The Keeping Safe Talking Mat resource provides a structured framework to ask someone ’How’s your life going?  It has 3 topics: Your Well-being;  Relationships; Thoughts and Feelings

Do you find it difficult discussing feelings with people who have limited understanding?

Do you have limited time to discuss sensitive issues with people?

Do you want to find out any issues which may be slowing recovery or preventing someone moving forward in life?

A cost benefit analysis demonstrated that using the Keeping Safe resource to create a listening space for people to think and share how their lives are going, is cost effective for organisations.

The design of the resource is described in the Tizard Learning Disability Review More Than Pictures TLDR 2017

It has been trialled and tested with people with learning disabilities throughout Scotland, but has also been used effectively with a range of people who find it difficult to discuss their life e.g. Young people with mental health condition.

It  has been shown as a helpful way to

•      discuss new information (89%),
•      discuss and resolve fears (84%)
•      support thinking (89%)

This poster gives an overview of the project KS 2nd Poster (click to enlarge)

The Thoughts and Feelings topic uses a different top scale and this resource is best used by people who have completed Talking Mats Foundation Training.  If you want to buy it (£55.00 +VAT)  contact the office  www.talkingmats.com   tel. (+44) 01786 479511

Conversation with friends is key to our well- being.

Talking Mats is a tool to maximise people’s capacity to communicate about things that matter to them.   For people with communication difficulties the ability to have a good conversation is restricted.  For this reason we have developed Conversation sets, described in an earlier blog http://www.talkingmats.com/talking-mats-conversation-sets/ 

The topics include Holidays, Gardens, Trips out, Sport.  Football even has one if its own!

Some of the members of the National Involvement Network in Edinburgh tried out the conversation sets.  Fiona’s conversation is generally limited to responding to questions and she has a tendency to agree with what other people say.  Using the Holidays topic, she told me that she liked camping and added that she had tried this a long time ago when she was a member of the Girl Guides.    I told her I had also been camping with the Girl Guides so immediately this created a bond between us.  Sharing experiences can be the start of a friendship.

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David and James used the Football topic to chat about a recent match they had attended together.   Before using the mat to discuss the match they did not know that they had felt differently about the stadium and the crowd.  This was a surprise and stimulated further chat. Together they relayed a funny incident that had happened and we all had a good laugh- another aspect of building friendships.

David and James have good conversational skills but the Talking Mat took their conversation to a more detailed level.  For people who have difficulty getting involved in conversations these topics allow them to share experiences and find links with other people.

A conversation is an informal interaction, between two or more people, in which news and ideas are exchanged. Having a conversation can be an enjoyable activity for people and is an important part of socialisation but is often hard for people with communication difficulties to take part and hard for families, friends and staff to support these informal conversations as well as finding topics to talk about. We have developed a range of Talking Mats symbol sets called Conversation Topics which can be used by people of all ages and abilities to take part in conversations and have a chat.

These are now available to anyone who has completed a Talking Mats training course.

Each Conversation Set is made up of 3 topics with specially designed symbols. Click on the image to enlarge.

Examples of how this resource has been used during our pilot phase:

Gardens: A resident in a Care Home chatted about what she liked and didn’t like about the Care Home gardens and made some suggestions for changes.

Trips Out: A group of people at a Day Centre planned where they wanted to go for their weekly outings.

Holidays: A young man with a learning disability talked to his social worker about where he had gone on holiday and what he had enjoyed.

Indoor Sports: A woman with a stroke chatted with her friend about the sports she wanted to try at the local Sports Centre.

Outdoor Sports: A man with dementia talked about the sports he used to do when he was younger.

Football: A group of people with learning disability chatted about what they liked and did not like about a football game they watched on TV. This set provoked lots of lively discussion.

Keep a lookout for further sets in the future.

If you have completed a Talking Mats training course and would like to order these sets please contact info@talkingmats.com or phone 01786 479511

Other resources to expand your use of Talking Mats can be found on our website – www.talkingmats.com.

We are delighted to have Celine Josephine Giese, a 4th year psychology student from the University of Stirling, on placement with us. As part of her placement she has to write a series of blogs which she has kindly shared with us. This is the first in the series.

