Find out about the Core and Essential Service Standards for Supporting People with Profound and Multiple Learning Disabilities. and thanks to Joanna Grace for this interesting and important guest blog ,she writes;

Last week I threw used deodorant canisters at an audience of earnest professionals and was cheered for doing so. What was going on?

I run The Sensory Projects an organisation that aims to share the knowledge and creativity required to turn inexpensive items into effective sensory tools for inclusion. In all I do I am working to contribute to a future where people are understood in spite of their differences.

The empty deodorant canisters had been washed, their roller balls removed to enable me to fill them with festive scented balm – some frankincense some myrrh – with balls replaced they make wonderful massage tools enabling me to form a connection through touch and smell with persons of all abilities and to share a sensory conversation around the season.

I lobbed them at my audience to bring to life the new Core and Essential Service Standards for Supporting People with Profound and Multiple Learning Disabilities. That title might not sound exciting and the link with my improvised massage tools might not be immediately apparent but I promise you the link is there and the document is very exciting indeed.

My original dream when I set up The Sensory Projects was to write five sensory stories. That dream was a bit of a fantasy and so I had to pinch myself when it came true. The original five stories are sold to fund the writing of more and there are now twenty available on the website. The stories led to books, of which there are five in print currently and a few more in the pipeline. The stories project led to another project, which led to another, and there are four currently and a fifth due to start next year. Through the projects I have had the chance to do some remarkable things and found myself in situations I never imagined I would be in: I’ve been featured in a book given away in Lush stores globally, I’ve been interviewed on Radio 4, I’ve done a TEDx talk, I’ve even exchanged text messages with the Foo Fighters! If I continued to pinch myself when remarkable things in my life happened I would be black and blue by now.

And yet of all of these wonderful things and the many adventures I have had, by far and away the best thing I have been a part of  is the new Core and Essential Service Standards for Supporting People with Profound and Multiple Learning Disabilities.

The new Core and Essential Service Standards for Supporting People with Profound and Multiple Learning Disabilities is a document that describes what best practice care looks like when supporting people with profound and multiple learning disabilities. It is beautifully simply having just 7 standards for what best practice looks like at an organisational level and 6 standards for what it looks like at an individual level. It was written by a team of volunteers over 140 strong over an 18 month period. It represents an enormous work of effort and hope. I am humbled and proud in equal measure to be one of its four lead authors. If adopted by the inspecting agencies it would change the face of what care looks like for individuals with complex disabilities nationwide and influence care provision globally.

Even without being adopted by the inspecting bodies it is having an impact. I encourage all settings to take a look at it. If you are a great setting celebrate that you meet the standards, declare it publicly, display it on your website, tell the world – and help us to create an expectation that this is what care should look like. If you are a middling setting celebrate that you are working towards the standards, use them as a reflective tool to drive up the quality of care that you offer. And if you work in a duff setting….well, I spoke to one woman who worked in a setting where the management were thoroughly uninterested in supporting their residents with profound and multiple learning disabilities. She looked through the document, thumbing the forward by Norman Lamb and the endorsement by NHS England, she gave me a wry smile “I don’t think my boss will know this isn’t legal” she winked, “I’m just going to give it to him!” However the change comes about, we want to see these standards upheld.

Early on in the writing process we had to make a decision: were we going to describe what best practice care looked like now, or what it ought to look like. We went with what it ought to look like. This is an aspirational document. But that is not to say it is unachievable. I cannot emphasise the “ought to” strongly enough. The first standard for individuals is communication, within the explanation for this standard is the following: “Communication should be a collaborative activity, it has to be a two-way exchange; reciprocal and responsive.” That is not asking a lot. It is a shame on our society that such basic standards are aspirational at all. It should already be happening.

We launched the standards at an event called Raising the Bar last year. Raising the Bar II was held this year and looked at how far we had come since the launch. One speaker told the room full of delegates “before you seek to raise the bar you must allow family members to say where the bar is currently” and we did. Families presented about the level of care their loved ones had received and their stories were horrific to hear. The bar is currently set very very low. Standards such as two way communication are aspirational. It is so low that it should be easy to raise. Simply by being aware of what we should be doing, making others aware, and expecting to see positive change we can go some way to improving care. Raising the Bar III is due to be held at Birmingham University next year on the 25^th of October.

Most importantly of all we want families and primary carers to know about the standards so that they can use them as an advocacy tool and demand that settings meet them. There is a community of practice hosted on Facebook that networks people working together to see this change come about. Please join us.

