We’re always amazed to hear from people about the variety of topics they cover using Talking Mats –from how someone is managing their self care or domestic tasks, to arranging a wedding, or thinking about whats important at a funeral.

As a communication tool Talking Mats maximises a person’s capacity to reflect on a topic and express their view.   It gives confidence in decision making.

Here are some other topics we’ve heard about recently.

• As a conversation tool in class
• Pupil voice in school improvement plan
• Client contribution to meetings and review day placement
• Respite
• Operations e.g. gastrostomy
• Health
• Postural management
• Where to live
• Childs opinions in relation to GIRFEC
• Respite feedback/choices
• SW assessments
• Choices available within service
• Going somewhere new
• Transitions
• Problem solving ie horse riding, identifying the problem
• Eating and Drinking
• Keeping Safe
• Social Media

What do you want to talk about?  There is no limit!

We are now half way through our project, funded by The Health and Social Care ALLIANCE Scotland, whose overall aim is to empower people with a range of long term conditions, with and without additional communication difficulties, to self-manage their own health and well-being by using Digital Talking Mats.

Participants

We have carried out all the initial visits and 16 follow-up visits and participants are sending in their completed mats, choosing whichever topics they want from the digital Health and Well-being resource. At the time of writing this blog we have received 137 completed mats.

We have received very positive feedback with many examples of how people are using the Digital Talking Mats to self-manage.

Here are 3 examples:

One participant with learning disability has diabetes. Through using the Digital Talking Mats she has stopped buying takeaways every night and is now buying M&S ‘Balanced for You’ meals. This is a huge step forward for her as she refused to discuss healthier eating before.

A man with early onset dementia has identified that he used to enjoy singing and has decided for the first time in his life to join a choir. This is not something that had come up in conversation before. Despite the diagnosis of dementia he has realised that he is still keen to try new things.

 

 

The wife of a man with severe aphasia said ‘This (Leisure away) has highlighted how few things he can do away from home. We discussed this but can’t see how we can change the situation.’ However at the second visit he used the same mat and indicated that he had been thinking about his mobility and was about to start swimming and a fitness class.

We already have an increased awareness of the meaning of self-management as we observe how participants are using the Digital Talking Mats to think about their situation, state their own views and share them with carers/support workers. We are also noticing that there is a shift in some relationships as the carers/support workers realise that the person with the long term conditions can make decisions and express their own views rather than having decisions made for them.

We are very grateful to Marieke Lindenschot from the Netherlands for this great blog about finding out what activities children like and we look forward to hearing the next stage of her PhD.

For my PhD research in the Netherlands I use Talking Mats as a tool for my interviews with children. The children I interview vary in their communication abilities. Some are able to express their opinions and feelings very well, others are not able to communicate orally. As I was able to purchase the Talking Mats cards without text, I wrote down the words in Dutch in ‘children’s language’ on the cards.

Last week was an exciting week. I conducted the first pilot interviews with a boy of 12 years, a boy of 9 years and a girl of 8 years. They varied in their development. The first interview went great. The child could express which activities he liked, which he disliked and which were ‘so, so’ (in between like and dislike). With Talking Mats he could also tell me with whom he performed the activities and where. It was a fun way to get a lot of information in only 15 minutes! The child and his mother were very enthusiastic. He was able to tell a lot more then he usually does when he is asked about his activities! Unfortunately the other two interviews didn’t produce the same amount of information. The cognitive level of these children seemed too low to use Talking Mats. The boy didn’t understand the top scale ‘like’ and ‘dislike’, whereas the girl didn’t recognize the activities on the cards.
Overall we were very satisfied with these pilot interviews. The goal was to check if the interview guide with Talking Mats ‘worked’ and also to see for which developmental level this way of interviewing is possible. The pilot interviews gave a lot of information on these two goals. I am looking forward to the next interviews as Talking Mats showed to be a very helpful tool in finding out which activities children like.

Please send us any other examples of how you have used Talking Mats.

Health professionals from Stockport have shared how using Talking Mats has positively impacted on their clinical work.

