Get involved in choosing a Communication Access UK Symbol , and set the standards to go with it!

In early 2017 Communication Matters[1] found out  that –

• People with  communication  difficulties  don’t  always  get  the  support  they  need  in  the  community.
• People would  like  a  Communication  Access  symbol  in  the  UK.  Businesses  already  use  some  symbols e.g        

A small group of people  were asked to  choose  a  symbol  to  represent  Communication Access.  2  ideas  were  very  popular.     For  an  organisation  to  display  this  communication  symbol  it  will  mean  the  staff  have  been  trained  to support communication  and that the business meets certain standards

Communication Matters now want to hear from more people,  with and without  communication difficulties.

To have your say about 1) the symbol and 2) the standards to support communication  follow this link.       http://www.talkingmats.com/wp-content/uploads/2017/12/Communication-Access-UK-Symbols-and-Standards.pdf     You will find the symbol choice and a Talking Mat to decide what is important to include in the Communication Access Standards.                                                              Send your responses to Communication Matters

Email : admin@communicationmatters.org.uk

Or post :  Communication Matters, 3rd Floor, University House, University of Leeds,                                             LEEDS, LS2 9DF

[1] http://www.communicationmatters.org.uk/

Do you need training to use Talking Mats ?

Talking Mats is an effective but deceptively simple tool so a question we are often asked is do you need training to use it.  Communication and supporting people with communication difficulties is a complex process and Talking Mats is based on a number of research projects which examined who could use Talking Mats, and how best to use it in different situations. It is therefore important that the integrity of the Talking Mats model is maintained and that Talking Mats training teaches the principles developed from our evidence base.
All our trainers are registered with Talking Mats and provide high quality training based on robust research findings. Only trainers accredited by Talking Mats are eligible to train others.

Some of these principles include:

• Understanding who can and who cannot benefit from using Talking Mats
• Asking open questions
• Handing over control
• Pacing
• Maintaining neutrality
• Interpreting additional information including both non-verbal and verbal information
• Matching the top scale to the question or view being explored
• Presenting the options in an order that maximises the individuals ability to respond by using our model which focuses on concrete to abstract symbols
• Monitoring language complexity and topic sensitivity

All our training courses include hands-on practice and video examples as well as reflection on all these aspects of using Talking Mats

The techniques used in Talking Mats accord with best practice guidance in semi –structured interview techniques including:

• being clear in what you want to find out and using open questions
• enabling elaboration in whatever form is appropriate
• planning in advance but in a context that is flexible and can respond to the dynamics of the conversation
• being cognisant of the influence of the environment
• taking time to establish engagement and rapport
• being non-judgemental
• supportive of periods of silence
• ensuring there is a summary at the end so that both parties agree on what was said .

So whilst Talking Mats may seem simple, it is not simplistic. The listener is creating a space that enables the thinker to think and express themselves. Training gives the listener time to reflect on the components of an effective Talking Mats conversation and identify which ones they are already skilled in and which ones they need to develop further. There are no short cuts to reflective practice training and we know Talking Mats foundation training has impact. Time and time again people who thought they knew about Talking Mats reflect and say things like ‘I got so much more from this training than I expected’ or ‘ I now see I  can use Talking Mats for so many different conversations not just ’ I like’ , ‘I don’t like’ ‘or ‘I have been using Talking Mats but now feel much more confident to use it and to make my own submats’

This is why we put so much emphasis on training.  We have developed our successful “Train the trainer” scheme to ensure that quality is maintained and reflective practice maintained.  If Talking Mats is passed by word of mouth then key aspects of the framework are missed and/or misinterpreted which in turn lessens its effectiveness and impact.

People who come on training are often excited, want to tell colleagues and share it with others. Demonstration and sharing is fine, but it is important to be aware of the difference between sharing and training.

