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Many thanks to Joan Murphy, our Talking Mats Founder, for this great blog sharing Jeppe Forchhammer’s thoughts about the importance of social communication – communicating ‘offline’ – for AAC users:
I met Jeppe Forchhammer at the 2019 ISAAC Conference in Denmark. We had an interesting conversation about the importance of social communication for AAC users and he kindly sent me this presentation and gave me permission to write a blog about his views.
Here are a few quotes from Jeppe but it is well worth reading his whole presentation
We have reached a time where communication systems become more and more electronic. I have noticed that children who need AAC ie augmented and alternative communication are starting more and more early. This I would like to question! In this lecture I will try to explain, why I think it is better to teach the children to use their body first. In order first to get direct communication relation to another person.
I think it is most important for an AAC user first to learn to interact with another person face to face. This is of course important for all infants in particular if they don’t have a spoken language. I think the eyes begins naturally to take over and the baby begin to communicate. At least I began to observe what happened around me using my eyes by watching things around me. In this way I began early to take contact with people around me.
I am afraid that AAC users in the future will lose some of their abilities to communicate with their body or facial expression. Especially if one starts too early. I think there is a risk that the child get blinkers and we have the risk that the child will be introvert. This might give the child some social problems if it doesn´t learn to use and read the body.
We must remember that a good relation is created face to face and not through a Speech Generating Device.
If they only communicate through their speech generating computer they may miss the face to face communication.
Many thanks to Jeppe for his thoughtful and stimulating comments.
If you would like to contact him, please email jeppeforchhammer@gmail.com
The importance of social and non-verbal communication is highlighted in our Talking Mats training courses. If you are interested in accessing this training take a look at our options here – https://www.talkingmats.com/training/
In this latest blog, our Talking Mats OT Associate, Rachel Woolcomb tells us how Talking Mats can support delivery of Personalised Care:
“Person centred practice”, and “partnership approach” are common phrases heard in health and social care settings but what does this really mean in practice?
How good are we at ensuring our service users are truly heard, and given opportunities to talk about what is important to them?
Recently NHS England set out their ambitions for the delivery of personalised care. This is a commitment to enabling people to have the same choice and control over their mental and physical health that they have come to expect in every other part of their life.
This however requires a shift in culture.
One of the cornerstones of personalised care is shared decision making. This is a collaborative process in which people are supported to understand the options available to them including the various risks, benefits and consequences. A shared decision will have acknowledged personal preferences, circumstances, values and beliefs. This ensures that when a choice is made it is fully informed.
There is substantial literature which demonstrates the usefulness of goal setting as part of the communication and decision making process.
A well written person-centred goal will describe the anticipated achievement of a specific activity. It will be meaningful and help create a common vision within the rehabilitation process.
Talking Mats is an ideal tool to help facilitate these processes. They enable better conversations and provide an interactive thinking space. They have also been demonstrated to be a useful tool in enabling people to think about their rehabilitation goals.
Read more about this in the TMOT Resource 2: How Talking Mats can help facilitate shared decision making and goal setting: Goal setting TMOT 2
If you would like to find out more about the different Talking Mats training options we offer, take a look here: https://www.talkingmats.com/training/
In this latest blog, Laura Holmes (Talking Mats Associate based in Stockport) shares a great example of how Talking Mats can be used by education staff to help children to share their thoughts and feelings:
One of Teaching Assistants I work with at Woodley Primary School in Stockport, Lucie Porteus, attended Talking Mats Foundation Training in December 2018. Since then Lucie has been using Talking Mats with many of the children on our Speech and Language Therapy caseload in school.
Lucie’s use of Talking Mats with a group of Year 6 children is a great example of the benefits of using Talking Mats to help children to share their views and opinions. Lucie had carried out initial Talking Mats sessions with four children, on a one-to-one basis. These sessions had focused on getting a general idea of each child’s thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resources. A common theme had emerged through use of ‘blanks’ – all four children wanted to talk more about their upcoming school residential trip. Here is a picture of one of the mats (click on the picture for a clearer view):
Lucie then planned and prepared options to ‘sub-mat’ the topic ‘PGL’ – the residential school trip, and chose the topline questions ‘happy about/not sure/ not happy about’. She then met with each child individually to complete the mats. Some of the issues/ questions which emerged from the mats were:
- ‘I don’t know who the people there are’/ meeting new people
- ‘I don’t know what we will be doing’
- ‘Do we have a choice about what activities we can or can’t do?’/ ‘I’d like to have a choice’.
- Privacy – getting dressed
- Will any instructions be written down – do we just listen or will we be shown what to do?
