We are grateful to Rachel Woolcomb OT,  for sharing this Talking mats story.

Within my occupational therapy practice I have found Talking Mats to be an excellent thinking tool to help my clients establish their priorities for therapy.

I was asked to work with a teenage girl who had sustained a brain injury resulting in a mild cognitive impairment which was impacting on her participation and ability to learn at school.

She had undergone formal cognitive testing with a clinical psychologist, however had shown poor levels of engagement with the assessment process (which had taken over two hours). She was reported as having erratic focus and inconsistent answers to questioning. The results were therefore deemed to be inconclusive and no recommendations made.                                                                  I knew that Talking Mats would provide me with similar information to that which the psychologist was trying to gain, but in a way that would be engaging and client focused. I also felt that the concept of the Talking Mat, which enables the thinker to express their own views rather than a “right or wrong” answer, would help to improve participation.

I selected the learning and thinking topic cards from the communication set within the Health and Wellbeing pack. These cards cover areas that I would normally look at within any cognitive assessment and are functionally relevant.   Together we selected the visual scale, choosing the question “how well are you managing?”

She explained that organising herself, writing, listening, reading, problem solving and planning were all going well. She talked about how she sometimes had difficulties concentrating and paying attention due to getting distracted in the classroom. She also felt she was struggling more than before with calculating and that this was affecting her scores in Math tests. She explained that remembering and making decisions were “not going well’ and she was particularly worried about the fact she had forgotten some of the teaching she had received prior to her brain injury.   I was also able to conclude from the way she understood the concept of the mat, as well as her ability to engage and attend for the whole session, that she could concentrate, learn new skills and had the ability to weigh up information to help her make decisions.

Together we used the information gained from the Talking Mat to set goals for therapy which were focused around having a range of strategies to help her concentrate in class, remember new information, and make decisions.

Two months later, once having completed a therapy programme, we used the Talking Mat again to explore her current thinking about the topic area. She explained that making decisions was something she no longer had difficulty with as her confidence had grown. She felt that there had been some improvement with her ability to remember information and we discussed the strategies she now used to help her concentrate in class, which included ways to minimise any distractions.

In summary, the Talking Mat enabled her to think about how her brain injury had affected her ability to remember, make decisions and learn. This provided valuable information from which a therapy programme could be created. The Talking Mat also provided a visual representation of her perception of the issues before and after therapy, showing clearly her progress. This was well received by her parents, teachers and the other professionals involved in her care.

Once again I have been amazed by the power of the Talking Mat to produce a breadth of information in a relative short space of time and I will be advocating its use within cognitive assessment and rehabilitation across all ages.

On the 17^th April we held a seminar exploring  the innovative work being done to support young people with communication needs within justice and mental health settings in both New Zealand and Scotland Read about the morning in our first blog    Talking Trouble, New Zealand kindly gave a gift to all delegates of their fantastic Top Tip cards shown in the photo . You can download your own set here

The afternoon session continued the underlying theme that communication support needs are often hidden and many looked after children have support needs that remain unidentified.

Dr Ann Clark from Queen Margaret University presented her research findings looking at Panel members’ and Children’s Reporters’ perspectives on communication in Hearings.  Her informative presentation highlighted the need and desire for more training on Speech, Language and Communication Needs.  The conclusion was that it is better to assume ALL children who are attending a Hearing have additional support needs, whether or not they have a diagnosis of Speech Language and Communication Needs (SLCN) and Social Work support is also essential in achieving positive outcomes for Looked After Children. SLCN in Hearings April 2018

Our interactive session asked participants to reflect on the information presented during the day and to think about opportunities to improve practice in supporting communication as well as the barriers faced.  The main themes that emerged from the barriers were:

1. Identifying Speech, Language and Communication Needs in children and young people
2. Constraints within Speech and Language therapy services
3. Lack of education and training – the word “communication” because practitioners think they know about it when in fact there is a large knowledge gap
4. Routes to services can be either Offending or Mental Health pathway
5. The balance of power and control in relationships between the practitioner and the person with SLCNs – how committed are we to put genuine inclusive communication approaches in place.

Identify the barriers helps to inform the opportunities and the themes emerging were:

1. Some good collaborative practice is happening already and the impact of working together is proven in research – we need to extend this further.
2. Joint training sessions – good visual and other communication supports
3. SLT have a vital role going forward
4. We have a real opportunity at the moment to effect real change in a legislative context with recent Government policy

Kim Harley Kean, Head of the Royal College of Speech and language therapy Scotland office concluded the day and injected a great sense of impetus going forward. She asked 2 key questions:

Q: Is communication support and equality an issue in justice and care services?

Q: Do we want to do something about that?

Having responded with a unanimous YES she helped us to see the potential we have for change. It was obvious from the day that collaboration is vital and the event demonstrated how many different professions and organisations want to do something about the issues. We can be more effective if we do this collectively, even across continents!

