The transition from children’s to adult health services for young people with exceptional needs and their families is complex, multifaceted and fraught with concerns and fears. CEN Scotland commissioned Talking Mats to carry out a study to collect the views of 10 young people and their families who are experiencing this transition in Scotland.

The families in the project have given us clear views about their problems and fears and also some thoughtful suggestions for what could be made better. It is often in making small changes that significant improvement can occur. These suggestions include:

• Courses for parents on transition
• More specialist nurses e.g. transition nurses, acute liaison learning disability nurses
• Start preparing early – at least 2 years
• Transition wards for young people
• Training for doctors and nurses about complex needs
• More respite, not less
• Emotional support for parents
• Longer appointment times
• A hotline to GPs

This study captures the complexity and variation of transition health services for young people with complex health needs from the perspective of both the young person and their parents. Despite the problems and fears we also saw evidence of good practice and suggestions, such as those above, which give hope for the way ahead.

To read the full report, including a moving case study, and direct comments from families, please click here CEN Transition Report

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Sophie Mitchell SLT describes how she supported her students to develop their EHC Plans with the Talking Mats app .

In September 2014 our  team and I were asked to facilitate the production of Education and Health Care plans for the Year 14 students at the Secondary Special School (for adolescents with complex, profound and multiple learning difficulties) where we  are based. As Speech and Language therapists we were asked to work with the students to gain their view on what they would like to be detailed in their plan and also what their aspirations were for their future. We wanted to ensure the production of these plans were as client centred as possible so therefore decided to use the Talking Mats App on the Ipad using the Health and Wellbeing resource.  This resource proved invaluable when working with our students. Not only were our students highly motivated to participate in the sessions due to the Ipad being used, talking mats empowered them to make meaningful decisions about their future, communicate any areas where they would like further support and discuss likes and dislikes. The impact on our students became clear when working with one 19 year old student. Although he did not have any spontaneous expressive language and would only echo things said by others, during a Talking Mats sessions when talking about his likes and dislikes, he appeared to be placing most items under ‘dislike’.  As the session went on the student started to appear agitated, then started pointing towards ‘like’ although no symbol was presented. Suddenly the student said ‘Garden’, still pointing towards the ‘like’. When presented with a gardening symbol he soon placed this under ‘like’. This information was then presented in his plan and his college were instructed to explore opportunities for this student to develop his gardening skills. For all students this information was then used to not only create their Education and Health Care plan but also expand and explore areas they were highly motivated by while still at School and also identify possible work placements for the future.  Furthermore the School invested in Talking mats training to ensure this approach is used throughout each academic year and school staff are skilled to use Talking Mats as each student starts their assessment for their Education and Health Care plan.

We would like to thank Sophie who is from Sandwell and West Birmingham NHS trust  for such a great example of how to use the app in EHC Planning . If you are interested in purchasing the digital Talking Mat then please phone the office 01786479511. We are just changing the purchasing model from subscription to one off sale so its temporarily removed from the web site.

We are delighted that the free seminar we are holding in London on the 20^th of October is now full, so have planned an additional session on the same day.

This is a great opportunity to find out about this communication tool which gives children and young people a voice. Children and young people are experts in their own lives and Talking Mats is a useful framework for enhancing participation and inclusion.  It is suitable for a range of people who need support to express their views, interests and aspirations, and make decisions about their support. e.g. pupils with communication difficulties; pupils who have English as an additional language; and those who are reluctant communicators or who find it difficult to organise their thinking.  We would particularly welcome staff from educational settings.

During the session we will

• Show examples of pupil participation
• Provide hands on experience of the Talking Mats resources, both original and digital
• Exchange practice and ideas

The seminar will be on the 20^th October 2015 from 1.15 pm –3.00 pm and located close to London Bridge station.

To book a place contact info@talkingmats.com.

Places will be allocated on a first come first served basis.

The Children and Families Act 2014 makes clear that local authorities in England must have regard to the views, wishes and feelings of the young person and the parents. How do you ensure children and Young People are fully involved in decisions about their support and what they want to achieve? This blog describes how Talking Mats can be used to support the Education and Health Care Plans (EHCP).

A question like ‘What do you want to be able to do in the next 12 months,  that you can’t do now ?’ is difficult for us all. For children and young people who struggle with communication, this is even more of a challenge.Talking Mats is an ideal tool to support the young person to consider this big question because it breaks down the dialogue into bite-size chunks, makes abstract concepts more concrete, and creates a visual record of the discussion.

The top scale can change depending on the topic and what the interviewer wants to find out.  It can vary from

• things I like/ don’t like/ unsure
• things that are important to me / not important/ not sure,
• things I want to try/ don’t want to try/ not sure .