So what was the deodorant canisters thing about? Well a two way communication for someone who does not use words can begin at a sensory level. It can be me massaging your hand with a festive scent and watching for your response. To be truly two way I need to share this time with you on multiple occasions as your responses today might be indicative of something other than your opinion of this scent. They could be a pain in your stomach, a tightening of a muscle, a epileptic shudder. To truly know your response, your opinion, to truly make the communication two way I need to repeat, and to give you time, and to tune in to your response and then I need to listen to it and act upon it. If through our conversations you tell me you like one smell and dislike another then this will help me choose from the pile of toiletries you are given for Christmas which you will really enjoy. As I share these simple conversations with you over time I address another of the standards:

Standard two is about health and wellbeing and describes how staff will have an awareness of what good mental health looks like for an individual and how to support it. Smell has a particularly powerful effect on the emotions and fostering an engagement with smell is a good way of supporting someone’s mental health – regardless of their ability, disability or neurodiversity. On my Sensory Engagement for Mental Well Being training day I look at many simple sensory strategies for supporting mental health for people with complex disabilities.

A document like the standards can seem dry and impersonal, throwing things at my audience helped me to bring it to life. My whole working life, and much of my private life – I have worked for inclusion in mainstream education settings, I have taught in a school for children with severe and profound special educational needs and disabilities, I have inspected schools for their provision for children with additional needs and provided consultancy services to schools looking to improve their provision, I have family members with neurodiverse conditions and physical disabilities, I have been a registered foster carer for children with severe and profound special educational needs and disabilities and I have run The Sensory Projects – has been about working to see people be better understood, better included and better appreciated for being themselves. The Standards are the pinnacle of all of this work.

You can download the Standards for free from the PMLD link website: www.PMLDlink.org.uk by following the ‘Resources’ tab, or from my own website www.TheSensoryProjects.co.uk – again follow the Resources tab. Please print them off and share them far and wide, make sure everyone you know who is involved in the lives of people with profound and multiple learning disabilities, or has influence over their lives in anyway, knows about them. Together we will create this change.

I also warmly invite you to join us on the Community of Practice, let us know who you have shared the Standards with, it is great to hear what others are doing.

This 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 . HMP Berwyn is a large prison which opened in February 2017. To help you understand the challenges facing me when setting up this service in a new prison, I’ll tell you something about prisons, the people in prison, and the healthcare provision at HMP Berwyn.

In the UK the prison population is just growing and growing.  The graphic above  is taken from the Commons Library Briefing of April 2017 so that you can see the trend.  The number of people in the prison system as of April 2018 is 83,617.  The reoffending rate is about 30%.

From this data alone, we can see that something needs to change in order to reduce offending and re-offending.  Part of the ‘something which needs to change’ is considering offender rehabilitation / prison reform.  This led to the building of the UK’s newest prison – HMP Berwyn.

We tend to shorten the name of the prison to just ‘Berwyn’, so that is what I will call it in this short piece.   Berwyn has a focus on rehabilitation and treating people as individuals. We aim for the provision of high quality healthcare.  We have space for 2106 gentleman – which makes us quite a large facility.  We also give attention to the words which we use in our daily conversations – the clients are not called prisoners, but ‘men’, the cells are ‘rooms’, people are called by their first names, etc.

The healthcare provision is an integrated multidisciplinary team with a mix of professionals offering a range of skills.  It’s called the Health and Wellbeing Team as it offers holistic care to our clients.  I’m happy to say that this includes full time Speech and Language Therapy (SLT), which is where I come in.

Speech and Language Therapy is necessary in a prison setting as a significant proportion of people in the criminal justice system will have speech, language and communication needs.  Some research suggests that this may be as high as 91% (Brooks, 2011).  Many of these people will not have accessed SLT in the past, and will have developed their own strategies in hiding their difficulties.  This is why communication impairment is a hidden disability in this client group.  Alongside this, people in prison experience much worse mental and physical health compared with the general population.  There are more head injuries, more illnesses caused by drugs and alcohol, higher numbers of people with diagnosed mental illness and more people with conditions such as ADHD.  The prison population is aging, so we have all the illness which link with an aging population too, such as strokes, dementia, cancers.  You can see that as a service, we are going to be kept very busy!

We’ve got lots of plans for how to tackle some of the things which we want to do as an SLT service, but something which we have already achieved is using Talking Mats.