The majority of participants felt we should use the event to establish a collaborative network.  The key purposes would be to:

1. Market – get message out there – tell more people – politicians, government and public – about Speech Language and Communication in Criminal Justice Settings explaining how SLT and Talking Mats have a vital role.
2. Share stories, gather evidence.
3. Facilitate enriching conversations between practitioners, for example, about aptitudes and approaches needed to negotiate communication behaviour change among professionals as well as people with SLCN…

If you would like to join the network and help to influence change please email info@talkingmats.com  with a request to add your name to the youth justice mailing list.

Talking Mats were delighted to be involved in the launch of Care Opinion’s Picture Supported stories at the Life Changes Trust Gathering in Perth Scotland this week. We have been working with Care Opinion for the past two years to develop this feature.  This earlier Talking Mats blog describes the development process and this recent Care Opinion blog gives some examples of the feature in use.

However, in this blog,  I want to reflect on two events I went to within a short space of time; the gathering in Perth on Monday and the Royal College of Speech and Language  Therapists study day the previous thursday in Stirling . It felt to me like my two worlds colliding or maybe it was just my stars aligning ! At the RCSLT study there was a session on the public perception of Speech and Language therapy and how there is still much work to do in changing the myths that are spun and repeated about what Speech and Language therapists actually do . For as John F Kennedy said in 1962 ‘ the great enemy of truth is very often not the lie but the myth , persistent, persuasive and unrealistic ´ The  National  Allied Health Professional  children’s lead, Pauline  Beirne suggested to the study day that Care Opinion is a great web site for encouraging that sharing of stories. Then, strangely when I got back into the office there was a story waiting for me in my in box all about the positive experience of a parent involved in a Hanen programme in NHS Lanarkshire  which reinforced that very message.

We know people relate to stories, stories resonate and have impact, they are easy to remember .  Our drive in working in partnership with Care opinion was to support more people to tell their health and care stories  by increasing accessibility . It was designed with and for people with dementia   through funding from Life Changes Trust but anyone can use it and they are! It is great to see the stories coming in.

Through stories let’s celebrate the good, develop and improve practice and let’s use stories to challenge myths and educate. So use Care Opinion and try out the  picture supported stories to share your experiences , tell other people ,spread the word and the picture supported story feature  !

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/

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 is a useful tool to help parents see their child’s point of view.

The stage for each parent when their child also has an opinion about what is best for them can come as a surprise and is sometimes challenging.  For parents of children with disabilities it can be even more so. This story is an example of how Talking Mats helped parents hear their own child’s voice amongst the background noise of the voices from health, education social and voluntary services.

David was in his final year of primary school.  He attended a small village school and was transitioning to a large mainstream secondary.  He has mobility problems due to cerebral palsy and uses a wheelchair.  He can walk very short distances with effort using a walker and in his primary school used this method to move around the classroom and go to the hall for lunch and PE. This was a functional way to meet 2 of his targets : changing position and walking practise.  His parents wanted this to continue when he transitioned to secondary school, although the health professionals involved felt it was going to be too difficult given the greater  distances in the new building.  An electric wheelchair was proposed for this new context.  David’s parents were finding this next step challenging.

One of the professionals involved wanted to find out what David felt was important in his new school and used Talking Mats as a way of supporting him to think about various factors.  The top scale used was ‘important/ not sure/ not important’.

David’s mat clearly showed that what was important to him in his new school was being with his friends.  When his parents saw his mat they realised that this would be impossible if he was to move from class to class using his walker and it helped them make the transition to seeing him in an electric wheelchair. It also helped them see things from David’s point of view. They were more than happy to fit walking practise into a different part of his busy day because they had heard what was important to him.

Talking Mats allows different voices to be seen and heard.The name has been changed to protect identity.

Talking Mats is at its heart a Person Centred approach and makes this abstract concept real for practitioners and accessible to more people.

The skills we teach in our training are core to its values:

• Being explicit about the purpose of the conversation
• Using open questions
• Affirmation
• Active Listening
• Personalising
• Summarising
• Clarification
• Acknowledging that this is the persons view today and it is likely to change with time

‘ To improve the lives of people with communication difficulties by increasing their capacity to communicate effectively about the things that matter to them’

Our  vision statement  matches what is quoted in the introduction of the new Core Skills framework ‘Person-Centred Approaches’ produced by  NHS Health Education England, Skills for Health and Skills for Care http://www.skillsforhealth.org.uk/news/latest-news/item/576-new-framework-to-promote-person-centred-approaches-in-healthcare

Talking Mats foundation training gives practitioners a tool to turn the values expressed in this powerful document into practice Read how one health authority made this a priority                         http ://www.talkingmats.com/person-centred-approach-to-health-planning

To support your organisation evidence they are using a Person Centred Approach look at our website www.talkingmats.com  or contact info@talkingmats.com

Thanks to the Action Group  in Edinburgh for their great blog about their co-trainer Lynnette Linton .

In 2016, a number of people with learning disabilities attended a Talking Mats training  designed to build their communication skills and confidence so they could  use  to interview others about their community participation, in regard to Charter for Involvement goals. One of those trained was Lynnette Linton, the National Involvement Network Chairperson, and a Service User of The Action Group in Edinburgh.

