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It was a great privilege for Nicki and Lois to visit to Australia and New Zealand and share our experience of Talking Mats with such a fantastic group of interested people. We learned a lot about the opportunities and challenges their work settings present.  Our first blog focuses on Australia and the second on New Zealand.

Australia 

Agosci

We had just over two weeks in Australia. During that time we attended and presented at the Agosci conference – a great gathering of practitioners from all over Australia and further afield who are focused in improving practice in Alternative and Augmentative communication. There was a lot of interest in Talking Mats – our stall was busy and our preconference workshop full.agosci

A key driver for the interest was the implementation of the National Disability Insurance Scheme (NDIS) which is changing the way the individual packages of care are being administered with the need to establish what is important to the person and their life goals. Talking Mats is recognised as a great tool to help that happen and although there did not appear to be any NDIS planners at the conference we are hopeful with the buzz that was created the message will get out.

Dementia

It was interesting for us to see that at Agosci there was no mention of the role augmentative and alternative communication could play in terms of supporting communication with people with dementia. It is true that in the UK equivalent conference ‘Communication Matters’, the use of AAC in dementia is not the strongest theme but you will still find discussion and papers about it. It felt to us the world of AAC and dementia was still very separate in Australia and closing that gap could provide an enhanced quality of life for people with dementia.

We appreciated being invited to deliver training for Hammond Care in Sydney. They were an experienced group of practitioners and we had interesting discussions about using Talking Mats in their work with people with dementia.

We are excited too that one of our new Australian accredited trainer, Lyn Philipson  will be using Talking Mats in her research with people with dementia.

Keeping Safe

Our new ‘Keeping Safe’ resource sparked a great deal of interest. Naomi Rezzani of Scope Australia organised a seminar which Lois was invited to speak at.KS presentation

It was good to hear about the local initiatives in the state of Victoria to support people with learning disabilities who have experienced or are at risk of abuse . The presentations discussed the role of  advocacy, therapeutic support, education about rights, the Scope  ‘Speaking Out’ resources that support communication. The countries may be different but themes are similar.

Accredited training and Zytec

At the end of our stay we held an accredited training course and are delighted that 9 Australians and and 3 New Zealanders can now provide training in their respective organisations.

Throughout our visit we were very well supported by our Australian Partner Zyteq and being able to work closely with them for two weeks has strengthened our partnership. We are delighted that Tracey Bode and Karyn Muscat of Zyteq will continue promoting Talking Mats in Australia. They are the Australian providers of face to face training and the original Talking Mats resources

Time off!

It was of course not all work. We loved seeing for real the iconic images of Sydney opera house the harbour bridge , bronzed bodies surfing in the sea , Melbourne with its myriad of art deco buildings , graffiti street art and the cute wee St Kilda fairy penguins. So lots of happy memoires and hopes we will be back.

More information

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Five short stories from our recent accredited training course in Stirling.

  1. A looked after child was unhappy but no one knew specifically why. Using the Talking Mats, she indicated that she was upset by the weekly phone call with her mother because it always happened when it was her playing time. The time of the call was moved to just before her bedtime but this resulted in bad dreams. The time of the call was finally moved to Saturday afternoon which helped her settle and reduced her distress.
  2. Talking Mats was used with an Iraqi boy who had come to England via Libya, Italy and the jungle camp at Calais. When he picked the symbol of a waiting room he indicated that despite all she had been through he really liked this because it reminded him of all the children in his family and made him happy.
  3. A 76-year-old man with a learning disability disclosed that he had been attacked and suffocated by his upstairs neighbour one week previously. It was only when he used the Talking Mats that he disclosed to anyone what had happened.
  4. A lecturer usually used quantifying measuring with her students to find out how they were managing their studies. Instead she used Talking Mats to find out how they were coping with their work life balance. One student told her that she was managing fine except that her pet rabbits always escape under the bed and it takes her a long time to get them back out so she does not let them out very often!
  5. Talking Mats was used with a man who had had a stroke and had to go into residential care because his family could no longer look after him. They were very worried that he was unhappy with the new care set up. He was able to show with the Talking Mats that he was happy about everything except that he was not given enough time when he went to the toilet. Once the staff realised this they then gave him more time which resolved the situation and reassured his family.