We have two resources that can be used to support conversations about planning :

1. Health and Well being – this resource is based on the WHO ICF framework and allows you to have a topic focused conversation on the various aspects that make up well being
2. Consulting Children and Young People this resource gives a much more holistic overview of how the young person or child is feeling about their lives
3. Example from Health and Well being resource

Using the work/education topic from the Looking after yourself  set in the Health and Well –being resource, this pupil is able to express what his aspirations are  post school. Click on picture to enlarge.

2. Example from Consulting Children and Young People resource

This example came from a primary teacher and demonstrates how the process of using Talking Mats can help a young person reflect on their lives and in this case make positive change . The teacher told us about a pupil aged 8 who placed the symbol for ‘being listened to’ in the position for something he liked, and the symbol for ‘listening to others’ in the position for something he didn’t like.  ‘That’s not right’, he exclaimed.

There was no miracle cure she said.  ‘But it was like a light bulb going on!’  He began to engage with work on his interaction and listening skills and ended up a playground champion.

Free Seminar 

We are holding a free half day seminar in London on the 20th October. The seminar is an introduction to how you can use Talking Mats to support pupil participation in planning . If you wish to attend please let us know by responding to our invite. We would love to see you. London Seminar Invite

Thanks to Karen Wilson, a specialist teacher and one of our accredited trainers, who describes how Talking Mats can help in supporting Looked After Children in having their say.

‘I work as Principal Teacher for children with additional support needs in a mainstream secondary school. In supporting a wide range of children and young people, I am frequently involved in Looked After Children reviews. These reviews can be quite daunting for an adult, as all agencies involved with the young person are represented, along with their carers and their support agencies. I can’t imagine what it must feel like as the child.
Many of these young people find it difficult to express their views, partly because of the circumstances they find themselves in and partly because many of them have communication difficulties linked to their early experiences. I have been struck by how little information is often contained in their Having Your Say form. This should be one of the key ways for young people to express their views and is completed in advance of the review.
I recently used a Talking Mat to help a young person complete her ‘Having Your Say’ form. The young person reported that it was much easier to engage in the process and told me that she had enjoyed doing it. She normally does not like filling in the form. All of those involved in the review expressed surprise and delight at how much more information it was possible to get using a Talking Mat.
I am now working with Talking Mats to explore how this idea can be developed to give more of our Looked After young people a stronger voice in decisions which directly affect them.’

Have a look at the following blogs for further information on theTalking Mats GIRFEC resource and how it is being used

As part of the Right to Speak initiative Talking Mats was funded to develop ‘Promoting Inclusion and Participation’: an online learning resource for staff working with children and young people who use Alternative Augmentative Communication (AAC).  We have been delighted to work with NHS Education Scotland on developing this free resource and also have really enjoyed working in partnership with the learning and development consultancy: Forum Interactive.

The complexity of care for children and young people who use Alternative and Augmentative Communication (AAC) is multifaceted. Ensuring that goals are centred on the young person and family’s needs is a constant challenge to practitioners. There are several resources that focus on developing the technical skills of developing AAC but there is a scarcity of resources that focus on the impact of AAC on the child’s day to day life.

Promoting Inclusion and Participation is based on an earlier project which determined the key indicators of a quality AAC service from the perspective of AAC users and their families.

Promoting Inclusion and Participation uses the following frameworks to help practitioners structure their decision making:

1. International Classification of Functioning, Disability and Health – Children and Young People (ICF-CY)
2. Janice Light’s Communicative Competencies (2014)
3. GIRFEC (Getting It Right For Every Child) wellbeing indicators

These are brought to life in a series of DVD vignettes which tell the stories from the perspective of the child, their families and schools. It poses the practitioners’ questions that allow them to reflect on the impact of AAC on the child’s day to day life. The resource is designed to be used for group discussion. The feedback from the expert practitioners that reviewed the material suggest that the DVD and resulting questions can enable AAC practitioners to have  a rich discussion about best practice and how to time educational and therapeutic input to achieve holistic outcomes.

This on-line resource will help practitioners:

1. Understand the role that collaboration and involvement play in delivering wellbeing outcomes for children who use AAC.
2. Apply a holistic approach and outcomes focused approach to assessment, implementation and review which places the child at the centre.
3. Recognise that as the child develops and changes, so the level of different team member’s involvement will ebb and flow.

Download the resource here. It takes a little time to download so be patient !

We would be delighted to receive feedback of how it is being used.