Lynnette interviewed several fellow service users using Talking Mats, and was supporting in the role of ‘Listener’ by Liz Taylor, an Action Group Training Officer, who as a consequence of this work requested to become an Accredited TM Trainer. The Charter highlights that support organisations should involve Service Users in training their staff, so it then seemed natural for Liz and Lynnette to deliver TM training to Action Group staff together, with Lynnette in the role of volunteer co-trainer.

Lynnette has since been a core part of training over 50 employees (including those at Senior levels) in Foundation Talking Mats training with the Keeping Safe add-on. Liz says, it helps that Lynnette is “naturally gifted at speaking to people, and ably demonstrates the significance of TM as a means of having your say on the service you wish to receive”.

Lynnette and Liz do a demonstration Mat together, and then when trainees are doing their own Mat or showing their videos, Lynnette points out where they are applying the key TM principles (Lynnette enjoys issuing certificates to those who successfully complete the course). She also shares anonymised stories from her experience of interviewing ‘Thinkers’, which help get across what Action Group Users “want to change and improve about their service”.

Liz says, “Our first experience of demonstrating a Mat together didn’t quite go to plan, as Lynnette became unexpectedly upset when discussing her views of a football team, when she was reminded of a close friend who had died who had been a fan”. As difficult as this was for both Lynnette and Liz at the time, it was a powerful example of how TM helps us express emotions we may not even have been ourselves aware are ‘under the surface’, and sparked real interest in TM as a communicative tool.

The Action Group started gathering feedback specifically for Lynnette in her role as co-trainer, as part of the training evaluation and trainees have said that “she is exceptionally welcoming and puts everyone at ease; her passion for the topic is very evident, and it is very beneficial to hear real life examples, and how TM helps in her own life”. This includes how Lynnette benefits from the Keeping Safe pack, as a means of raising more ‘difficult’ issues.

Lynnette says, “As a service user, I also now see myself as an important, valued co-trainer. [Training] is something I see myself doing more of in the future. My confidence has shot right up. It makes me feel proud, and my parents get to hear about it at my Review”.

Staff also see the real importance of acting on the actions from each person’s Mat. Lynnette acknowledges that co-delivering has sometimes “been difficult, because I know some of the people we’re training. But I’ve been able to speak up about what I want from my support, my environment.”  Recently she trained her own Service Development Manager and Team Manager, and although she felt it was harder to be honest, she had a captive audience, and her Managers then followed through on actions from her demonstration mats:  “It’s made a difference to me, after doing a Mat with my DM about my home. I put ‘safety’ in the ‘Thumbs Down’, because I get frightened, and now I’ve got a security chain and a peephole on the door”. 

“I never thought I would be training the staff.  Now we’re booked up!”

Click for  information  about the Accredited training and or the Keeping Safe resource mentioned in the blog

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.

Thanks to Natalie Leader, one of our Accredited Trainers from Hobart, Australia for this blog reflecting on her experience of doing the online Foundation training.

The beauty of online training is that no matter where you are or what time zone you’re in, there are options. This is really brought to bear when living in a rural or remote area, such as here in Southern Tasmania.No matter how much those of us here in beautiful Tassie brag about what an awesome place it is to visit, there are limits as to which training organisations will provide professional development sessions here, and how often.

I missed an opportunity to attend Talking Mats Foundation training by a few months so registered to do the online training instead.

My experience with the Talking Mats online training platform was that the organisers were responsive and positive, and the content offered variety, with steady monitoring of progress. Amongst the easy navigation and helpful resources you also participate in discussion forums. As one who doesn’t often participate on line, I found them encouraging and helpful, It was also interesting to read people’s descriptions of different ways that Talking Mats can be used.
Doing the modules in sequence (and with some time in between) worked well for me, as I reflected more deeply on the role of the listener and the qualities I needed to foster in my practice, such as observation, pacing and neutrality.Fostering those qualities and being guided by principles such as self-determination is now an ongoing goal for me.

I have now introduced Talking Mats into my practice and have taken the next step of becoming an Accredited Trainer.

Becoming an accredited trainer involved attending a 2-day workshop in Melbourne for face-to-face training and assessment from Lois and Nicki from Talking Mats Ltd, Stirling, Scotland. As if having excellent trainers was not enough, there was the added bonus of a roomful of like-minded practitioners, all sharing their skills and experiences with Talking Mats. Because each person’s work setting was unique, our group had a rich and diverse array of perspectives on implementation of Talking Mats training and techniques.
So, now I’m making preparations for delivering my first training workshop, sharing Talking Mats with my colleagues. I actually don’t have the jitters (except regarding the IT!) And, I’m confident that Talking Mats will speak for itself. Perhaps I may have appeased the IT deities by taking a giant leap from my former self and participating in a blog, so that side of things will run smoothly!

Good luck with the training Natalie!

This month we have online course participants from Singapore, Canada, Ireland and the UK. Register now for our next online training starting on the 5th of September.