Sharing can often be appropriate especially when there is a team of people supporting the person or  parents are keen to see how it works. You can show someone how to use a Talking Mat about a specific conversation. We call this a ‘demonstrating model’. It is helpful to give the listener the words to say to go with it. That way you are enabling other colleagues or family members to have an effective but specific conversation only.

If they then want to use it for other conversations we would strongly recommend they go on to attend the training. Attending a foundation course will enable them:

• to get more out of the technique
• to understand more about their own communication
• to become creative in their use of Talking Mats whilst still adhering to the research principles
• to be able to create their own mats or explore a topic in more depth using submats

So do you need training to use Talking Mats ? The answer is a resounding  yes . Training supports you to be an effective Talking Mats listener and get the most out of this versatile communication framework. So if you have not attended a course check out our course opportunities.

https://www.talkingmats.com/training/foundation/

There are a few myths around about Talking Mats. What does it do? – It  supports communication and it doesn’t replace a person’s existing modes of  communication, be that speech, signing, a symbol book, a voice output communication device or app.  Talking Mats works alongside  these modes to help people communicate even more effectively about a particular topic.

Some more myths busted!    Click on the picture to make it clearer.

We have been working with Care Opinion to develop the accessibility of their site for people with dementia through picture supported stories.We are very grateful to Life Changes Trust for funding this partnership.

What is Care opinion ?

Care Opinion is an independent third sector organisation that supports feedback on health and care services. They promote honest and meaningful conversations between users of health and care services and their provider organisations. If you want to see how Care Opinion works then take a moment to watch this excellent video

Why is our partnership important?

Both organisations believe it is important that everyone can tell the story of their experience of using health and care services. This can be hard as there can be barriers to telling a first-hand account of an experience. These barriers can include

• difficulties with expression and finding the correct words
• difficulties with memory
• difficulties with writing or typing on a computer

Care Opinion is skilled and experienced in supporting feedback through their web platform and supporting health and care improvements through responding to and sharing that information . Talking Mats is skilled and experienced at supporting people with communication difficulties including people with dementia, to express their views.  Partnership working between the two organisations has enabled a fusion of ideas and learning from each other to develop and action our vision of a care opinion platform that is more accessible and relevant to more people. This is particularly important when Alzheimer’s report  ‘Fix Dementia Care: Hospitals’ reports that at least 25% of hospital beds are occupied by someone with dementia ,that they stay twice as long as other people over 65 and the experience of being in hospital is recognised as being a particularly frightening and confusing time.

What have we done ?

We have created an alternative picture story space on the Care Opinion website that is adapted from the work of Talking Mats. The picture story sets were made up after thinking about the topics that arose on the care opinion website .Then we worked with our expert advisor groups which included

• people with dementia,
• their carers
• staff

Our aim was to find a structure that would be comprehensive whilst keeping  thing simple and not  overwhelming .After  a period of consultation and trialling the sets with people with dementia and their carers  we have ended up with two sets one that covers the  ‘environment’ and one that covers ‘care’

Who can use this and what support will they need?

We know people with dementia have a very diverse range of needs and that people will require different levels of support to give their feedback on the care opinion site ranging from technical support, scribing, to reducing number of pictures, to pre-preparation using paper pictures. Some people with later stage dementia may find it hard to use it to give their own feedback but hopefully, the pictures will mean that they will still be involved and understand some of the things being talked about if people are submitting feedback on their behalf.

We felt important that that the picture story space is an inclusive feature available to all to use if they want to. Whilst this feature was designed for people with dementia we have already had feedback that other people are finding it helpful.

The Picture Stories and Talking Mats     

Several people have asked us if this is a Talking Mat and our response is that it is inspired by our work but it is different and for that reason we call it a ‘picture supported story’ .It   is different partly, for technical reasons but also because the contexts in which people choose to give feedback will be varied e.g. some will do it by themselves, some supported by family and friends. Above all we want this to be freely available and recognise that that means people will use it in a variety of different ways some of which will surprise us!

We are still developing support materials and webinars to go along with the site to help people get the most from it.

