Many thanks to Charlotte Phillips and Laura Douglas, SLTs at Blossom House School, New Malden, for this latest guest blog which looks at how Talking Mats are used for therapy goal setting within the context of a specialist school for children with SLCN.   Further information can be found on their RCSLT Poster Presentation (September 2019) here – AAC Poster RCSLT Conference September 2019

Goal setting can be a labyrinth to navigate! Do these goals reflect the pupil’s own views? Is there a discrepancy between staff and pupil ideas for goals? Are these goals motivating? Are the goals functional? Are pupils avoiding goals they would like to achieve for fear of failure? Add to this the language rich dialogue required in order to establish goals and similar to a maze you may encounter dead ends, twists, turns and a feeling of entrapment. How can we ensure we do not assume needs and that the goal setting process is collaborative and person-centered? Enter Talking Mats; a tool which enables you to make sense of the maze, like the lookout tower in the middle it allows you to have a clear view of how everything fits together. You’ll now find the goal of exiting is far easier!

How can Talking Mats help?

At Blossom House the Talking Mats framework is utilised at the beginning of therapy to support pupils with DLD and specific learning difficulties to identify areas of their strengths and needs and develop personally meaningful goals that are associated to these areas. Some of the pupils are competent verbal communicators within a social context but due to the emotive subjects they may be exploring they may not be able to access these skills within therapy. Talking Mats are also used to baseline students’ self-awareness alongside prompting pupil voice. Talking Mats are tangible and have low linguistic demands which allows students with kinaesthetic and/or visual learning style preferences, and communication needs to engage in these discussions.

Case Study This Talking Mat (using Widgit Symbols as options) was created with a student at the start of therapy whilst the therapist was building a therapeutic relationship. It helped a student who was reticent to share with a new adult to have a full conversation about things that he was happy with and those that were not happy. The mat options were chosen to include a) communication strengths and needs, b) school subjects and c) some areas the SLT knew were areas of strength. The function of this mat was threefold: to baseline the confidence the student felt about certain areas (with the aim to increase this over therapy), to assess his self-awareness of his strengths and needs and finally to act as a tool to help prioritise targets for therapy and develop relevant goals. The student’s self-awareness was accurate as he was able to rate known areas of strength e.g. singing, dancing and drama, as ‘happy’, whilst known areas of difficulty e.g. spelling were accurately labelled as ‘not happy’. Some of the areas of need that the student rated matched the SLT’s referral information as priorities for therapy from his teacher (starred) therefore these were used to go on to create joint goals with the student.

Next Steps

The school would now like to embed Talking Mats as a whole school approach. The first step will be Talking Mats forming a core part of School council meetings to ensure that every pupil has a voice. There will be consultation with SLTs around integrating Talking Mats into the Annual review pupil voice protocol and into therapy outcome measures. This will be facilitated through the use of the digital talking mats package which allows for staff to create mats with pupils on the move, with minimal resources. These can then be emailed to staff and pupils which makes this information practical for staff to use within the context of their extremely busy school day. The use of technology to facilitate self-advocacy is an interesting field which needs further investigation.

If you are feeling inspired and would like to access Talking Mats training to enable you to introduce a similar approach in your school take a look here – 

https://www.talkingmats.com/training/foundation-training/

To find out more about our resources, including our Digital Talking Mats app, check out this link here – 

https://www.talkingmats.com/shop/

Many thanks to our Talking Mats Founder, Dr Joan Murphy, for this latest blog talking about the training course she recently delivered at the Cyprus University of Technology.

Cyprus is a beautiful Mediterranean island with a population of approximately 1 million.

I was invited by Dr Eliada Pampoulou to run a 2-day course on Talking Mats for 12 Speech and Language Therapists, some of whom are masters students and some, lecturing staff at the Cyprus University of Technology. The Cyprus University of Technology founded the first Department of Rehabilitation Sciences  in Cyprus and the Department offers the first public recognised university bachelor degree in Speech Language Therapy / Speech Language Pathology in the Greek language (https://www.cut.ac.cy/faculties/hsc/reh/).

Day 1 was a Talking Mats foundation training course and Day 2 focused on discussion around capacity, research and clinical applications. This model worked very well as the participants were able to think about and discuss how to apply the training immediately.

Some of the immediate plans of the participants were both clinical and research oriented and are outlined below:

• To administer the Greek Stroke and Aphasia Quality of Life Scale (SAQOL-39) with healthy people over  50 both with the text version and an adapted Talking Mats version quality and to examine which they prefer.
•  To use Talking Mats both with people with people with aphasia and their carers in order to share their understanding about  the communication skills and needs of people with aphasia.
•  To use Talking Mats as a tool to identify the factors that are related to AAC system acceptance or abandonment by focusing directly to the views of people with complex communication needs
• To use Talking Mats as a goal setting tool for both paediatric and adult population
• To use Talking Mats to gets clients feedback about therapy services
• To use Talking Mats for student appraisals regarding their clinical training

Dr Eliada Pampoulou has created the first Talking Mats centre in  Cyprus which aims to gather all people who received training every few months to share their experiences and support each other to embed Talking Mats in practice and research.

We hope that Eliada will come to Stirling next year to gain her Talking Mats licence to enable her to train others and extend the reach of Talking Mats even further.