Talking Mats is a social enterprise, that has developed a unique communication system that aspires to improve quality of life for people who struggle to communicate effectively, such as people with a learning disability or a stroke as well as people who have dementia. People who are affected by communication barriers have difficulty articulating their needs, emotions and wishes, which can be particularly challenging for carers and clinical practitioners.
The interactive communication tool consists of an actual doormat and different sets of communication symbols that are placed on the Talking Mat. The communication symbols represent a scale from positive, medium to negative. Specifically, designed topical image sets are used to communicate how the person feels about activities, eating, support and so forth. In addition, they also developed a digital app version.

Talking Mats simplifies the communication process by breaking down information into small manageable chunks without the need for literacy. A range of training courses are offered to help individuals to use Talking Mats effectively.
The first day I arrived I was excited as I have not worked in an office environment before. In advance of the meeting I read a lot about their concept and ongoing projects to demonstrate my enthusiasm and interest. I was introduced to the team, who were all very kind and welcoming. During the first meeting, I was introduced to their communication system via a Talking Mat with a general interests’ topic to get to know me better. This was a great way to understand and see how their system works in action. We also filled out the placement agreement and discussed the project I will be involved in.
My role involves supporting Talking Mats in the analysis and impact of the training. For this I am looking at recorded Talking Mat outcome stories from trainees as part of a large-scale project in London Health Authority. I am recording specific details of the stories in an excel spreadsheet, such as the outcome for the patients which will aid the further development of Talking Mats and give feedback to the funders on their investment. Moreover, this analysis will shed light on the bigger impact Talking Mats has on the communication between patients and their carers.
The analysis will be useful in determining the impact Talking mat has on the person whose mat it is and on who used the mat i.e. the interviewer. In addition, it will provide evidence to the organisation of the effectiveness of using Talking Mats. My involvement in the thematic analysis will allow me to further develop excel skills and experience an office setting in a social enterprise, while expanding my knowledge on its origins, current use and future direction potential. Because the cases disclose patients’ personal details I have signed a confidentiality agreement. I look forward to learning more and contributing to the project as well as working with the team. The atmosphere is both pleasant and inspirational and I admire the concept of the enterprise and I feel privileged to be part of such a life changing organisation.

Celine’s second blog will be posted soon.

Many thanks to Nicola Lewis from London who has sent us this powerful blog. She has 2 roles – one as a Registered Intermediary with adults with learning disabilities and the other as a family mediator working with children.

I started work as an intermediary, assisting vulnerable people to communicate their evidence to the police and in court. I work with adults with a mild to moderate learning disabilities or mental health issues and with children. The Talking Mats tool has proved invaluable, initially as a rapport building exercise which enables me to build a connection with the person. At the same time I can assess their communication in an informal way. I notice that it is often a relief for those who don’t want to talk as they can just engage in moving the pictures around, without having to make eye contact or without having to speak.They do often start chatting, in spite of themselves as there are not many people who don’t like to talk about their likes, dislikes  and preferences and to be heard about what is important to them. I use active listening: reflecting back what they say, summarising, reframing and a touch of humour if appropriate to build a connection, using the mat. When they see me the next time, they often remember me in connection with the Talking Mat:”oh yeah, we did that picture thing!”

 

 I also work as a family mediator and have a specialist qualification enabling me to meet with the children of the family to discuss their wishes and feelings. Again, the Talking Mats tool is the first thing out of my bag and on the table. After working through likes and dislikes in a natural and informal way, I can then use the cards with the children and ask about “your family”, “where you live” etc to find out about how they are managing in a divorce situation and what they might want their parents to know about their feelings. Many mediators will only meet with older children. The Talking Mats tool has given me access to the thoughts of those as young as 5. They are at ease with me and there is a level of trust that did not exist when they entered the room.I have had 100% positive feedback from these meetings as a result.

 

Thanks for developing this amazing tool. It is incredibly useful to me in both my roles.