- The instructions might be confusing – what will I do?
- I don’t like heights – I’m worried about climbing up high
- Working in groups – we might all fall out
- Sleeping – it might be hard to get to sleep. Sometimes other children talk and I can’t get to sleep.
- What will the food be like?
- What happens if I don’t feel well?
- The journey – I might feel sick if I’m not at the front of the coach/ Do we get to choose who we sit with?
This information was passed on to each child’s Class Teacher and Teaching Assistant. Further conversations then took place to answer/address the above queries and concerns. Using Talking Mats meant that these conversations were personalised and focused. The children’s queries/concerns were listened and responded to well before the school trip itself.
School staff report that all the children had a fantastic time on their school trip!
Talking Mats enabled these children to have their voices heard about a topic which was really important to them. If you are interested in finding out more about accessing training to enable you to support the children and young people you work with to have their voices heard, take a look at our training options here: https://www.talkingmats.com/training/
Many thanks to Tina Wood, Occupational Therapist at Therapy In Motion, for this great example of how Talking Mats can be used to explore thoughts and feelings both in present-day and in retrospect, to evidence positive outcomes from a change in educational placement. Tina’s use of colour coding and pie charts really helps to illustrate this.
Tina attended our Talking Mats Foundation training back in September 2016 and since then she has been using Talking Mats regularly in her work as an Independent Occupational Therapist.
In this example, Tina has used Talking Mats to enable Ben (name changed for anonymity, age 12½ years) to share his thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resource packs – focusing on the topics ‘My Body and Skills’ and ‘What I do and Support’.
At the time of this Talking Mat, Ben had been accessing a new placement at a Pupil Referral Unit for the past 11 months (click on the picture below to see a clearer version).
As there was clearly a difference in how Ben felt things were going when he was attending his previous school, Tina decided to ask him to do a retrospective Talking Mat of how things were going for him 11 months ago in January 2018, when he started to feel “unwell”.
This enabled comparison with how he feels now in the “safe setting” of the Pupil Referral unit (click on picture to see a clearer version).
Tina then compiled the information from the above tables into pie charts, enabling a clear visual comparison between the two times/situations (click on picture to see a clearer version):
As can be seen from these charts, there had been a huge change in Ben’s perception of how he is coping with life in general and school in particular.
Tina recommended that this information needs to be considered along with the rest of Ben’s sensory needs (as reported in her full OT report) when deciding on what is the best educational setting for him after leaving the pupil referral unit.
We love this use of colour coding and pie charts to illustrate the information from Ben’s Talking Mats – to really ensure that Ben’s feelings and thoughts are seen and heard.
If you would like to know more about accessing Talking Mats training – available across the UK and Ireland as well as online – please take a look here: https://www.talkingmats.com/training/
If you have any examples of how you report/share information about completed Talking Mats we would be interested to hear about it! Just email laura@talkingmats.com
In this latest blog, our Director, Lois Cameron describes the initial stage of a Scottish Learning Disabilities Observatory project aimed at enabling involvement and engagement of people with learning disabilities in supporting people with learning disabilities to have a voice. A great example of co-production in action:
Background
The Scottish Learning Disabilities Observatory aims to generate evidence, build understanding and provide information on the causes of poor health and health inequalities experienced by people with learning disabilities in Scotland. However, they recognised that there was a need to develop their approach to involving people with learning disabilities. They considered whether a citizens’ jury for people with learning disabilities on health and health research would be a constructive way of engaging people with learning disabilities in supporting people with learning disabilities to have a voice. From the outset, they acknowledged that communication would be a key challenge and approached Talking Mats to work with them to put forward a bid to the Welcome Trust Public engagement fund. This bid was written, submitted and was successful.
To establish the project, our first task was to recruit a Public Engagement Lead to take the lead on project delivery. This raised the first hurdle, as since the Engagement Lead was not in post there was no citizen’s jury and therefore no pool of people with learning disabilities to approach to be involved in the interview panel. From the outset, involvement of people with learning disability was seen as central to the project. Talking Mats had recently completed a course working with people with learning disabilities from the National Involvement Network to become Talking Mats interviewers, so we approached one of the participants who had completed the course and asked if he would be willing to be on the interview panel. He was very happy to take part and contribute his skills and experience to the interview panel.