My first thought was how the men at Berwyn would respond to a conversation using a set of symbols and a doormat.  Needless to say, they took it to without question – even the toughest looking customers who had been ‘inside’ for many years happily sat down with me to chat using the tool.  Not only did they tolerate the Talking Mat, but they loved it – reporting that they were able to organise their thoughts and report their views more easily.

To start with (and to ease clients into this way of sharing information) we tried Talking Mats about the problems faced by individuals at Berwyn.  The question was ‘what do you feel about ________ at Berwyn?’ with symbols for the experiences and situations that men face during the day.  It looked something like this: You can see that this gentleman was having some problems with his mental health, his computer in his room (which is necessary to book visits and make purchases), his memory and his weight.  Other aspects of his life were OK such as family contact and care from the doctor.

Some clients wanted to say more about emotions following completing the ‘problems’ Talking Mat.  We used a ‘me’/’not me’ visual scale and symbols to represent emotions.  This Talking Mat requires the client to have some emotional awareness skills so that they can recognise what they are feeling.  Not all of the clients are at this stage, and it is especially hard for depressed people to access their emotions vocabulary (Bryan,2013).

Here is an example of this Talking Mat.  This information could be used as a starting point to develop an emotions safety plan with an individual. After completing this Talking Mat with a 21 year old man who has a significant history of Adverse Childhood Events, he wanted to make his own Talking Mat about his life experiences.  This is a young man who finds expressing his emotions and past very difficult. I was quietly excited that he was prepared to share more information.  We have sat together and used the symbol software to make his symbols, and next week I will get to see what he is going to tell me.

And lastly, we have met some clients who have a diagnosis of an Autistic Spectrum Condition.  They had attracted this diagnosis during their teen or adult years, but had limited understanding of what Autism is or how it affects them on a personal basis.  Being in prison, they can’t Google to find out more as you and I might.

We have developed a Talking Mat which explores ‘what is Autism?’ and allows the client to learn while they report on what having autism feels like for them.  We hope to develop the responses on this Talking Mat into a person centred communication passport which can be shared to help all their communication partners.

We keep thinking about ‘what next?’ with the clients and the SLT service, and we continue to develop symbol sets for more Talking Mats conversations.  Often we are being led by the clients in terms of what they need in Talking Mat form.

We have strong links in the wider team, so will be doing more Talking Mats work with psychology, substance misuse and nursing colleagues.  We hope to access the Talking Mats Accredited Training and expand the number of people using Talking Mats to include Offender Managers and Prison Officers.  Alongside this we are developing healthcare pathways for clinical work such as end of life care, so will be applying the Talking Mats methodology to advanced care planning.  There’s a lot to do!

Postscript 

If any of you want you to link with Jacqui to discuss this further please let us know and we will link you with her. If you want to become confident and skilled at using Talking Mats then please come on a training  We also have an online course

References

Brooks, V., 2011. Report outlining the findings of a 13 month pilot project examining the effectiveness of speech and language therapy for young people known to Exeter, East and Mid Devon Youth Offending Team. East and Mid Devon Youth Offending Team.

Bryan, K. (2013). Psychiatric disorders and communication. In L. Cummings (Ed.), The Cambridge Handbook of Communication Disorders (Cambridge Handbooks in Language and Linguistics). Cambridge: Cambridge University Press. doi:10.1017/CBO9781139108683.020

One of the reasons why Talking Mats works is because it reduces the demand on the ‘thinker’ to remember the question, find the vocabulary needed to answer, construct the answer into a sentence, and then say it clearly.  This reduced demand allows more ‘thinking time’.

Here’s a link to our website with more reasons why Talking Mats works

https://www.talkingmats.com/about-talking-mats/#whyitworks

Another reason people respond well to it is there is no right or wrong answer.   It is not a test.

Sometimes the listener can forget their role and use the interaction as a test or as a language exercise.  E.g .  ‘Do you know what this picture is?  ‘What’s this one called?’  This makes the demands on the thinker instantly increase as they are required to formulate an answer. Checking the persons  level of understanding first may be necessary but it shouldn’t be done as part of the Talking Mat.

In our training we recommend avoiding ‘why’ questions , as they can make a person feel they have made an error.  If the listener wants to know more, then a sub mat can be done

Our mission statement is to maximise the person’s capacity to express what they think.  Let’s help them to do that!