Please send us any other stories you would like to share

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

Where:  Warwick Conference Centre, Coventry, England

When:  Sunday 5 and Monday 6 March, 2017

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

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

The following themes will be discussed

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

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

This is a wonderful opportunity to

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

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

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

Many thanks to Cheryl Strutt for this lovely blog about how she developed and used an Aromatherapy Talking Mat with people with learning disability.

I am an Aromatherapist who works with adults who have a learning disability and often additional communication difficulties. As part of a recent service review I wanted to develop patient involvement. Talking Mats (TM) was suggested as a possible option to support patient feedback. I decided to look into this tool further and access training. During my TMs training I was supported to develop my specific Aromatherapy TM. The main aim behind this initiative was to adopt a system that could identify how each patient felt about the service and identify if there were areas where changes or improvements could be made. I wanted to work closely, alongside each patient, in order to learn how they really felt about their Aromatherapy treatments, their likes/dislikes etc. and to give them a sense of ownership of their sessions. It’s all about giving individuals with a communication difficulty a voice that can be heard.

The Aromatherapy TM supported patients to understand what is involved in an aromatherapy session and has been effective in helping them to personalise their session.

I used the Aromatherapy TM within the patient’s first session and following their last session, taking a photograph of the completed mats as evidence. The TM is an excellent way of offering a range of different types of massage experience and the patient can select their preferences. I found it an excellent way, to obtain valuable feedback on patient experience. One patient with a severe learning disability and autism was able through the use of symbols, to indicate his dislike for the music being played during his Aromatherapy session. He has no verbal means of communication and feedback like this would not have been achieved if the Aromatherapy TM wasn’t used. Through the implementation of the TM I now have evidence of patient centred practice, in relation to the therapeutic value of the Aromatherapy Service. The Aromatherapy TM supported patients to understand what is involved in an aromatherapy session and has been effective in helping them to personalise their session.

Since the implementation of the Aromatherapy TM, patient feedback is now at the heart of the Service. The patient is now able to openly give comments, make choices on their treatment plan, which in turn is making their attendance at the department, a very pleasurable one and it’s very personal to the individual. Another patient who said that he wasn’t able to read or write, was able to explain what the symbols meant and chose the symbol for happy. He went on to indicate his preferences stating ‘I like foot-spa and a foot massage.’ Prior to using the TMs, I was often reliant on observing the patient’s body language to assess their level of enjoyment and gain feedback. The Aromatherapy TM now allows for a more accurate method of evaluating interventions. I am so enthusiastic about the increased level of patient involvement and the willingness of the patients to become involved in this activity. This project clearly demonstrates the value of involvement, leading to improved partnership working and better experiences.

Cheryl Strutt, Aromatherapist, Cheryl.strutt@belfasttrust.hscni.net

Many thanks to Greg Cigan for this great blog about his study that explored how children and young people with an intellectual disability feel about undergoing clinical procedures.

A clinical procedure is any activity performed by a healthcare practitioner to diagnose, monitor and/or treat an illness such as blood pressure testing, x-rays and other scans (Cigan et al., 2016). While some procedures cause no pain or only mild discomfort when completed, others can be prolonged and potentially painful (Coyne and Scott, 2014). Children and young people with an intellectual disability are more likely to develop physical illnesses including epilepsy and digestive disorders than the general population and can be frequently required to undergo healthcare procedures (Emerson et al., 2011; Short and Calder, 2013). Yet, there is currently little empirical research reporting how children and young people with an intellectual disability experience procedures (Peninsula Cerebra Research Unit, 2016). More research is required so that healthcare services can better understand the needs of children and young people with an intellectual disability (Oulton et al., 2016). As part of my doctoral studies at Edge Hill University, I am conducting a study that explores how children and young people with an intellectual disability experience having a clinical procedure.

From the outset of the study, I felt it was important to obtain data directly from children and young people rather than relying on parents and carers to speak on their behalf. I was keen to adopt methods during interviews that would enable as many children and young people as possible to take part, including those who find verbal communication challenging. After researching different methods, I chose to utilise Talking Mats as the innovative design of the tool offered children and young people the option to express their views entirely non-verbally should they wish to by arranging symbol cards. To date, I have interviewed 11 children and young people about their experiences of undergoing procedures. Each participant was between 7-15 years of age at the time of the interview and had a mild to moderate intellectual disability.