Please send us your Talking Mats stories – we love hearing them.

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

particiapnts
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.

LD Self care

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.

 

Demntia Leisure

 

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.

Stroke Leisure
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.

The Keeping Safe Talking Mat resource provides a structured framework to ask someone ’How’s your life going?  It has 3 topics: Your Well-being;  Relationships; Thoughts and Feelings

Do you find it difficult discussing feelings with people who have limited understanding?

Do you have limited time to discuss sensitive issues with people?

Do you want to find out any issues which may be slowing recovery or preventing someone moving forward in life?

A cost benefit analysis demonstrated that using the Keeping Safe resource to create a listening space for people to think and share how their lives are going, is cost effective for organisations.

The design of the resource is described in the Tizard Learning Disability Review More Than Pictures TLDR 2017

It has been trialled and tested with people with learning disabilities throughout Scotland, but has also been used effectively with a range of people who find it difficult to discuss their life e.g. Young people with mental health condition.

It  has been shown as a helpful way to

  •      discuss new information (89%),
  •      discuss and resolve fears (84%)
  •      support thinking (89%)

This poster gives an overview of the project KS 2nd Poster (click to enlarge)

The Thoughts and Feelings topic uses a different top scale and this resource is best used by people who have completed Talking Mats Foundation Training.  If you want to buy it (£55.00 +VAT)  contact the office  www.talkingmats.com   tel. (+44) 01786 479511

Laura, shares a story from a speech and language therapy colleague. Her 4 year old daughter  was getting upset at the thought of going to nursery; she wanted to see if using a Talking Mat might shed some light on why she was upset as the reasons were unclear.

Topic: Nursery

nursery
Top Scale: Like/ Don’t know/ Don’t Like
Options: 14 in total, focusing on different aspects of Nursery involving      staff, other  children, activities and environment.
The parent reports that her child was very engaged when doing the Mat, and took the photo of her completed mat at the end. Mum took the role of the ‘Listener’ however Dad was also there watching, so the child had the attention of both her parents.
The completed mat indicated that the child liked a number of aspects about nursery, however did not like ‘smell’, ‘sound’ and playing games with other children outside. The parent then fed this information back to nursery staff who are now monitoring these areas in order to gain further information.
This further information from staff will help to provide ideas regarding possible options to sub-mat in the future, using the topics of ‘smell’, ‘sound’ and ‘playing outside’, and therefore enabling this child to communicate her feelings about these areas in more detail.

Those of us who are parents can find ourselves in the position of trying to work out why our child is behaving in a certain way. Sometimes a change in behaviour can be very sudden. Often the underlying reason can be far removed from what we assume it is.
Talking Mats can help in this situation, as it provides a visual, picture-based framework to focus on, supporting discussion between parent and child. Children will often share more information using a Talking Mat as opposed to a purely verbal discussion. Talking Mats is less confrontational and puts the child in control, as the ‘Thinker’.

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.being_involved_in_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.

supervision mat

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.

Conversation with friends is key to our well- being.

Talking Mats is a tool to maximise people’s capacity to communicate about things that matter to them.   For people with communication difficulties the ability to have a good conversation is restricted.  For this reason we have developed Conversation sets, described in an earlier blog http://www.talkingmats.com/talking-mats-conversation-sets/ 

The topics include Holidays, Gardens, Trips out, Sport.  Football even has one if its own!

Some of the members of the National Involvement Network in Edinburgh tried out the conversation sets.  Fiona’s conversation is generally limited to responding to questions and she has a tendency to agree with what other people say.  Using the Holidays topic, she told me that she liked camping and added that she had tried this a long time ago when she was a member of the Girl Guides.    I told her I had also been camping with the Girl Guides so immediately this created a bond between us.  Sharing experiences can be the start of a friendship.

.camping

David and James used the Football topic to chat about a recent match they had attended together.   Before using the mat to discuss the match they did not know that they had felt differently about the stadium and the crowd.  This was a surprise and stimulated further chat. Together they relayed a funny incident that had happened and we all had a good laugh- another aspect of building friendships.

David and James have good conversational skills but the Talking Mat took their conversation to a more detailed level.  For people who have difficulty getting involved in conversations these topics allow them to share experiences and find links with other people.

Awards
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