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:

1. Identifying Speech, Language and Communication Needs in children and young people
2. Constraints within Speech and Language therapy services
3. Lack of education and training – the word “communication” because practitioners think they know about it when in fact there is a large knowledge gap
4. Routes to services can be either Offending or Mental Health pathway
5. 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:

1. Some good collaborative practice is happening already and the impact of working together is proven in research – we need to extend this further.
2. Joint training sessions – good visual and other communication supports
3. SLT have a vital role going forward
4. 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:

1. 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.
2. Share stories, gather evidence.
3. 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:

1. 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.
2. 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.
3. Recognition of the intergenerational cycle and the importance of getting care and support correct so we break patterns and enable change.
4. 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.
5. 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.
6. 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.
7. The importance of inclusive, visual tools becoming common place so that they are not used in isolation and in a vacuum.
8. The challenge of supporting and nurturing a young person’s inner voice when they have significant difficulties with language.
9. 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.
10. 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

• CJSCENTalkMatsPresentation170418
• Talking Mats presentation 17 April 2018 Sally Kedge Alayne McKee TTANZ final
• TM seminar 04-18
• Talking Mats & Justice CEN April 2018 Draft

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  !

 ‘For every pound invested in the Talking Mats Keeping Safe resource and training there is a potential saving to services of £23.00’ .This was the findings of a cost benefit analysis carried out during the development phase of the Keeping Safe Talking Mat resource.  A Cost-benefit analysis demonstrates the overall economic value of an intervention with numbers and evidence.

 The Keeping Safe resource

The Keeping Safe resource is a visual framework that has been developed and trialled over 6 years in partnership and with funding from various organisations e.g. Survivor Scotland, Scottish government , Kingdome Abuse survivors project and NHS Fife

The Keeping Safe resource provides:

• A listening space for people with learning disability and communication difficulties to raise concerns and express their point of view.
• A structure for staff to find out what people are thinking about their lives, and raise issues that can be difficult to discuss.

A reflective practice training was developed and  provided to over 700 staff to allow staff become familiar and confident with using the the resource

Findings of the cost benefit intervention

There is a significant financial advantage to services using Talking Mats. Analysis of six scenarios found that for each pound invested in the Keeping Safe training there is a potential saving to public services of £23.00. In learning disability services it is easy for costs to accelerate quickly. If services don’t respond effectively, challenging behaviours can escalate and relationships and placements are at increased risk of breakdown. Talking Mats can help provide staff with a comprehensive and accessible framework to help them listen to people who can find it difficult to articulate what is really going on for them e.g. issues of pain, relationships or levels of support. In this project 89% of Talking Mats resulted in staff learning new information about the person they were working with, even when they thought they knew them well.  The Talking Mats framework provides a way to turn these points of views into actions that can be monitored and reviewed. It is these early interventions that not only save money but improve quality of life.

Cost benefit Process

With support from Inspiring Scotland a cost benefit analysis was done that examined the cost of the Talking Mats intervention and any resulting actions. 6 cases were chosen from over 100 detailed descriptions of how practitioners working with people with learning disabilities had used the resource.  These descriptions  represented a cross spectrum of  people with learning disabilities in Scotland in terms of living situations e.g. living at home , in supported settings and an inpatients facility . They were also chosen to represent the comorbid conditions that often exist with learning disability e.g. autism, mental health and cerebral palsy. An alternative scenario was created and tested with critical friends as to the likelihood of what might have happened without the Talking Mats intervention. All the scenarios that were developed are  available here 20180110 scenarios cost benefit   The primary source of financial information and the subsequent calculations  was the Unit Costs of Health and Social Care produced by the Personal Social Services Research Unit (PSSRU) 2015/16 . This contains detailed cost estimates for a range of services such as care placements, NHS services, social work, mental health, and family interventions. This analysis can only be illustrative as assumptions are subjective.

The findings from our final report 160512 Keeping Safe report 2013-2016 showed that effective use of the resource   not only led to  improvements to quality of life for individuals but that it can save services money. Book a place on our  webinar and get the Keeping Safe  resource 20180122 Keeping Safe Webinar  or if face to face discussion is more your thing attend the advanced course in April 2018 – you get the resource with that booking too!

Do you want to introduce Talking Mats to people with a communication disability and autism, but know they will need support to learn it?

