their school trip!

Talking Mats enabled these children to have their voices heard about a topic which was really important to them. If you are interested in finding out more about accessing training to enable you to support the children and young people you work with to have their voices heard, take a look at our training options here: https://www.talkingmats.com/training/

Many thanks to Tina Wood, Occupational Therapist at Therapy In Motion, for this great example of how Talking Mats can be used to explore thoughts and feelings both in present-day and in retrospect, to evidence positive outcomes from a change in educational placement. Tina’s use of colour coding and pie charts really helps to illustrate this.

Tina attended our Talking Mats Foundation training back in September 2016 and since then she has been using Talking Mats regularly in her work as an Independent Occupational Therapist.

In this example, Tina has used Talking Mats to enable Ben (name changed for anonymity, age 12½ years) to share his thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resource packs – focusing on the topics ‘My Body and Skills’ and ‘What I do and Support’.

At the time of this Talking Mat, Ben had been accessing a new placement at a Pupil Referral Unit for the past 11 months (click on the picture below to see a clearer version).

As there was clearly a difference in how Ben felt things were going when he was attending his previous school, Tina decided to ask him to do a retrospective Talking Mat of how things were going for him 11 months ago in January 2018, when he started to feel “unwell”.

This enabled comparison with how he feels now in the “safe setting” of the Pupil Referral unit (click on picture to see a clearer version).

Tina then compiled the information from the above tables into pie charts, enabling a clear visual comparison between the two times/situations (click on picture to see a clearer version):

As can be seen from these charts, there had been a huge change in Ben’s perception of how he is coping with life in general and school in particular.

Tina recommended that this information needs to be considered along with the rest of Ben’s sensory needs (as reported in her full OT report) when deciding on what is the best educational setting for him after leaving the pupil referral unit.

We love this use of colour coding and pie charts to illustrate the information from Ben’s Talking Mats – to really ensure that Ben’s feelings and thoughts are seen and heard.

If you would like to know more about accessing Talking Mats training – available across the UK and Ireland as well as online – please take a look here: https://www.talkingmats.com/training/

If you have any examples of how you report/share information about completed Talking Mats we would be interested to hear about it! Just email laura@talkingmats.com

We are delighted to introduce Rachel Woolcomb our first Talking Mats OT Associate. She is joining the Talking Mats Team and will be working to develop awareness and use of Talking Mats by Occupational Therapists. I will let Rachel introduce herself:

I am delighted that Talking Mats have asked me to join their team for one day a week. I am passionate about occupational therapy and about Talking Mats and to have the opportunity to bring these two loves together and seeing what develops is very exciting.

I live in South Gloucestershire and have had a varied career since I qualified as an Occupational Therapist in 1992. I was introduced to Talking Mats in 2008 and have never looked back, using them with my clients ever since.

In 2017, having spent over 25 years working in the NHS, I made the decision to move into independent practice. I work predominately with teenagers and adults who live with long term neurological conditions or who have experienced catastrophic injuries following trauma. I am very aware of the psychological impact of sudden disability and the need for people to be able to express who they are and what is important to them, even in difficult circumstances.

I now use Talking Mats with most of my clients. It doesn’t matter if they are old or young, can speak or have communication needs, they all benefit from the opportunity to stop and think and have someone really listen to them.

In the last few weeks a man who has had a stroke and has limited expressive speech has used a Talking Mat to talk about what leisure activities he used to enjoy. He then used a second mat to explain what he can and cannot achieve now. This helped us together, set goals for occupational therapy. I am also working with a teenager who has had a traumatic brain injury and now struggles with her education. She uses Talking Mats with me regularly, to think about her coping skills at school. Looking back at her previous mats is helping her to recognise progress. I have so many more examples and will be sharing them with you soon!

I really want to inspire OT’s, helping them to consider how they enable their clients to think, communicate their choices and make decisions. A Talking Mat is a great for this. It is also creative and interactive something that in my experience OT’s like! I will also be looking at important issues within the field of occupational therapy that are currently driving practice, such as personalised care, goal setting and shared decision making. I believe it is vitally important that we collaborate with our clients as together we can achieve so much more. Talking Mats is an effective tool in enabling this, so watch this space, and please do get in touch if you want to know more or have stories to share.

It is great to have Rachel working with us to build on some of the excellent work being done already in the Occupational Therapy Sector. Our Director, Lois Cameron shares why we are so excited to welcome Rachel to our Team:

‘I am really pleased that Rachel is joining us . I think the Talking Mats approach sits well with the values and approach of Occupational therapy, In my experience OTs are naturally holistic in their approach. I remember at a training course in London an OT said for her Talking Mats was the missing link in her toolkit. The training and experience of OTs allow them to see things through a different lens and that will be really helpful to us’

For more information about how OT and Talking Mats are a winning combination, take a look at Rachel’s recent blog – https://www.talkingmats.com/talking-mats-and-ot-a-winning-combination/

Feeling inspired and want to know more about the training courses we offer? See www.talkingmats.com/training/ for details.