Prior to an interview beginning, I spent time describing and showing each child/young person a Talking Mat and asked whether they would like to use the tool during their interview. Out of the 11 children and young people I have interviewed, three used a Talking Mat. Those that chose not to use the tool were older children who were confident having a verbal conversation with me or those who had a visual disability and could not see the symbols. In all cases, the decision of the child/young person in relation to using the Talking Mats was respected.

The three children who used the Talking Mats were able to express their views non-verbally and also seemed to convey more information than some of those who chose not to use the tool. Viewing the symbol cards within a Talking Mat appeared to help children and young people break down information into smaller chunks which then made it easier for them to process and discuss. Indeed, using a Talking Mat led all three children to discuss information that was new to their parents who sat in while s/he was being interviewed. An example of a completed Talking Mat is shown below which was created by an 11-year-old boy during his interview. The boy clearly expressed that he did not enjoy his experience of having a clinical procedure.

Within my study, I feel using Talking Mats has helped to augment the verbal communication of some of the children and young people which in turn enabled them to take part in interviews and share their views and experiences of procedures. Talking Mats are a valuable tool for researchers working within the field of intellectual disabilities. If used more widely, Talking Mats has the potential to enable more children and young people with intellectual disabilities to have the opportunity to be involved and express their views within healthcare research.

Reference List

CIGAN, G., BRAY, L., JACK, B. A. and KAEHNE, A., 2016. “It Was Kind of Scary”: The Experiences of Children and Young People with an Intellectual Disability of Undergoing Clinical Procedures in Healthcare Settings. Poster Presented at the 16th Seattle Club Conference (Awarded Best Poster Prize), 12-13 December. Glasgow: Glasgow Caledonian University.
COYNE, I. and SCOTT, P., 2014. Alternatives to Restraining Children for Clinical Procedures. Nursing Children and Young People, 26(2), pp. 22-27.
EMERSON, E., BAINES, S., ALLERTON, L. and WELCH, V., 2011. Health Inequalities and People with Learning Disabilities in the UK: 2011. Lancaster: Improving Health and Lives: Learning Disabilities Observatory.
PENINSULA CEREBRA RESEARCH UNIT, 2016. What’s the Evidence? Reducing Distress & Improving Cooperation with Invasive Medical Procedures for Children with Neurodisability. Exeter: University of Exeter.
SHORT, J. A. and CALDER, A., 2013. Anaesthesia for Children with Special Needs, Including Autistic Spectrum Disorder. Continuing Education in Anaesthesia, Critical Care & Pain, 13(4), pp. 107-112.

If you would like more information about Greg’s work you can contact him at Cigang@edgehill.ac.uk

Talking Mat would like to wish you all a Happy Christmas

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

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

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

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

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

2 Continuing to work with

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

3 Launching more resources

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

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

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

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

Exploring sibling attitudes towards participation when the younger sibling has a severe speech and language disability

We were delighted to receive this publication from a friend and colleague, Prof Juan Bornman from Pretoria in South Africa. It reports on a study carried out with 27 typically developing children who have a younger sibling with a severe speech and language disability. Juan and her colleagues used Talking Mats to carried out an adapted structured interview to find out the views of these children on four everyday life situations identified by the WHO-ICF-CY (World Health Organisation’s International Classification of Functioning, Disability and Health, Children and Youth Version).

The four topics were:
Communication
Domestic life
Interpersonal interaction and relationships
Major life areas.

The findings showed that the children were ‘most positive towards participation in play activities with their sibling with a disability. They were also positive towards participation in household tasks. They were less positive towards communication participation and least positive about participation in interpersonal relationships’.

The following example is taken from Juan’s publication.

The overall findings suggest that the attitudes of the young children in the study towards participation with their younger siblings with severe speech and language disabilities were generally positive.

The article’s reference is:
Exploring sibling attitudes towards participation when the younger sibling has a severe speech and language disability. M Hansen, M Harty, J Bornman  South African Journal of Child Health 2016 Vol. 10 No. 1

To read the full publication with details of the methods used and the results click here sibling-attitudes-2016