We are holding a 2 hour seminar on the 1st of February in Stirling to share ways of supporting people with autism to learn to use Talking Mats and express their thoughts.Twilight ASD Seminar

Do you want to help people think about the future and what they might want to have in place at end of life?  Talking Mats and Strathcarron Hospice have developed a powerful new resource to support these sensitive conversations and an advanced course is being held in Stirling on the 21^st February   and in London 27^th of March http://www.talkingmats.com/training/specialist-seminars/

These opportunities are only open to people who have attended Foundation training

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.

This week it was hot in New Zealand, so I sat under a tree in a school playground in the shade with an eight-year-old girl to do a Talking Mat. I’m a speech-language therapist engaged by the child protection agency who have guardianship of her. This doesn’t happen that often in NZ but the team involved with this girl and her brother realised that as well as dissociative behaviour related to the impact of trauma due to family violence exposure, there was also significant difficulty with language acquisition for both children. The mix of a trauma history and a language disorder was resulting in significant difficulty expressing emotions and explaining what had happened when behavioural outbursts happened.
Some of my work with this child has been to help the team understand how her language profiles impacts on her life, and to develop her language skills at school via a programme she carries out with a teacher-aide and a friend. My role has also involved helping her understand her own life story and to equip her to process this, as it hasn’t been a pretty ride so far.
At a multidisciplinary planning meeting for her and her sibling recently, the team were concerned to make sure the children had accurate information about when their father was going to be released from prison. Their mother has recently been released too but no one knows where she is currently. I suggested a Talking Mat might help us to find out what she knows at the moment about her parents and how she felt about the next few months, as there are likely to be some changes happening in her world. We wanted to give her accurate information so she didn’t need to fill in the gaps herself.
Using a Talking Mat helped me establish that currently this child feels many things in life are going well. This is good progress. However, we identified a few things that she felt were not going that well at school (‘in the middle’) and I was then able to talk to her teachers about preparing for the new school year starting in February. We figured out that she is looking forward to seeing her dad but doesn’t know when she will see him or where he is going. A conversation with her Social Worker and the drug rehabilitation residence has allowed me to put together some visuals and a timetable to show what is going to happen next. Dad can have these as well as her carer and others in her team.

Another child with a similar history also did a Talking Mat with me last week. My purpose was to help the team find out how he feels his current care situation is going. A very mixed picture emerged with some concerning cards placed in ‘not going well’. I asked the boy at the end if he knew anyone who could help him with those things and he said, ‘no one’. I was able to explain that I am one of the adults who need to figure out how to make life easier for him and I would talk to some other adults and come back to see him. The photo I took of the Talking Mat allowed me to follow up with the team and I took the photo back to the boy to explore further some of the ‘not going well’ cards. At this second visit, this boy initially did not want to speak at all, but he engaged fully in looking at the photo of the Talking Mat with me.

We used a scale of 1 – 5 (how much of a problem is this for you – 1 = not much, = 5 = really really bad) on a piece of paper that he could mark with a pen to explore the ‘not going well’ items in the photo. He picked out ‘mood’, ‘people coming to his house’ and ‘learning at school’ as ‘really really bad’. We agreed that these needed to get sorted out for him to make life easier and we agreed who I could talk to about these things. Once we got that agreed and written down, he initiated some conversation about less heavy topics and started playing. I’m now following up with the team. Easier said than done, but without the Talking Mat I don’t think we would have got his views so clearly.
Our Talking Trouble Aotearoa NZ team is involved with children, young people and adults involved with care and protection, justice, mental health and behaviour agencies. We have been very excited about the wide range of opportunities that Talking Mats has provided us and the professionals we work with to explore people’s views on their own situations, their preferences, and their well-being. This year we’ve been exploring how Talking Mats might be used in our contexts:
– in sexual assault health assessments undertaken by specialised health professionals
– for Social Workers in our Youth Justice and Care and Protection Communication Projects
– When finding out about how people feel about talking and understanding in legal contexts such as courts and Family Group Conferences when we are engaged as court-appointed Communication Assistants (equivalent to ‘intermediaries’),
– and in our own speech-language therapy assessments and interventions.
The social workers, paediatricians, teachers, lawyers and others we work with have also been excited about exploring how Talking Mats can assist in these contexts. We’re looking forward to more training from the Talking Mats team next year.

sallykedge@talkingtroublenz.org

Come and hear Sally speak at our Criminal Justice Seminar on the 17th of April 2018. Contact info@talkingmats.com  for more information.