However, there will be some people particular those with more severe communication difficulties who will need increased support to access the story space. Effectiveness for this group will improve if there is some preparation work to prepare their feedback .Using the paper set combined with the principles of Talking Mats to support communication will help. It is for this type of support we recommend attending a Talking Mats foundation training so people are confident and skilled using the pictures in a Talking Mats framework.

Soft Launch

For the last month the picture story feature has been available on the site and we are starting to get a range of stories on it. I particularly like the one that was submitted by a school pupil on work experience supporting  a person with dementia to share his experience  of going to an inter-generational quiz at the local nursery which had been a very positive experience for all involved.

So please give the site a go, submit your stories or encourage others to use it and please tell us how you got on. Click here to start 

Thanks to Rosie Murray for this great blog describing how she used a collaborative Talking Mats ‘Wall’ to help students comment on how different activities inside and outside college make them feel.

As a student, I trained in the Talking Mats approach, after finding it incredibly useful in clinical placements. I am now a speech and language therapist at St John’s College in Brighton. This is a college for young adults with autism, learning disabilities and SEBD. Our learners have a wide range of communicative needs and cognitive abilities. I was approached by our nursing team in the lead up to world mental health awareness day, as they were organising a ‘tea and talk’ session for our learners of all abilities.

We organised a range of activities, such as symbolised conversation starters. However, we felt we needed something to allow our less verbal learners to make their voices heard. I thought back to my training, and remembered Joan Murphy talking about large, collaborative Talking Mats – or ‘talking walls’. We discussed this idea, and felt it would be a great way for students to feedback on how different activities inside and outside college make them feel.
It took some considerable planning. Due to the emotional needs of some students, our top scale required us to avoid words that were too upsetting for individuals. In the end we settled on ‘good’ (with a widget ‘calm’ symbol) and ‘worried’. We also wanted it to provide a genuine opinion, so although we considered including activity options that were clearly negative, e.g. ‘fire alarms’, we took the opportunity to show our learners that we all have different opinions on things, and that this is good. We hypothesised that because of this, learners would be skewed towards giving positive opinions, and this informed the order of presentation of the top scale and the activities themselves.
On the day, we had 15 different activities to give an opinion on, each with different border colours for differentiation, and of course blank tiles so our learner’s could come with their own activities. Students were encouraged to write their name on the back of a chosen activity, and a consistent script was used to present the wall to each learner. Makaton signing was used alongside the script to support understanding.

Everyone loved the wall!

Learners of all abilities offered their opinion, and it generated discussion between learners of differing abilities. It signposted staff to particular likes and dislikes of learners, and showcased the power of talking mats to all staff. For example, one of our learners is a cheerful young man, who uses minimal verbal utterances to communicate. When the board was presented to him, he very clearly selected ‘talking’ as an activity, and clearly indicated that it makes him worried. This has allowed us to reflect as a staff team about how we can support him to communicate with minimal anxiety.
Learners too took away some important lessons from using the wall. They saw that while some activities are VERY popular (e.g. computer time), some are quite polarised, e.g. animals. This highlights the important issue of mutually respecting each others differences. Since the event, staff have discussed ideas they have on how to utilise this tool. We are considering how we could use Talking Mats as a tool in our peer mentoring sessions between learners of higher and lower verbal ability, as we feel it would be beneficial for both mentee and mentor. We are looking forward to using Talking Mats as a flexible tool for the college in the future.

Please let us know of any other innovative ways of using Talking Mats!

Talking Mats and Autism- Have you sometimes tried it and it didn’t work?

There is a growing interest in teaching TM to people with ASD. We know that some important adaptations might be required to make this a meaningful experience, and are keen to share our learning so far.