Planning the interview Talking Mat
We examined the job description and divided it into questions that were more factual and knowledge-based and those that we might describe as ‘softer’. However, calling them soft might be misleading as they were actually value based and we felt that the successful candidate’s proficiency and self-awareness in responding to these options would be central to the success of the project. After going through this sifting process we came up with 8 possible options for the interview talking mat. We met with our interviewer from the National Involvement Network and with him honed it down to six and choose the top scale: extremely confident, confident, not that confident. He also choose the symbols he wanted to use. Candidates would be asked to justify where they placed their options. A script was developed to support the interviewer e.g. ‘It would be good if when you placed the card down you gave us a reason why you placed it there. Examples from other work you have done would be helpful’ . The full script can be found here – Interview Script
The six options were:
- Making information accessible
- Making sure everyone has a chance to speak
- Helping the group understand research
- Helping the group set its goals
- Involving people with severe learning disabilities in the research agenda
- Not taking power away from the group
The interview
In the interview, candidates were asked to give a short presentation, and then the member of the National Involvement Network carried out the Talking Mat. After this, there were some further panel questions and a chance for the candidate to ask questions.
The experience and outcomes
“I really liked being involved in making the mat. At the interview I knew what I had to do and I felt the other interviewers listened to me and my opinion.”
Other panel member’s perspective
“Having never used a Talking Mat in a recruitment interview before I was not sure how effective it would be as a recruitment tool. We wanted the process to be as inclusive as possible, where all interviewers had a clear and purposeful role. The Talking Mat worked really well, both as a way of gathering knowledge and information from the candidates, but also by providing an opportunity to observe the interactions between the candidate and the interviewer. I also think that the structured framework of the Talking Mat put the interviewer at ease and it was nice to observe that his confidence in using it in this context and, where necessary, in prompting and supporting the interviewee. All in all this was an effective way of conducting an inclusive interview process that signalled to our candidates that people with learning disabilities should be involved meaningfully in all stages of the process. It also meant that when we came to reviewing the candidates against the role criteria all members of the panel were able to contribute. I can’t wait to do more interviews like this!”
Candidate perspective:
“For me, an interview process is really about making sure that you and your potential new employer have compatible values. Therefore, it was a relief to have someone with learning disabilities on the interview panel who could help direct the questions. It was also clear that the interviewer knew how he fit into the interview process and was taking the lead on his section of the interview.
The Talking Mat itself was an interesting tool for the interview discussion because the top scale allowed me to look at where my skills and confidence were but also identify some potential challenges within the project. The interviewer also really kept me on my toes with some good follow up questions. In one in particular, he asked me what I would do if he was talking too much and dominating the conversation in the group. It was a challenging question and quite uncomfortable on the spot, but it forced me to be honest about my own values and say that actually, the right thing to do is to politely confront someone who is not letting others speak.
The benefit of a Talking Mat is that it has to be really clear and concrete to work, so I actually felt that I understood the demands of the role better than reading the much longer job description.”
Summary
The involvement of people with learning disabilities was possible from the start of the project because we were able to harness the skills and experience of a person from the National Involvement Network who was trained in Talking Mats. He had a clear independent role which was central to the interview process and improved the quality of the information gained by panel members . The Talking Mats design gave all panel members particular insight into those ‘soft skills’ that were felt to be crucial to the project and that might not have come through so clearly if just the traditional presentation and questions were used.
If you are thinking about a Talking Mats project for your own organisation/service you can find more information here: https://www.talkingmats.com/projects/
Rachel Woolcomb, our Talking Mats OT Associate, tells us about the recent Royal College of Occupational Therapists’ Report and considers the ways Talking Mats can support:
The Royal College of Occupational Therapists have recently published a new report. “Making personalised care a reality: The role of occupational therapy.”
As the OT Associate for Talking Mats, I took the opportunity to review the document and consider how Talking Mats can help OT’s in fulfilling the recommendations made.
The report recognises that people living with long-term conditions bring different and equally important, knowledge and expertise to the decision –making process.
It challenges OT’s to ensure that they really listen to, and hear the views of the people they work with.
A Talking Mat can help facilitate this. It helps people to understand what is being discussed, to reflect and organise their thoughts, to say what matters most to them and record their views. It helps OT’s to really listen, to learn new information, to involve the person in their own planning and support decision making.
Read more about how Talking Mats can help OT’s to make personalised care a reality in the TMOT Resource 1: TM Personalised Care – Copy.
The RCOT report is available here: https://www.rcot.co.uk/news/delivering-personalised-care-frontline
Rachel would love to hear from you if you have any examples of how Talking Mats have helped you to provide personalised care, or if you want to know more about OT and Talking Mats. Her email is: Rachel@talkingmats.com.
