I am a parent of a child in Primary one. We are expected to take our child along to the parent / teacher consultation meetings. After our first meeting I felt dissatisfied and no more informed. As a shy primary one, Eilidh gave no verbal feedback in the meeting, I felt I couldn’t voice any real concerns I had in case I knocked Eilidh’s confidence and the teacher was probably in a similar situation. Instead everyone was very nice but I left without any plan of action and no feeling that Eilidh’s teacher knew how she was feeling about her progress at school.

This time, I plan to be more prepared and to make sure Eilidh is properly at the heart of the consultation. I decided this time to use the new ‘Consulting Children and Young People’ pack, and felt the ‘my body and skills’ section was ideal for thinking about the key aspects of school life.

Eilidh engaged immediately with the mat and seemed confident with what the symbols represented. By the end of the mat and after going over it with her and checking if there was anything we had missed, I feel we have a really good starting point for discussion when we attend the meeting on Thursday.

The key points were:
Eilidh is most concerned about her drawing skills. Her face dropped when she saw the card. She perked up a little when she looked at the symbol as she decided she was good at drawing sunshine but not people. On discussion it turned out she really wants to be able to draw clothes on people. We talked about what we could do and decided she could do drawing practice with her dad (who is much better than me!). She was happy with this and has since already drawn a fully clothed person!

She is a bit unsure about numbers, writing and trying new things. These are things to discuss with the teacher but it shows her awareness of where she needs more support. Going to the toilet and drinking water both require her to ask the teacher for permission and she put those in the middle as she doesn’t always like to ask and often comes home with a full water bottle. This is something we can bring up and hopefully the teacher can reassure Eilidh it is fine to ask.

Finally, we were able to finish on a high as we acknowledged that she has really increased her confidence in talking (at school), reading and getting dressed independently. Again it really shows how aware she is of her own abilities and what she has struggled with in the past.

I would really recommend using the pack for this purpose. If I have time before the meeting I plan to use the other symbol sets to explore how she is feeling about the people at school (friends / teachers / support staff). By Morag Place

Eilidh’s Mat

Teens are comfortable using communication tools in the form of social media. They can feel less comfortable with direct communication and often find it hard to put their feelings into words. Using a Talking Mat when talking to teenagers provides a communication tool which takes the focus off face to face interaction. It gives a thinking space to help them to express their feelings. It also allows you to have a balanced conversation because it talks about the positive things in daily life as well as the opportunity to talk about difficult things.
Tina is a 13 year old girl who initially had coped well with the transition to High School but in February had started to refuse to come to school. She was unable to explain what the problem was and when asked about the reason for her absence, would say “ I hate school”.
The “Consulting children and Young people -secondary resource” was used to consult with Tina. She was presented with some of the options from “My body and Skills” to think about how she was feeling. Tina used the top scale Happy(Things are going well and Not happy (things are not going well).
During the Talking Mats interview she opened up about how she felt about travelling to school (she hated going on the school bus and felt embarrassed) She clearly identified the fact that she has specific learning needs as she has difficulty understanding and concentrating in class and often falls behind with her written work. Attending her maths class was particularly difficult and she did her best to avoid going. She also talked about her difficulty with talking to adults and also to her peers. Often she feels excluded in conversations as although she is listening, she doesn’t always understand what they are discussing and doesn’t know what to say. She has a problem with sleeping and feels her mood is low a lot of the time. She also commented that she can feel extremely angry and this has a negative effect on her behaviour. On the positive side, she loves to read and feels happy about her diet and her weight.

Helping Tina to grade her feelings about specific issues helped to identify what needed to be done in the first instance to get her back to school.
Alternative travel arrangements were put in place, extra support provided for her in class and from the learning support base.
She is attending school again and the pupil support team are gathering together the appropriate “team around the child” to explore her difficulties further.

Find out more about how to use Talking Mats by signing up for a training course at Talking Mats.

The communities where children grow up can have a significant impact on the well-being of both children and families. The Consulting Children and Young people pack contains the topic “My Wider World”. This topic allows exploration of the impact of both school and life out of school as well as the support systems available to them. The World Health Organisation reminds us of the importance of gathering environmental information from children. As a child develops the environments of their everyday life are closely connected to home and school and finding out how the child feels will give insight into their independence and activity. Negative environmental factors often have a greater impact on children than on adults. In order to promote a child’s well-being, effort needs to be given to enhancing a child’s physical environment as well as their social or psychological environment.

Daniel is an 11 year old boy with a diagnosis of Asperger’s Syndrome. He completed a Talking Mat to explore the impact of his environment on his condition. He was asked to grade his responses using the top scale Happy (Things are going well) and Not happy (things are not going well).