Being asked for thoughts or views can be difficult for some people with communication difficulties.  In particular, there is a group of people with autism where some of the core principles of Talking Mats have to be taught in stages.   Some thinkers will just ‘get it’ and find it a valuable tool for sharing their thoughts and for supporting decision making.  For others there may have to be adaptations and /or  specific teaching e.g. the vocabulary of the top scale.  We heard recently of a student in a specialist centre who couldn’t use Talking Mats.  However the staff would include him in groups where it was used and make sure he was around others doing Mats.  After a few years, he did learn the principles and go on to use it effectively.

We have gathered ideas and knowledge from practitioners working in the field of autism and included these on our web-site under Free Stuff on Communication Disability.  ASD guidelines  It’s important that these guidelines grow and adapt as we learn more about using TM with an even wider range of people.

We’ve arranged a twilight session here at Stirling on the 1st of February 2018  to bring together practitioners working in the field of autism to extend our knowledge and encourage a staged approach to effective use of Talking Mats.
We’re delighted that Ruth Chalmers, Principal Teacher for Autism Spectrum Info and Support Team (ASIST) in Fife will be joining us to talk about developing social communication skills using Talking Mats. There will be time for small group chat so bring along a case you want to discuss.
Please share the attached flier 201802 AsD seminar with your network and we hope you can join us

Please come along and   If you are interested in attending this twilight session 4.00pm to 6.00 pm (cost £20.00),  please notify us at info@talkingmats.com

This story, which highlights the importance of finding out what really matters to people, was shared by one of the staff attending the second day of an enhanced Talking Mats training course. She works in a NHS facility for people assessed as needing hospital-based continuing care.

I was working with Bill (not his real name) who is a man with severe cognitive impairment resulting from a head injury and stroke. He was very angry and agitated and we couldn’t work out what was wrong. At times he was physically aggressive when we couldn’t understand him.

One day he drew a picture of a rabbit and was very insistent about it but we didn’t know what it meant. We contacted his sister about him being angry about a rabbit. She asked around to other family members and friends but no one could think what it meant.

Bill continued to draw a rabbit and then other pictures including money and TV  so I made an improvised Talking Mat using his drawings as the options and began trying to find out what really mattered to him. I gradually connected that the TV was about about programme called Dickinson’s Real Deal (a TV programme about antiques) and that in the past Bill had had an ornament of a rabbit which he thought was worth a lot of money.

We phoned his sister again about a possible rabbit ornament and she then remembered that he had collected figurines in the past. She finally discovered the rabbit in her garage.

Once we were able to reassure Bill that his rabbit was safe his frustration lessened,he was much less angry and became more settled.

This lovely story shows us how important it is to never assume that someone is just ‘being difficult’  but that if we can try to find out what really matters to them we can make a huge difference to their lives and ours.

Huge thanks to all the practitioners who have sent us guest blogs. We selected our 10 favourite guest blogs…in no particular order!

1.  Talking Mats to support children who stammer Kirsten Taylor, Speech and Language Therapist tells a moving story about how finding out what was upsetting a boy with a stammer helped to implement change.
2. Hearing the voice of the child Emma Atkiss, Senior Educational Psychologist, shares her findings from the Wigan Pathfinder project reporting that using a Talking Mat helps to meet the 5 criteria of Shier’s model of participation.
3. Talking Mats for capacity assessments in people with ASD/LD Ruth Spilman, Senior SLT from The Cambian Group, shares practical tips on assessing capacity.
4. Castle hill school supports pupil voice Jenna McCammon, SLT and Rebecca Highton, SLT Assistant, tell 3 inspiring stories using TMs in: selective mutism; safeguarding and motivational interviewing.
5. Supporting Looked After Children to have their say Karen Wilson, Principal Teacher for children with additional support needs in a mainstream secondary school  shares her experience of using TMs to give young people a stronger voice in making decisions affecting them.
6. Hearing the voices of Looked After Children Rachel Clemow, Head Teacher and Donna Wood, Education Support Worker, report that Talking Mats has enabled children to express their thoughts and views in a safe, neutral environment.
7. Talking Mats and Mental Health  Carla Innes, Clinical Psychologist for learning disability from Healthy Young minds Stockport talks about the impact of TM training on the whole team.
8. Mummy I don’t want to go to nursery today read about how using a Talking Mat might shed some light on why a 4 year old was upset at the thought of going to nursery.
9. How do you feel about starting school? The story of 4 year old twins and their thoughts about starting school.
10. Sibling Attitudes Prof Juan Bornman from Pretoria in South Africa publishes a report on a study carried out with 27 typically developing children who have a younger sibling with a severe speech and language disability.