Laura, our North West  Associate, met up with Carla Innes, Clinical Psychologist for learning disability from Healthy Young minds Stockport (a child and adolescent mental health service provided by Pennine Care NHS Foundation Trust) and Clare Royle, Family Support Worker,from the Children’s Learning Disability Team (provided by Stockport NHS Foundation Trust). The two organisations work closely together to provide joined up care to young people with a learning disability.

Six months ago Carla, Clare and seven others from the Healthy Young Minds Stockport Team  received training to enable them to introduce Talking Mats as part of their challenging behaviour pathway.

Carla and Claire said that the staff team are very positive about the impact of Talking Mats. The overall impression is that Talking Mats has enabled staff to gain an individualised sense of the child or young person they are working with, as well as empowering the children and young people to share their views and opinions. Carla also notes that using Talking Mats has helped her to focus on the child/young person’s abilities/potential – their ‘zone of proximal development’ – and to ensure that everyone is working within that.
Some of the other positive features of using Talking Mats include:
– Providing ‘headspace’ for the child/young person to process their thoughts and to really consider what is important to them.
– Giving a holistic, child/YP centred account and narrative of their feelings and behaviour.
– Helping to inform and direct clinical decision making e.g. introduction of an approach such as CBT.
– Enabling children/young people who have previously refused, or been very reluctant, to share their views and opinions about topics which have been troubling them for example, school attendance and issues with sleep.
– Providing of a communication framework which is neutral and non-threatening – much less intense than direct verbal questioning or conversation.
– Helping to make abstract concepts more concrete for the listener to understand.
– Being a safe, flexible and quick method of finding practical solutions and determining direct actions.
– Enabling the listener to gain a better understanding of the thinker’s level of knowledge and understanding about a particular topic such as healthy eating. This can help inform capacity assessments e.g. in terms of medical consent or the use of medication. The mental capacity act states that appropriate support should be given to young people to make informed decisions and to communicate those decisions.
In addition, from a wider team perspective, Carla and Clare report that they have all noticed benefits in terms of consistency of Talking Mats use by all members of the multi-disciplinary team. Each team member using the Talking Mats tool is working from a slightly different perspective; using Talking Mats ensures that the child/young person is kept at the centre of the process. This results in a truly holistic view of the child/young person’s feelings, views and opinions.

In 2016 ten Speech and Language Therapists working in Gloucestershire Care Services NHS Trust were funded to attend a Talking Mats training day. During that day the trainers mentioned that Talking Mats is used within their organisation to carry out appraisals. This highlighted that Talking Mats could not only be used with clients but also between professionals.

The Speech and Language Therapy Team decided to use Talking Mats for their supervision sessions. They came up with a set of labels that could be used. The supervisor takes the role of the “Listener” and the supervisee takes the role of the “Thinker”. The supervisor hands the labels to the supervisee who places them on the mat as either something that they wish to discuss, something they don’t need to discuss or in the middle – i.e. something that might be useful to discuss if they have time. They are then able to move the items around to prioritise items and add labels if required. This mat then forms the basis of the agenda for the meeting.

The Team discovered that although they had previously felt that the supervision agenda was set collaboratively, the use of Talking Mats allowed the supervisee to have an opportunity to shape the agenda of the meeting and the agenda setting became truly collaborative. It also helped supervisees to raise challenging and difficult issues more easily and led to better time management of the sessions as the mat could be referred back to throughout the session to ensure that discussions remained on track. At the end of the session, a photo of the mat would be stored alongside supervision notes as a visual reminder of the session.

The Team is very positive about the changes to supervision that have resulted from adopting Talking Mats as evidenced by the quotes below:

“As a supervisor I feel reassured that my supervisee has the opportunity to bring up any topics she may wish to discuss as there are prompts for so many aspects of our work. It allows her to prioritise issues to be discussed and makes the structure of the session overt and collaborative.”

“The visual and tactile nature of talking mats enabled me to quickly map out which areas were priorities for discussion in supervision. Because all topics have to be initially organised by how I feel about them/ what impact they are having, I found it was easier to discuss subjects that were previously difficult to broach.”