He immediately commented about how he felt about school (“yeah –it’s okay”) He expressed a strongly negative reaction when asked about where he lived. He was very unhappy about the location of his house as it is in an extremely remote location and he can never have any friends round to play. He never gets visitors to his house apart from an uncle that may drop by. He feels bad that he doesn’t have any neighbours and would love to live somewhere that has got other houses nearby. He has talked to his mum about it but she says, “she can’t take me places – too much petrol” He knows that his mum is worried about money. He also really dislikes “out of school care” as he is rarely allowed to play on the computer. He is happy with his teacher, support from health services and the emergency services.

Daniel was clearly upset about his lack of social integration and contact with his wider community.
Environmental support included supporting the care-givers in the “out of school club” by providing training and advice about  Asperger’s Syndrome.
Social work became involved to help to help locate local youth groups and finance.

Find out more about how to use Talking Mats by signing up for a training course at Talking Mats.

Talking Mats is fun! Whether you are sitting on the floor completing your mat or sitting at a small table, young children enjoy the fact that they can give information through multiple channels – Talking Mats is visual, auditory and tactile. It is an engaging tool to use when consulting children.They can express a view without words if they want to or they can have a conversation if they enjoy chatting. Watching a young child thinking and reflecting about where they place their symbol on the mat can be a humbling experience. Some adults still consider young children as incapable of expressing their views or opinions but in reality they can often express strong views about things and are very capable of grading their responses. Sometimes we just don’t take the time to ask them about the issues in their lives and free up some time to listen.

Talking Mats has created a specific Early years resource to make consulting young children easier. The symbols have been graded according to their developmental stage. When using the picture symbols it is important to remember:

• Most of the symbols in the Early years pack are concrete and you can quickly identify the shared meaning for example – “drawing”
• Others are concrete but have a broader meaning. An example of this is when asking about “eyes”
• 

We have found that it is best to allow the child to interpret the meaning at their level so it maybe they have sore eyes; they don’t like their glasses or they have brown eyes. Try not to be too prescriptive when presenting the option to the child; a symbol can act as a jump off point capturing what fits for the child at the time. Just allow the meaning to emerge.

• The abstract symbols do need a bit more explanation because they ask about more complex concepts such as safety. The Early years pack asks about safety in relation to the road,  physical safety and safety around others.

Asking about daily routines will give insight into how nurtured and cared for they feel. Let the child lead the discussion as much as possible.

Using visual communication is a great way to have a conversation with children in the early years and a good tool to involve children in decision making. Listening to the child’s view is essential for the GIRFEC process in Scotland and for co-producing Education Health care plans in England and Wales. Talking Mats has created a unique resource which is based on the “International Classification of Functioning, Disability and Health – Children and Youth version” Talking Mats uses a framework which helps children to express themselves in a way they feel comfortable with. As adults we need to be able to facilitate the conversation.

We find that to realize the full potential of Talking Mats it is best to attend a Talking Mats course . The courses allow you to focus on your situation and how you can be creative and apply it in your own work,

We are frequently asked if Talking Mats can be used by someone who is blind and we usually say ‘not really as its essentially a visual tool’. However today I had to eat my words when I was interviewed by Ian Hamilton who is a BBC Scotland TV and radio reporter. Ian is totally blind and was accompanied by his guide dog – a very large but gentle German Shepherd called Renton. Here is a link about Ian and Renton

When Ian asked me to explain Talking Mats I guided his hand to the positioning of the 3 top scale symbols and then he immediately understood the layout of the top scale, the topic at the bottom of the mat, and where to place each option by touch. I simply explained each symbol, placed it in his hand and he did the rest. The topic was how Ian feels about Domestic Life and we had a lot of laughs about his dislike of shopping, laundry and cleaning. He explained that shopping was a nightmare for someone who is blind. He said that the dislike of laundry and cleaning showed that he was lazy – I think it’s pretty much what lots of people think!

However he was clear about a number of things that he feels very positive about, in particular his daily routine and his security, both of which are very important because of his blindness. Interestingly he said that his guide dog is clearly on the positive side of the mat, but not as a pet. A dog like Renton is not just a form of mobility, he’s also a fantastic companion.

Ian seemed to keep 1 step ahead of me and asked loads of great questions about Talking Mats as a thinking tool and its possibilities for other groups of people. He commented that, like inventions such as the typewriter and the phone, Talking mats is something originally intended for people with a disability, but which is now being used by people of all abilities to help them consider issues and then express their views.

Ian generously agreed to me writing this blog and using his photo.

Hope he doesn’t mind me including a picture of Renton. This is also a first for me as I’m really scared of dogs – especially enormous shaggy German Shepherds!!