Thanks so much to all the practitioners who have sent us guest blogs about using Talking Mat in a Criminal Justice setting. Here are our top 5 – in no particular order!

1. Supporting Families in the Criminal Justice System: Sally Kedge, Speech and Language Therapist from Trouble Talking New Zealand shares two powerful case examples of using Talking Mats with children and families caught up in the criminal justice system. https://www.talkingmats.com/support-for-prisoners-families-experience-from-new-zealand/

2. Communication Needs within Youth Justice – Part 1: On 17^th April 2017, we organised a seminar to look at underlying issues and share good practice when addressing the communication needs of people in youth justice. We had representatives from: the Scottish government, the NHS; Third sector organisations working in youth justice, the police, social workers, professional bodies, universities and social work – from as far afield as New Zealand. The emphasis from the start was that understanding communication is key to improving service delivery. https://www.talkingmats.com/communication-needs-in-youth-justice/

3. Communication Needs within Youth Justice – Part 2: The afternoon session of our seminar on 17.04.17 continued the underlying theme that communication support needs are often hidden and many looked after children have support needs that remain unidentified. The outcome of the day was the establishment of a collaborative network. https://www.talkingmats.com/youth-justice-and-communication-needs-2/

4. Setting up a SLT Service in Prison: This inspiring blog by Jacqui Learoyd explores her role in setting up a speech and language therapy ( SLT ) service in a prison and her use of Talking Mats in that setting https://www.talkingmats.com/setting-up-an-slt-service-in-prison/

5. Has Talking Mats been used in Court? Two registered intermediaries talk about a couple of cases where Talking Mats was used as part of the achieving best evidence (ABE) interviews. https://www.talkingmats.com/talking-mats-used-court/

If you have been inspired and are not yet trained, come along to one of our Foundation training courses – for details see https://www.talkingmats.com/training/foundation-training/

We also offer online training if you are unable to access the training locations – for details see https://www.talkingmats.com/training/online-training/

In Stockport we have a termly ‘Voice of the Child/Young Person’ Champions Network meeting during which professionals working in health, education and social care settings across the area meet to discuss real-life examples and to share information and strategies – during the last meeting in October 2018, we discussed using Talking Mats to support police interviewing.

Louise Tickle, Specialist Learning Disability Nurse from the Children’s Learning Disability Team at Stockport NHS Foundation Trust, shared a great example of using Talking Mats to support a child she was working with to share information about a serious safeguarding concern. Louise had been asked by the police to carry out a Talking Mats session with the child as they were aware that she was already using this approach. Louise led the session and was supported by the child’s school SENCO, who had also been Talking Mats trained. The aim was to explore a disclosure which the child had previously made.

Louise shared some great tips about using Talking Mats during an investigation phase:

Introduce the Talking Mat with a familiar topic, then move on to the main topic/ area of concern
Watch out for non-verbal cues – initially, the child appeared to be happy and relaxed during the interview, however the child’s non-verbal communication visibly changed when the topic changed. It is easier to pick up on these non-verbal cues if you are able to video the session.
Have another Talking Mats trained observer present if possible to support and evaluate the session with you.
Make sure you use terminology that the child is familiar with, and use language that the child would use themselves e.g. when describing body parts.

Talking Mats are often used by people working within the justice system, including registered intermediaries – here is the link to one of our previous blog posts for more information: https://www.talkingmats.com/talking-mats-used-court/.

In this work you must be clear about the different stages of safeguarding and follow the procedures within your organisation. Disclosure and investigation are two different phases. The Keeping Safe resource has been trialled and tested to support people to raise concerns. https://www.talkingmats.com/keeping-safe-a-new-talking-mats-resource-available-to-purchase/ . When a disclosure moves to the investigation phase you may have to personalize the mat to fit the situation but what is key is that you keep the options open and non-leading.

For further information about accessing one of our Talking Mats Foundation Training Courses across the UK, and our ‘Keeping Safe’ Advanced course, see our training options here https://www.talkingmats.com/training/

We were delighted to get funding from the Big Lottery to deliver a Talking Mats training to parents and carers in Perth, Scotland. The feedback from this pilot group, (who have primary school aged children with speech, language and communication needs), will be used to develop a training course specifically for parents and carers, and design a Talking Mats resource for families to use at home.

We don’t yet know what the training and resource will be like. This will be designed with the parents when they have completed the training. Will it be a set for the digital app, or a mat and cards? Will the training be online or a face to face course? Exciting!

We will then apply for further funding to develop this and make it accessible to more families.

