Author Archives: Joan Murphy

Care Inspectors in Sweden and Talking Mats

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This blog is about how Care Inspectors in Sweden are using Talking Mats.

On 18th March I met up with old friends – Ulrika Ferm and Eva Holmqvist – at the ISAAC Denmark Conference in the beautiful Vingsted Conference Centre in West Denmark. Ulrika and Eva work at DART Communication Centre in Gothenburg Sweden http://www.dart-gbg.org/english/.

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I was giving a presentation on new developments in Talking Mats and as always happens when we meet, we talked non stop about families and work.

Ulrika told me about the following initiative in Sweden and we agreed it would be useful to write a blog about it.
The Health and Social Care Inspectorate https://www.ivo.se/ (the Swedish equivalent of the Care Commission) had been in touch with DART about how they could get the views of people with dementia who live in care homes.

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DART made a program of communication for the inspectors which included a first day about communication and dementia. Following this there was a full 2 day course on Talking Mats for 15 inspectors who then went on to pilot the use of Talking Mats as a way to get the genuine views of residents. It was so successful that they are planning to roll this out elsewhere. Now more inspectors in Sweden are getting Talking Mats training and using pictorial support as preparations before inspections.

It would be really good if this could happen in Scotland.

Let pictures talk

german app in action

Grateful thanks to Prof. Dr. Norina Lauer, OTH Regensburg – University of Applied Sciences, Germany for this blog.

At the conference of the German Society for Aphasia Research and Treatment (GAB) from the 1st to the 3rd of November Franziska Rau presented a poster – Let pictures talk – about her bachelor thesis on Talking Mats.

2018 TalkingMats – Germany

Speech and language therapists from German-speaking countries meet at this conference to present their latest research findings. This year’s theme was ” Aphasia Therapy Digital”.
The presented bachelor thesis about Talking Mats was performed at the HAN University of Applied Sciences, Netherlands, and was written by Franziska Rau together with Karoline Bitter and Lara Stobrawe. The students asked 29 people with aphasia and 63 people without aphasia for how representative they rated the images and terms used in the Communication section of the Digital Talking Mats Health & Well-being resource. While the healthy persons judged many items as not clear enough, the people with aphasia estimated significantly more pictures and names as appropriate. For this purpose, various reasons have been discussed, such as the possibility that the persons with aphasia directly perceived the pictures and terms as aids, while healthy persons judged more critically on the basis of the task. But also problems of concentration or comprehension in people with aphasia would be causally conceivable. This should be examined in further studies.
The poster was presented as part of a poster session and was well received by the audience. Thanks to Franziska, Karoline and Lara for their great study and to Holger Grötzbach, Janine Coopmans and Xaver Koch who supported the students.

We are always happy to receive projects and posters from anyone studying how Talking Mats can be used

Digital Talking Mats and Dementia

Jean and David laughing

Talking Mats received funding from The Health and Social Care Alliance Scotland to look at how using the Digital Talking Mats can help people with long term conditions, including dementia,  to manage their health and well-being and to recognise their own strengths and abilities. We also hoped that participants would be able to have more control over their lives and have improved communication with families and professionals.

11 people living with dementia and their partners were involved in the project. Each participant had a tablet device and was given a personal digital Talking Mats licence which gave them access to 13 topics in the Talking Mats Health and Well-being resource. We visited each participant at home, taught them how to use it and asked them to complete at least 1 digital Talking Mat per week for 6 weeks on any topic they wished. The design of the digital Talking Mat allowed them to email their mats directly to us. We visited each participant a second time to discuss how easy it was to use the digital Talking Mats and their views on their completed mats. We asked those who wished to, to continue sending us completed mats beyond the initial 6 weeks and we visited them again in 6 months to discuss how they were managing.

In total we received 94 digital mats across all 13 topics from the participants living with dementia who reported that the use of the Digital Talking Mats during this project gave them a better understanding of their own individual health and social care needs.

A woman with dementia said ‘It (Health mat ) made me realise things are not so bad and made me think I will continue with my exercise classes, carry on walking, socialising and eating well’

dementia health mat

As well as helping participants self-manage their lives, an unexpected outcome of this project was that many people found that using the Digital Talking Mats helped them see the positive things in their life and not just the negative. It also highlighted that despite having a deteriorating illness, things were not getting worse.

‘This mat (Environment) showed me how happy I am in my own home and my neighbourhood’
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The following are some of the comments we received throughout the project.
• It helps me sort out my thoughts – very useful
• I get so much out of the process
• I come up with insights which might help me in the future
• I can now talk to (my wife) in a way I couldn’t before
• I’m more relaxed now
• I come up with niggly health things that my partner didn’t know
‘It made me realise things are not so bad’.

If you know of anyone living with dementia would like to obtain the Digital Talking Mats please fill in the attached Personal Digital Licence 161117 DTM personal licence form with explanation and send it to us at info@talkingmats.com

Click here for the full report of the project which also included people with stroke and learning disability

Self-management for people with long term conditions

DTM Jean and David

Self-management for people with long term conditions (LTC) is now a key government strategy to encourage people to take responsibility for their own health, behaviour and well-being. Talking Mats received funding from The Health and Social Care Alliance Scotland to look how using the Digital Talking Mats (DTM) can help people with LTCs to manage their health and well-being and to recognise their own strengths and abilities.

The overall aim of our project was to empower people with different long term conditions, to manage their own health and well-being. Through using Digital Talking Mats (DTM) we hoped that participants would be able to have more control over their lives and have improved communication with families and professionals.