If you are feeling inspired and would like to find out about accessing Talking Mats Foundation Training, take a look at our upcoming courses across the UK, as well as online and organisational training options: https://www.talkingmats.com/training/
Many thanks to Mary Walsh, Health Service Executive (HSE) Senior SLT at St Mary’s Hospital, Dublin for this fantastic blog post about their project involving use of Talking Mats to support people with Dementia to participate in decision making related to their needs:
In September 2016 Aideen Lawlor (SLT Manager) and I (Senior SLT) won the Dementia Elevator award with a project entitled “Empowering Persons with Dementia to become more Active Participants in Decision Making Related to Their Present and Future Needs.” with Talking Mats being an integral part of this project. In November 2017, the prize money was used to fund my training to become an accredited Talking Mats trainer so that I could then train others in TM Foundation Course on a prioritised basis.
This project is now complete with 6 speech and language therapists (SLTs) from a variety of settings working with persons with dementia all trained in using Talking Mats. As part of their training, The SLTs used TM with patients/ residents with particular reference to the Assisted Decision Making (Capacity) Act 2015. TMs were also used to help the clinicians to get to know their patients, in care planning, in improving increased opportunities for interaction and in improving choices and decision making. In effect, we were checking it out!
All the SLTs found that when TM principles are followed, that it helped to empower people with dementia to make decisions about their care. Some of the reported findings:
- That the pictures help maintain attention and aid comprehension.
- That it facilitated strengths rather than a deficit model.
- That photographed completed TM provided a pictorial record for meetings – very positive.
- That it provided a significant catalyst for change in some instances.
- That it helped people with dementia and responsive behaviour get needs met
- That video recording sessions with consent greatly enhances reflective practice and may be helpful in key decision making
The next phase is to expand the number of SLTs who can provide training in Talking Mats across the Republic of Ireland. Funding from the national SLT professional body training grant scheme has been sought for these 6 SLTs to become trainers for Talking Mats. This will result in cascading training on a priority basis, increase evidence base/ knowledge re using TM and embedding TM in variety of clinical settings with SLTs leading this practice.
Mary Walsh,
Senior speech and language therapist,
St. Mary’s Hospital,
Phoenix Park, Dublin 20,
Ireland
Aideen Lawlor
Speech and Language Therapy Manager
If you are feeling inspired and are interested in accessing Talking Mats training, we offer Foundation Training courses throughout the UK and Ireland as well as online – take a look here for more details:
Once you have accessed Foundation Training you can apply for our Accredited Trainers course to enable you to deliver Talking Mats training to others in your area.
We are delighted to introduce Rachel Woolcomb our first Talking Mats OT Associate. She is joining the Talking Mats Team and will be working to develop awareness and use of Talking Mats by Occupational Therapists. I will let Rachel introduce herself:
I am delighted that Talking Mats have asked me to join their team for one day a week. I am passionate about occupational therapy and about Talking Mats and to have the opportunity to bring these two loves together and seeing what develops is very exciting.
I live in South Gloucestershire and have had a varied career since I qualified as an Occupational Therapist in 1992. I was introduced to Talking Mats in 2008 and have never looked back, using them with my clients ever since.
In 2017, having spent over 25 years working in the NHS, I made the decision to move into independent practice. I work predominately with teenagers and adults who live with long term neurological conditions or who have experienced catastrophic injuries following trauma. I am very aware of the psychological impact of sudden disability and the need for people to be able to express who they are and what is important to them, even in difficult circumstances.
I now use Talking Mats with most of my clients. It doesn’t matter if they are old or young, can speak or have communication needs, they all benefit from the opportunity to stop and think and have someone really listen to them.
In the last few weeks a man who has had a stroke and has limited expressive speech has used a Talking Mat to talk about what leisure activities he used to enjoy. He then used a second mat to explain what he can and cannot achieve now. This helped us together, set goals for occupational therapy. I am also working with a teenager who has had a traumatic brain injury and now struggles with her education. She uses Talking Mats with me regularly, to think about her coping skills at school. Looking back at her previous mats is helping her to recognise progress. I have so many more examples and will be sharing them with you soon!
I really want to inspire OT’s, helping them to consider how they enable their clients to think, communicate their choices and make decisions. A Talking Mat is a great for this. It is also creative and interactive something that in my experience OT’s like! I will also be looking at important issues within the field of occupational therapy that are currently driving practice, such as personalised care, goal setting and shared decision making. I believe it is vitally important that we collaborate with our clients as together we can achieve so much more. Talking Mats is an effective tool in enabling this, so watch this space, and please do get in touch if you want to know more or have stories to share.