Ref

Light J , Mcnaughton D, Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication? Augmentative and Alternative Communication, 2014; 30(1): 1–18

We are grateful to Nicola King SLT, who describes how she and colleagues use Talking Mats not only to gain feedback from parents about the therapy process, but also about the parent’s understanding of the child’s diagnosis and its impact.
The options to start the discussion are included in the mind map below. Click on image to enlarge.

Issues raised by one parent were
1) Information given to me –unsure . The mum went on to say ‘I’m worried/ frightened. I don’t want to ask too much as I’m frightened as to t he answers
2) My child’s progress –unsure. The mum offered ‘I’m inpatient’

Nicola commented –‘These were huge issues and each response gave me a chance to explore what she was thinking and meaning. For the first time this mum offered her fears about ASD and ADHD. She enjoyed the Talking Mats process and after the interaction agreed for the first time to an onward referral which ensured support was in place for her son starting school.
The Talking Mats format was a brilliant way to have that ‘difficult conversation’ ‘

The intention at the core of the Scottish Strategy Getting it Right For Every Child (GIRFEC) is to keep the child at the heart of the planning process. Helping the child to set personal outcomes based on what is important to them, should be the starting point. In practice, this can be difficult as many of the well-being indicators are difficult for children and parents to grasp. A primary headteacher highlighted the limitations, explaining that she was trying to find out about how safe one of her pupils felt. When the pupil asked her to explain what she meant, she replied “Well, do you feel safe in my office or do you think one of the books might fall off the shelf onto your head?”

The Consulting Children and young people resource allows you to reorganise the symbol sets to reflect on each of the specific well being Indicators. If we take the example of safety, we can make the concept more accessible to the child by providing concrete examples. This may include: asking for help if needed,  feeling listened to, as well as, safety in specific settings for example at home; in school; with friends or using social media. The CCYP resource helps the interviewer to think about the child’s age and stage of development and uses examples that are meaningful.

The visual framework means that their is a clear record of the shared understanding between the child and the interviewer of the concept of safety.

We are planning to run specialist sessions on using Talking Mats with the SHANARRI indicators in order to ensure that the child’s view is at the heart of the planning process. If you are interested please let us know what would work best for you.

Email us at info@talking mats and tell us if you would prefer a Saturday session, a Twilight session or a half day session and state your preference for morning or afternoon.

Thanks to Anita Devi,Education Consultant, for her helpful contribution to this blog.

The implementation of the recent SEND reforms in England requires interdisciplinary teamwork. Integrated assessments will now be carried out in cooperation with the young person and the parents. Capturing the child’s own perspective and recording their views, interests and aspirations is now a statutory requirement. The principles of the SEND Code of Practice state that practitioners should encourage the child or young person, and the child’s parents to participate as fully as possible in the decisions affecting their lives and use a common language to shape educational and other outcomes.

Talking Mats has produced a practical and creative resource – “Consulting Children & Young People” that helps practitioners to ensure that they take account of the SEND Principles at all stages of the assessment process and development of the EHC Plan.

We recognised the need to develop a tool that would give a holistic picture of how a child or young person feels about their lives at home, at school and in their communities. Having a visual framework means that there’s more time for reflection. You can help young people to see their personal strengths and abilities and take time to consider what their problem areas are.  Talking Mats gives greater choice and control about what kind of intervention is required to support them.

Communication is a two way process and the role of the facilitator is crucial. Talking Mats provides training at the following levels:

• Awareness – an introduction to the Talking Mats framework and the development of the CCYP resource.
• Enhanced – a whole day training to equip practitioners to use Talking Mats
• Specialist – In depth training which allows the practitioner to train others in their organisation.

(as stipulated on page 58 of The 2014 SEND Code of Practice for England)

Why not sign up for one of our training courses and learn more about –

    Improving the quality of your engagement

    Creating a visual framework for consultation

    A child centred approach to joint decision making.

Read Part 2 of this blog next week.

We are very grateful to Rhona Matthews for sending us this moving blog.

‘‘I met with Katie, the worker at Perth Young Carers who did the Talking Mats training and she told me this story:

It is recognised that there are many positive outcomes from being a carer.
For some young people helping care for a sibling can bring confidence, develop feelings of closeness to family and increase self esteem. However it can also add stresses and strains. Expressing frustrations or anger can be difficult and feel like a betrayal.
Using Talking Mats can make it easier to say the things that might cause upset. Using the Children and Young Person’s resource, a young person disclosed to a worker that the one aspect she was not happy about when helping look after her brother, was administering medication. She had seen this being done in hospital by injection and did not like the thought of having to do it. She was happy with all other aspects of helping with his care. The worker fed this back to her parents and they all agreed not to expect her to do this.
The worker felt that this issue would not have been highlighted without the Talking Mats.”