The programme will be broadcast on BBC Radio Scotland : Business Scotland on 24th and 25th May

In the Health and Well-being resource, we have provided four sets of symbols to help people consider how they feel about their communication. Because communication is  complex and often abstract, it can be particularly difficult for people to express their views about it, especially if they have existing communication difficulties. To make this easier, we have divided communication into four topics:

• Expression
• Understanding
• Learning and thinking
• Relationships.

In the following example, I show how each topic can be used to build up a picture of how someone feels about different aspects of their communication. I worked with Kate, a 42 year old woman who had a stroke which left her with severe expressive and receptive aphasia. She was able to communicate through vocalisations and gestures. She could sometimes draw or write down words and needed to point to ‘yes/no’ in order to reliably answer closed questions. Following discharge from hospital, I used Talking Mats with Kate to find out how she felt about her communication. I started with the ‘communication – expression’ topic and found that she felt that she was having lots of difficulties making herself understood, particularly on the phone and in group situations:

I then explored how Kate felt about understanding what people were saying to her. Kate was able to tell me that she found it easier to understand people on a one to one basis rather than in a group setting. She indicated that it really helped her if people used gestures or wrote things down. Her main difficulty was understanding people on the phone, and in fact she had stopped answering the phone altogether (see mat below).

We went on to do a mat about Kate’s learning and thinking. In this set, there are symbols which cover higher level language activities such as reading, problem solving and organisation. When we talked about these areas, Kate was able to tell me about the things she was finding most problematic, but could also identify some things that she felt she could still manage (such as calculations and reading newspapers).

I then asked Kate how she felt about communicating with different people in her life. This mat shows that Kate found talking to her husband and her parents (who lived quite far away) particularly difficult.

As a result of doing these mats, we were able to target the things that mattered most to Kate in relation to her communication, and came up with the following actions:
1. Kate felt that her husband needed support and information, so we spent time working with him, showing him the best ways to support Kate’s communication.
2. Because Kate’s parents lived quite far away, she could only contact them using the phone, which was very difficult. We worked on getting Skype set up so that Kate could communicate with her family using all the modes available to her.
By splitting communication into different sub mats, Kate was able to think about different aspects of her communication and identify the things that she found most challenging. Together we began to work out some ways to help her overcome her difficulties.
Use the communication symbols to find out what people want to work on and use a collaborative approach to establish some goals to work on in therapy. I used the original Talking Mats when I explored  Kate’s communication with her, but you could do the same with Digital Talking Mats. Find out more about it here.

Within the Health and Well-being resource there are four symbol sets (health, looking after yourself, communication and leisure & environment). Within the ‘health’ set, there are three topics which can be used to help people express their views about different aspects of their health:
• Health
• Coping
• Mobility
I worked with Pete who had severe aphasia. Pete had a range of health problems, including epilepsy and high blood pressure. Pete found it very difficult to communicate with his GP, and usually relied on his wife to translate. This meant that not all of Pete’s health problems were addressed or discussed when he went to the doctor, and he often felt excluded from conversations at these appointments. Prior to one of Pete’s GP appointments, I used Talking Mats with Pete to find out how he felt about his health. During our discussions, Pete was able to tell me that he was worried about a number of issues, but he especially wanted to talk to his GP about his ears, as he was having a lot of pain and also had a ringing sensation in his ears which meant that he found it very difficult to concentrate, particularly when watching TV.

Pete took the photo of his completed mat with him to his next GP appointment and his GP used this as a focus for discussions. As a result, Pete was referred to an audiologist for assessment. His GP also spent time discussing Pete’s epilepsy with him and referred him back to the epilepsy specialist nurse who worked with Pete and his wife to improve their understanding and management of it.

Using Talking Mats helped Pete prepare for his GP appointment and also ensured that his GP focused on what was important to him. As a result, time was spent more effectively by all and Pete felt listened to and really participated in his GP consultation.

Use the Talking Mats ‘health’ symbols from the health and well-being resource to help people prepare for appointments with health professionals and manage their health more effectively.

When people have been in hospital for a period of time, for whatever reason, consideration needs to be given to discharge planning. There are often concerns about what a person may manage to do independently when they get home, and this often has an impact on where people are discharged to and what type of support they might need.
The ‘looking after yourself’ symbol sets in the health and well-being resource provide a good starting point for exploring some of these issues. This set is made up of three topic sets:

• Domestic life
• Self-care
• Work/education

I used these when I worked with a woman (Ruby) who had severe receptive and expressive aphasia. She had been discharged from hospital with a care package (carers came in three times a day to help her with personal care, meal time preparation and housework). Ruby had difficulty communicating through speech but was able to use Talking Mats effectively to express her views. I used the ‘domestic life’ symbols to find out how Ruby felt about managing the daily running of the household. Ruby was able to tell me that she felt she could now do more things around the house, such as hoovering and the laundry. She was ‘unsure’ about cooking and shopping, but indicated that these were areas that she wanted to work on.