Talking Mats helps people have better conversations. Some parents are already using Talking Mats at home to have a conversation, to support their son or daughter to express how they feel about a topic or say when somethings wrong. Here’s a link to a blog about how Talking Mats helped a parent find out why her 4 year old daughter was getting upset at the thought of going to nursery https://www.talkingmats.com/mummy-i-dont-want-to-go-to-nursery-today/

We’re always keen to hear what topics would be useful to explore with children and young people with communication difficulties. Get in touch with your ideas via Facebook, Twitter @TalkingMats or info@talkingmats.com

We are grateful to Rachel Woolcomb OT, for sharing this Talking mats story.

Within my occupational therapy practice I have found Talking Mats to be an excellent thinking tool to help my clients establish their priorities for therapy.

I was asked to work with a teenage girl who had sustained a brain injury resulting in a mild cognitive impairment which was impacting on her participation and ability to learn at school.

She had undergone formal cognitive testing with a clinical psychologist, however had shown poor levels of engagement with the assessment process (which had taken over two hours). She was reported as having erratic focus and inconsistent answers to questioning. The results were therefore deemed to be inconclusive and no recommendations made. I knew that Talking Mats would provide me with similar information to that which the psychologist was trying to gain, but in a way that would be engaging and client focused. I also felt that the concept of the Talking Mat, which enables the thinker to express their own views rather than a “right or wrong” answer, would help to improve participation.

I selected the learning and thinking topic cards from the communication set within the Health and Wellbeing pack. These cards cover areas that I would normally look at within any cognitive assessment and are functionally relevant. Together we selected the visual scale, choosing the question “how well are you managing?”

She explained that organising herself, writing, listening, reading, problem solving and planning were all going well. She talked about how she sometimes had difficulties concentrating and paying attention due to getting distracted in the classroom. She also felt she was struggling more than before with calculating and that this was affecting her scores in Math tests. She explained that remembering and making decisions were “not going well’ and she was particularly worried about the fact she had forgotten some of the teaching she had received prior to her brain injury. I was also able to conclude from the way she understood the concept of the mat, as well as her ability to engage and attend for the whole session, that she could concentrate, learn new skills and had the ability to weigh up information to help her make decisions.

Together we used the information gained from the Talking Mat to set goals for therapy which were focused around having a range of strategies to help her concentrate in class, remember new information, and make decisions.

Two months later, once having completed a therapy programme, we used the Talking Mat again to explore her current thinking about the topic area. She explained that making decisions was something she no longer had difficulty with as her confidence had grown. She felt that there had been some improvement with her ability to remember information and we discussed the strategies she now used to help her concentrate in class, which included ways to minimise any distractions.

In summary, the Talking Mat enabled her to think about how her brain injury had affected her ability to remember, make decisions and learn. This provided valuable information from which a therapy programme could be created. The Talking Mat also provided a visual representation of her perception of the issues before and after therapy, showing clearly her progress. This was well received by her parents, teachers and the other professionals involved in her care.

Once again I have been amazed by the power of the Talking Mat to produce a breadth of information in a relative short space of time and I will be advocating its use within cognitive assessment and rehabilitation across all ages.

On the 17^th April we held a seminar exploring the innovative work being done to support young people with communication needs within justice and mental health settings in both New Zealand and Scotland Read about the morning in our first blog Talking Trouble, New Zealand kindly gave a gift to all delegates of their fantastic Top Tip cards shown in the photo . You can download your own set here

The afternoon session continued the underlying theme that communication support needs are often hidden and many looked after children have support needs that remain unidentified.

Dr Ann Clark from Queen Margaret University presented her research findings looking at Panel members’ and Children’s Reporters’ perspectives on communication in Hearings. Her informative presentation highlighted the need and desire for more training on Speech, Language and Communication Needs. The conclusion was that it is better to assume ALL children who are attending a Hearing have additional support needs, whether or not they have a diagnosis of Speech Language and Communication Needs (SLCN) and Social Work support is also essential in achieving positive outcomes for Looked After Children. SLCN in Hearings April 2018

Our interactive session asked participants to reflect on the information presented during the day and to think about opportunities to improve practice in supporting communication as well as the barriers faced. The main themes that emerged from the barriers were:

Identifying Speech, Language and Communication Needs in children and young people
Constraints within Speech and Language therapy services
Lack of education and training – the word “communication” because practitioners think they know about it when in fact there is a large knowledge gap
Routes to services can be either Offending or Mental Health pathway
The balance of power and control in relationships between the practitioner and the person with SLCNs – how committed are we to put genuine inclusive communication approaches in place.

Identify the barriers helps to inform the opportunities and the themes emerging were:

Some good collaborative practice is happening already and the impact of working together is proven in research – we need to extend this further.
Joint training sessions – good visual and other communication supports
SLT have a vital role going forward
We have a real opportunity at the moment to effect real change in a legislative context with recent Government policy

Kim Harley Kean, Head of the Royal College of Speech and language therapy Scotland office concluded the day and injected a great sense of impetus going forward. She asked 2 key questions:

Q: Is communication support and equality an issue in justice and care services?