Many thanks to Ashleigh Denman, Principal Speech and Language Therapist, Gloucestershire Care Services NHS Trust for this interesting blog.

Please let us know of any other ways that Talking Mats has been use innovatively.

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.

It was great to meet with Nikki Steiner, Principal Speech and Language Therapist with Central London Community Health Care Trust (CLCH), to evaluate the work that was commissioned by CLCH. The project started in the spring of 2016 and aimed to support a person-centred and inclusive approach to health planning and intervention using the Talking Mats framework.

Those words ‘person-centred’ and ‘inclusive’ are easy to say but much harder to implement. Our approach was threefold:

1. We provided 100 staff with the Talking Mats resources to use in their practice (both the original and digital versions).
2.  We ran 3 Enhanced Talking Mats training courses for those staff which involved two days training. The first day introduced the framework and built staff confidence in using the resource. The second day supported staff to reflect on their use of the Talking Mats in their work setting, and allowed them to think creatively about further application and development.
3. To sustain the capacity of CLCH to continue with the project we trained three accredited trainers. The plan is they will continue to build staff skills and training on an on-going basis and provide local leadership and expertise.

The evaluation framework that we are using looks at impact of this investment using the Kirkpatrick model of evaluation. This allowed us to evaluate:

1. Participants’ reaction to the training,
2. Participants’ learning – did they increase their knowledge skills and learning?
3. Transfer and application – did they apply their learning to the workplace?
4. Result – this was based on the impact that using the Talking Mats skills and resources had on the lives of people with communication disability

We had different measurements for each part of the model and these ranged from course feedback, a quiz, personal reflection and stories from people with communication difficulties. It is these that we are in the process of analysing so watch this space for the final report. Nikky said ‘This is such an exciting project that impacts on all the different client groups that we support’.

If you would like to discuss implementing Talking Mats at an organisational level then have a look at this link – Organisational Training

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

We are delighted to be travelling to Australia and New Zealand in May 17 and look forward to the opportunities the trip gives us to discuss Talking Mats in these countries.

Firstly, we are pleased to have been invited over to Australia to be involved in the Agosci Communication Conference in Melbourne from the 18-21 May 2017. Agosci is an inclusive organisation that supports the participation of all people with complex communication needs. The theme of this conference asks participants to involve people with complex communication needs in all aspects of life to create a more welcoming society for people with communication support needs.

Lois and Nicki will be attending for Talking Mats and their involvement at the conference includes

• A one day pre – Agosci conference Foundation training for professionals in Melbourne
• 2 presentations – one on the potential use of Talking Mats in National Disability Insurance Scheme (NDIS) and one on our current  Keeping Safe project
• A poster on using Talking Mats in Eating and Drinking
• A stand which will run throughout the conference and where we can and meet and chat to delegates

In addition prior to the conference we are running

• A one day Foundation training in Sydney for Hammond Care

New Zealand

Plus we are really pleased to have linked with the Talk Link trust in New Zealand and will be visiting both Christchurch and Auckland and running foundation courses in both those places. New Zealand can be proud of their world record of electing Robert Martin in June 2016  to become the first person with an intellectual disability to serve on the UN committee dealing with people with disabilities. It feels a privilege going to a country which is providing such leadership in self-determination.

Train the trainers     

We fly back to Melbourne and run a two day Accredited Training in St Kilda’s Melbourne for Australian and New Zealand professionals previously trained in the use of Talking Mats via our online course. This course will allow them to train others within their respective organisations. By providing our accredited training and ‘training the trainers’ we are facilitating the increased use of Talking Mats in Australia and New Zealand . This increases professional skills, improves the quality of the service being provided and most importantly improves the quality of life of the person with the communication difficulty by assisting them to express their views.

So a busy schedule but exciting and we hope to have some time off to relax and enjoy new sites and a different culture. There will be more blogs to follow……… Plus if anyone has any top tips for coping with long distance flights we would like you to share them!