It is great to have Rachel working with us to build on some of the excellent work being done already in the Occupational Therapy Sector. Our Director, Lois Cameron shares why we are so excited to welcome Rachel to our Team:
‘I am really pleased that Rachel is joining us . I think the Talking Mats approach sits well with the values and approach of Occupational therapy, In my experience OTs are naturally holistic in their approach. I remember at a training course in London an OT said for her Talking Mats was the missing link in her toolkit. The training and experience of OTs allow them to see things through a different lens and that will be really helpful to us’
For more information about how OT and Talking Mats are a winning combination, take a look at Rachel’s recent blog – https://www.talkingmats.com/talking-mats-and-ot-a-winning-combination/
Feeling inspired and want to know more about the training courses we offer? See www.talkingmats.com/training/ for details.
Thanks so much to all the practitioners who have sent us guest blogs about using Talking Mat in a Criminal Justice setting. Here are our top 5 – in no particular order!
1. Supporting Families in the Criminal Justice System: Sally Kedge, Speech and Language Therapist from Trouble Talking New Zealand shares two powerful case examples of using Talking Mats with children and families caught up in the criminal justice system. https://www.talkingmats.com/support-for-prisoners-families-experience-from-new-zealand/
2. Communication Needs within Youth Justice – Part 1: On 17th April 2017, we organised a seminar to look at underlying issues and share good practice when addressing the communication needs of people in youth justice. We had representatives from: the Scottish government, the NHS; Third sector organisations working in youth justice, the police, social workers, professional bodies, universities and social work – from as far afield as New Zealand. The emphasis from the start was that understanding communication is key to improving service delivery. https://www.talkingmats.com/communication-needs-in-youth-justice/
3. Communication Needs within Youth Justice – Part 2: The afternoon session of our seminar on 17.04.17 continued the underlying theme that communication support needs are often hidden and many looked after children have support needs that remain unidentified. The outcome of the day was the establishment of a collaborative network. https://www.talkingmats.com/youth-justice-and-communication-needs-2/
4. Setting up a SLT Service in Prison: This inspiring blog by Jacqui Learoyd explores her role in setting up a speech and language therapy ( SLT ) service in a prison and her use of Talking Mats in that setting https://www.talkingmats.com/setting-up-an-slt-service-in-prison/
5. Has Talking Mats been used in Court? Two registered intermediaries talk about a couple of cases where Talking Mats was used as part of the achieving best evidence (ABE) interviews. https://www.talkingmats.com/talking-mats-used-court/
If you have been inspired and are not yet trained, come along to one of our Foundation training courses – for details see https://www.talkingmats.com/training/foundation-training/
We also offer online training if you are unable to access the training locations – for details see https://www.talkingmats.com/training/online-training/
Improving communication with board games
Thanks to Karen MacKay from Focus Games for this new guest blog.
Playing board games can deliver more benefits than just having fun with friends and family. In the workplace they help people to learn, collaborate and communicate, while they are having fun:
1. Breaking the ice
Ever attended an event or meeting where you didn’t know anyone? A board game helps everyone to become involved, talking and interacting, with each other – who doesn’t feel more comfortable, relaxed and happy to chat after playing a game together?
2. Learning through play
We learn through play when we are children, and it works just as well for adults too. Educational board games are a great way to learn from others, share experiences, ideas and gather new knowledge from the game itself. Plus you’ll be having fun – what’s not to love?
- Developing social skills
Playing board games helps children learn to share, take turns, be a gracious loser and, for shyer children, to come out of their shell more. As adults, we continue to refine our social skills through games. They promote collaboration, communication, and teamwork, useful skills for us all!
If you like the idea of improving your communication skills using a board game, The Communication Game is your ideal tool. Effective communication allows everyone the opportunity to express themselves clearly. In health and social care, effective communication is vital to ensure individuals receive safe and appropriate care.
For many people who have communication support needs, accessing health and social care and other public services is a challenge. We partnered with Talking Mats who worked with us and a group of people with communication support needs to develop and test The Communication Game. Initial development was funded by NHS Education For Scotland, and The Communication Game was born as an engaging way to help us all to reflect and develop our own and our teams communication, and thus improve the quality and safety of services.
The Communication Game is designed to help anyone working in health and social care to improve how they communicate, particularly with people who have communication support needs. Playing the game will help you think about the barriers to effective communication; and things you can do to ensure you communicate well with others. It is being used by many groups across the country including allied health professionals, nurses, charities, voluntary and community groups, nursing/care home staff and students studying nursing, speech and language therapy, social care and more.
The Communication Game uses questions to help build knowledge, scenarios to help you see the issues people face when communicating, and activities to help you practise different ways of communicating. It is a 1-hour training session for up to 10 people that you can use over, and over again with different groups.
The game is available from Focus Games and you can learn more and order at www.communicationgame.co.uk