Using Talking Mats, Ruby was able to tell me that she wanted to try to do more things for herself. We used photographs of the completed mats to discuss these issues in more detail with Ruby’s social worker and her husband. Initially, Ruby’s husband was hesitant about her doing more things around the house, but seeing the mat in front of him meant that he really listened to her views and felt happier about her taking risks and trying things for herself. As a result of our discussions, Ruby’s social worker reviewed her care package. She reduced the daily visits by carers and Ruby was given support from the rehabilitation team to help her work on preparing meals. Her husband arranged for a friend to take her to the supermarket once a week so that she felt more in control of the cooking. Use of Talking Mats meant that Ruby was really involved in setting her rehabilitation goals and ensured that her views were heard when her care package was reviewed.
The ‘looking after yourself’ symbols can be used to include people with communication difficulties in the decision making process. This is particularly important given the current legislative drive to promote self-directed support. Find out more about how to use Talking Mats by signing up for a training course at Talking Mats.

In a previous Blog, Joan talked about the four purposes of communication (Light 1988):
1. Expression of needs and wants
2. Information transfer
3. Social closeness
4. Social etiquette
Social closeness can often be overlooked when we support people with communication difficulties, as there can be a temptation to focus on what some see as the ‘important things’ – helping people to express their needs and wants or to transfer information. Social closeness is the glue which binds us together and helps us to form and maintain relationships. It’s really important that we establish this before we start exploring some of the difficult issues that many of the people we are working with face. In my work with people with severe aphasia, I spend time getting to know what matters to them and finding out what their interests are. This is a crucial part of building a relationship with the person and their family. It also provides a much more concrete starting point for beginning to explore rehabilitation goals, as this example shows:
When working with Jack (a man with severe receptive and expressive aphasia), I started by using Talking Mats to ask him how he felt about leisure activities. This was a great way to get to know Jack as a person and to find out his interests. During our conversation, Jack told me that he enjoyed going out for a drink but hated shopping and bingo – and we all had a laugh as he told me this. Jack also told me that he used to like ten pin bowling. He pointed to his leg to indicate that this was something he could no longer participate in as he was now in a wheelchair. I could see that this was important to Jack, so we talked about possible ways round his physical difficulties. Jack agreed that this was something he could work on with the help of his family and the rehabilitation team.

Given that Jack had severe receptive aphasia, if I had started by using Talking Mats to identify specific problems (using a top scale of ‘managing’ and ‘not managing’) as part of the goal setting process, it is highly likely that Jack would have found this too abstract and difficult to engage in. By using the more concrete topic of leisure (with a top scale of ‘like’/’dislike’), Jack was able to reflect on his life since his stroke and tell me how he felt about his restricted physical abilities. I was also able to build up a picture of him as a person and we had fun at the same time.

When using the Health and well-being resource, think about the person you are working with in relation to the ideas and concepts that they can cope with. Exploring leisure activities is a great way to start as it means you can establish rapport by finding out what matters to them.

Have a look at this Blog to see how other people have used a topic such as leisure to build social closeness.

The Health and Well-being resource is based on the WHO International Classification of Functioning, Disability and Health (ICF) which is a framework which covers almost every aspect of daily life and can be applied over different cultures (WHO 2001).

Use of the WHO ICF helps professionals to think holistically about the people they are working with. We have produced four sets of symbols, based on WHO ICF, to help people express their views about different aspects of their lives. These cover 13 topics:

You can use the symbols in different ways, depending on the cognitive abilities of the person you are working with. For example, if you are working with someone who can understand abstract concepts, you could start with the 13 main health and well-being symbols. Your top scale might be ‘managing’ and ‘not managing’. Here is an example of a mat completed by Duncan who had a stroke which affected his ability to communicate through speech:

Using these symbols as a starting point, Duncan could tell us that his main concerns related to worries about his health, expressive communication and work. From here, we did ‘sub mats’ to help Duncan identify the specific areas he wanted to work on/explore.

Here is the mat Duncan completed in relation to his health:

Having done this mat with Duncan, it became clear that he was worried about various aspects of his health, particularly the risk of having another stroke. The wider team were able to give him and his wife information about stroke prevention. Other mats were also completed, exploring expressive communication, work and education and higher level communication (which is included in the ‘learning and thinking’ topic, and covers written communication as well as memory and concentration). Using the Health and Well-being symbols, we were able to work with Duncan to help him identify the main issues that he wanted to work on and then work towards more specific rehabilitation goals. Duncan had copies of all the mats he had completed and found it useful to refer to them over the months. This helped everybody stay on track in relation to his goals and he was also able to track his progress over time.

Have a look at our Health and Well-being resource on our website. It is available both as an original Talking Mat with a physical mat and symbol cards or as a  digital version  as part of The Talking Mats pro subscription