Q: Do we want to do something about that?

Having responded with a unanimous YES she helped us to see the potential we have for change. It was obvious from the day that collaboration is vital and the event demonstrated how many different professions and organisations want to do something about the issues. We can be more effective if we do this collectively, even across continents!

The majority of participants felt we should use the event to establish a collaborative network. The key purposes would be to:

Market – get message out there – tell more people – politicians, government and public – about Speech Language and Communication in Criminal Justice Settings explaining how SLT and Talking Mats have a vital role.
Share stories, gather evidence.
Facilitate enriching conversations between practitioners, for example, about aptitudes and approaches needed to negotiate communication behaviour change among professionals as well as people with SLCN…

If you would like to join the network and help to influence change please email info@talkingmats.com with a request to add your name to the youth justice mailing list.

Addressing the communication needs of people in youth justice is key to improving lives. The lack of attention to this is costly. On the 17^th of April, we organised a seminar to look at the underlying issues and share good practice.

We were delighted with the collaborative mix of people attending. We had representatives from: the Scottish government, the NHS; Third sector organisations working in youth justice, the police, social workers, professional bodies, universities and social work.

Our thanks to Professor Richard Simpson for chairing the day and setting the tone by emphasising from the start that understanding communication is key to improving service delivery. Following his introduction a series of excellent and stimulating presentations took place creating a fusion of ideas and practice from Scotland and New Zealand.

Kim Hartley Kean, head of the Royal College of Speech and language therapy Scotland office highlighted the current position in Scotland
Sally Kedge and Alayne Mckee described the approach adopted by their organisation Talking Trouble in New Zealand.
Jane Macer the therapeutic service co-ordinator from Starley Hall Fife described an whole system approach to embedding good communication practice within an organisation
Yvonne McKeown and Sandra Polding Speech and Language Therapists working with young people in a NHS inpatient psychiatric unit in Glasgow shared some case examples.

In different ways the speakers brought up very similar themes:

Communication can be treated glibly. There is a lack of understanding of what communication difficulties are and of the impact that they have on the lives of young people. These difficulties are often hidden and take time to identify. Lack of identification can have a huge impact on the future lives of young people.
Finding ways to hear the young person’s voice is key both for the young person but also for organisations in order to deliver appropriate and effective care.
Recognition of the intergenerational cycle and the importance of getting care and support correct so we break patterns and enable change.
Providing collaborative solutions and understanding the breadth of communication will help services improve. However, given services often don’t know what they don’t know in terms of the impact of communication difficulties we have to find ways to express those solutions in language that those services can relate to and understand. Listening to organisations and exploring their processes by analysing the communicative demands of each stage can be a helpful way to start.
Moving forward it is important to knock on open doors i.e. work with people who are receptive to recognising the impact of communication difficulties on young people and their lives but also find the strategic influencers who are sympathetic, in the words of our New Zealand colleagues ‘the aunts and uncles in the field’ who can help to promote the issue and raise awareness at a National level.
You can’t explore the issue of trauma and adverse childhood experiences without certain precursor, building blocks being in place. This takes time and requires a constancy of approach.
The importance of inclusive, visual tools becoming common place so that they are not used in isolation and in a vacuum.
The challenge of supporting and nurturing a young person’s inner voice when they have significant difficulties with language.
Lack of understanding of communication difficulties may lead to services responding to internalized behaviours that can lead to a fork in life; one way can send the young person down a route of offending behaviour services and the other mental health services.
The solutions lie in partnership and collaboration between professions and services.

There were lots of creative ways of using Talking Mats that were shared. A couple of examples that stand out were

Using Talking Mats with social workers to help them unpick what they already know about a young person’s language and communication. This approach helped them think about all the different aspects that contribute to communication and where the young person’s strengths and weaknesses lay e.g. non verbal communication , humour , word finding , understanding complex information, understanding simple information etc .
Using Talking Mats to support a psychiatric assessment of a young person. One person used his Talking Mat to say he was hearing voices something he was unable to disclose verbally. In this case this enabled an accurate mental state assessment and non-custodial sentence.

I will leave the last word to a young man living in an inpatient unit to support his mental health, his words about communication difficulties are ‘They make you more vulnerable when bad stuff happens’ how true that is and this is why it is important we work together to improve services .

Next steps The community justice network met in the afternoon and were challenged to think about the opportunities and barriers in developing services – read the for blog that covers the afternoon ……… If you missed the seminar and want to join a multiagency network to discuss this and help take this forward in Scotland then please let us know .

Click to read the excellent presentations from the seminar

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