There were a total of 28 participants in this project living with one of three different long term health conditions – stroke, dementia and learning disability. Each participant had access to a tablet device and was given a personal DTM licence which gave them access to 13 topics in the Talking Mats Health and Well-being resource. We visited each participant at home and taught them how to use it and asked them to complete and send us at least 1 digital mat per week for 6 weeks on any topic they wished. The design of the digital Talking Mat allowed them to email their mats directly to the researchers. We visited each participant a second time to discuss on how easy it was to use the digital Talking Mats and their views on their completed mats. We asked those who wished to, to continue sending us completed mats beyond the initial 6 weeks. We visited them again in 6 months to discuss how they were managing.
15 participants completed all 6 mats and 12 participants continued to complete mats over the length of the project. Participants completed 235 digital mats across all 13 topics

There were 3 particularly significant findings

1. At 18 months the participants living with dementia actually felt their well-being had improved, despite dementia being a progressive illness.
2. For the participants living with stroke the results were even more striking as 95% felt things were going well at the end of the project in comparison with 47% at the beginning.
3. At the end of the project the percentage of people with learning disability who felt things were not going well had reduced from 19% to 10%. Furthermore the percentage of people indicating that they were not sure about their views had increased from 27% to 42%. There can be a tendency for people with learning disability when using Talking Mats, to express their views at either end of the mat and to rarely use the mid- point. However being able to use the unsure mid- point is noteworthy as it indicates that the participants in the project realised that they could express their views not only as black or white but could indicate that they were unsure. This awareness opens up the potential for people to express views more thoughtfully with opportunities for further exploration.

Here are three examples of how using the DTM supported people to self-manage situations in their lives. Click on image to enlarge.

DTM stories

As well as helping participants self-manage their long term conditions, an unexpected outcome of this project is that many people found that using the DTM helped them see the positive things in their life and not just the negative. It also highlighted that despite having a long term condition and, for many also a deteriorating one, that things were not getting worse.

Click here for full report including 6,12 and 18 month reports to the funders  20180717 Alliance full report

Click here for the summary report 20180717 Alliance Final Short Report

Click here for a video link of 2 participants

Learning Conversations – How do I feel about what I do and the support I get?

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Thanks to Laura Holmes for this blog about the support she gets from Talking Mats for ‘Learning Conversations’ with the children she works with.

I use Talking Mats for a variety of purposes in my role as a Speech and Language Therapist (SLT) for NHS Stockport Children’s Therapy Services Team, working with children with speech, language and communication needs (SLCN) in mainstream primary schools.

The introduction of the SEND Reforms in 2014 and SEND Code of Practice (January 2015) firmly places children and young people at the centre of the planning process – ‘No Decision About Me, Without Me’.  The following principles underpin the reforms,

  • Support for children and young people with SEND should be based on an understanding of their views, wishes and feelings.
  • Wherever possible, children, young people and their parents should participate in decision making, and should be supported to participate.
  • Support should help children and young people achieve the best possible outcomes, and prepare them for adulthood.  (Howe C., et al 2016)

One of the main advantages of the Talking Mats approach is that it has enabled me to have ‘learning conversations’ with some of the children I work with.  These learning conversations support children to participate meaningfully in decision-making in terms of setting SLT targets based on their views, wishes and feelings, which are then incorporated/ linked into their SEN/ Education, Health and Care Plans.

I usually introduce the Talking Mats approach using ‘practice’ mats focusing on familiar topics such as animals, food, activities.  Once a child is using the mats to clearly indicate their views/feelings on these familiar topics, I introduce topics such as ‘My Body and Skills’ and ‘What I do and Support’, using the Talking Mats ‘Consulting Children and Young People – Primary’ resource, to support a learning conversation. I use original and/or digital versions depending on what each child responds best to.  Here is an example of a mat focusing on the topic ‘What I Do and Support’, using the topline question ‘Happy About/ Not Sure/ Not Happy About’:

Laura's blog

 

Using the Talking Mats approach as a basis for this learning conversation enabled me to learn about B’s views and feelings regarding the things he does and the support he currently receives.  This approach also provided me with a deeper understanding of how he felt about these skills, as he was noticeably more communicative when we had the mat to focus on rather than answering direct questions.

At the end of the session we discussed what B would like to work on in particular.  B shared that he wanted to work on asking for help, and making choices.  These two targets were then set in his updated therapy plan, which also included recommendations in terms of supporting B to follow routines in school, for example through increasing use of visual supports and strategies, and also in terms of providing opportunities for B to try new things in school with an appropriate level of support and guidance.  It will be useful to carry out follow-up learning conversations using sub-mats – for example, submatting ‘routines’ (once the recommended supports and strategies are in place) using the topline question ‘what helps/not sure/ what does not help’, will enable B to share what he feels works best for him.

Using the Talking Mats approach has often taken a child’s therapy ‘journey’ down unexpected paths as the mats have sometimes revealed areas of difficulty and/or challenges for that child which were not previously apparent or identified.   These areas would not have been targeted otherwise, indicating the power of Talking Mats to empower and enable the children I work with to participate in their own therapy planning.

References:

Howe C., et al. (2016)
Guidance for Speech and Language Therapists on their roles and responsibilities under the Children and Families Act 2014 and associated Code of Practice
Royal College of Speech and Language Therapists Position Paper. RCSLT: London

For further information about Talking Mats training options click here