If you have been inspired and are not yet trained to use Talking Mats – come along to one of our training courses.

The Talking Mats  Keeping Safe Learning Disability projects ends but a resource that promotes safeguarding and well-being  continues.

The Keeping Safe Talking Mat provides a structured framework to ask someone ’How’s your life going?  We are grateful to the Scottish Government Keys to Life monies for funding the trials. Impact of use of the resource was gained by practitioners sending in examples of their use of Keeping Safe, and the outcomes and actions from the Mats were themed.

The resource has been shown as a helpful way to

• discuss new information (89%). Staff frequently commented that using the Mats revealed things they had not known previously.
• discuss and resolve fears (84%) . It provided a framework that was supportive for those more difficult and or sensitive conversations e.g.’ Usually when she expresses her feelings she can get either upset or angry. She did not get upset or angry at any point through doing the Talking Mats, although the subject and things she was saying was at times difficult issues.’
• support thinking (89%) ‘It helps with memory and attention as she has something visual to keep her focused.’

As of June 2017, 609 people who work with adults with a learning disability in Scotland have the Talking Mats Keeping Safe Resource and are trained to use it. This includes a wide range of professions : clinical psychologists, social workers, advocacy workers, community nurses, support workers and allied health professionals.  21 people extended their training to become trainers themselves, and are now training people to use Talking Mats and the Keeping Safe resource in their geographical area.

Initially many staff thought using the resource would take too much time but in fact were really surprised to find how much quality information they got in a short space of time.  A cost benefit analysis demonstrated that using the Keeping Safe resource is cost effective for organisations i.e. for every £1.00 an organisation spends on the training and the resource, the potential financial benefit to the organisation is £23.00. We believe this is because the Mats create a powerful listening space and so that issues can be addressed timeously and not spiral out of control. This has not only a financial benefit but also a return in terms of an individual’s well-being and access to local non specialist services.

Although this resource was developed with adults with a learning disability, several people have reported  that they have found it useful with other client groups e.g. adults with acquired neurological disorders and young people particularly with mental health issues .

If you want to read in more detail about the design process behind the resource then please read this journal article published in the Tizard Learning Disability Review  More Than Pictures TLDR 2017

We are currently working to develop a Talking Mats resource to support conversations relating to Advance Care Planning (ACP) with staff and patients from Strathcarron Hospice. People who use hospices often have specific difficulties communicating their thoughts and feelings because of advanced illness and emotional factors.

Sixteen staff from the multidisciplinary team at Strathcarron Hospice were trained to use Talking Mats by Sally Boa who is Head of Education, Research and Practice Development at Strathcarron Hospice and also one of our accredited trainers.The staff trained used it successfully with patients in the hospice and found that they could use it with a range of patients for a variety of purposes: getting to know someone; identifying goals; discharge planning.

A sub-group of staff attended a workshop with members of the Talking Mats team to discuss the potential use of Talking Mats to support conversations relating to ACP. Topics and options were agreed. These were then presented to a wider forum of staff from Highland Hospice for validation and checking. Three main topics to support ACP conversations were identified: Affairs; Care and Personal Values. New symbols are being developed and the resource will be trialled with a range of patients in the hospice setting.

Our hope is that Talking Mats can be used by trained staff in a hospice setting to support people to express their views and help them plan for the end of life and that it will also be helpful for many other people to consider future options in their lives.

We will write an update once the new resource has been completed.