We regularly run our Licensed Trainer 2-day courses at our base in Stirling – if you have attended Talking Mats Foundation Training and would like to train other people find out more here:

https://www.talkingmats.com/training/train-the-trainers-accredited-training/

Many thanks to Lynn Blair, SLT (NHS North Lanarkshire) for writing this guest blog describing a recent project in which she and her colleagues used Talking Mats to gather the thoughts of secondary-aged pupils with social, emotional and behavioural support needs:

Do you remember your school janitor? Was he/she a cheery soul who you enjoyed talking to?  Perhaps there was another member of school staff who you trusted and felt you could chat with.  Secondary school can be a challenging environment for any teenager, let alone those who have speech, language and communication needs (SLCN).  Young people need adults in their lives who they can feel at ease talking with.

The purpose of our recent project (See Lanarkshire SLT SEBN Poster 2019 and Lanarkshire SEBN Project Summary) was twofold.  Firstly we wanted to find out how many of the young people in our local secondary schools for pupils with social, emotional and behavioural needs (SEBN) had language and communication difficulties.  We also wanted to hear about the impact of those support needs by gathering the thoughts of the pupils themselves and that’s the focus of this blog.

We have to admit we were a bit anxious before we met with the pupils.  Would these young men and women even give us the time of day with our friendly faces, mats and pictures? In the actual event, for the most part the tool was met with curiosity and then full engagement.  The young people quickly grasped the idea.  Some did not speak at all as they placed the images and others used the opportunity to tell us a great deal about how they felt about talking to different people in their lives and in different settings.

The information that we gathered is now being used to plan evidence-based speech and language therapy services to the school and young people.  The use of Talking Mats gave us interesting information like the fact young people felt auxiliary staff such as janitors and assistants are often easier to talk with than teachers and as a result, we are thinking about how we involve all school staff in future events.

We are only too aware that the young people we met have often felt excluded from other people and from certain places.  Talking Mats gave them the opportunity to be heard and we’re excited to consider how we can use them in the next phase of our work to support their communication needs.

If you are feeling inspired and would like to find out more about accessing Talking Mats Training – check out this link here: https://www.talkingmats.com/training/

Many thanks to Susan Gowland, SLT at NHS Fife Forensic Learning Disability Service, for this guest blog summarising the fantastic presentation she delivered at our TM is 21 event in August 2019.

As a speech and language therapist within NHS Fife’s forensic learning disability service, I work across two low secure wards. In my presentation for the “Talking Mats is 21 event”  I talked about the way in which Talking Mats is used within these wards and the positive impact this has had for staff and patients.

Regular Check In: “it’s the same questions, but it’s easier to talk with the pictures”

Some of the people I work with use Talking Mats as a regular check in tool. Conversations are often based around the Wellbeing, Relationships and Thoughts and Feelings cards of the Keeping Safe resource, with personalised adaptations agreed with the thinker. Some people who find it difficult to express how they are feeling and irritations can either build up to a serious incident or the person can get weighted down by unexpressed needs and concerns. For these people a regular check in can address the small things before they become big things. This can help the thinker feel listened and responded to, build experiences of communicating effectively, as well as trust and therapeutic relationships, all of which are assets which will support the person to move on.

Self Reporting: “It helps me understand how I’m feeling about things”

For some people, the check in can have a specific focus. In a hospital based forensic service, unexpected and unrecognised changes in mental health can lead to serious incidents. To address this we have used Talking Mats to talk about mental health. SLT have worked with individuals, psychiatry & nursing to identify personal symptoms of mental health changes. These symptoms become options in the Talking Mat & can be used to support person to self report at the times their mental health changes. Being able to do this enables people to discuss the support they need & reduce the risk of out of the blue incidents. The Talking Mat itself can be a support. As one thinker said, “Talking Mats relaxes you, it calms you down”.

 As and when required:

The regular use of Talking Mats on the ward has led to other patients asking for Talking Mats sessions. As a licensed trainer I offer training to all professionals within our multi-disciplinary team and there is often at least one Talking Mats trained nurse on shift. This means ad hoc requests can be facilitated and some thinkers have started using Talking Mats in weekly meetings; as a tool to talk through emotional events and as a way of exploring the mixed emotions around discharge. In the words of one of the charge nurses:

“Talking Mats has enabled me to communicate with people in a way that is meaningful. To support someone to express and understand their thoughts and feelings regarding both joyous and distressing events is a privilege. The format may be simple, but the outcome is often comprehensive and insightful.”

 (Picture drawn by Fiona Glanville, staff nurse, NHS Fife)

If you would like to find out more about accessing Talking Mats training, check out this link:

https://www.talkingmats.com/training/

 If you are interested in our Keeping Safe resource mentioned here (available to those who have accessed our Foundation Training / Online Training Course) please see these links for more details:

https://www.talkingmats.com/keeping-safe-a-new-talking-mats-resource-available-to-purchase/ 

 https://www.talkingmats.com/product/keeping-safe/

Recently, Associated Prof. Ida Marie Mundt from Denmark completed our Talking Mats licensed trainer course. She has been looking at the theories which underpin Talking Mats and is planning to publish her work. One of the areas she speaks about is Identity.

In this blog, our Talking Mats Associate Rhona Matthews explores the area of Identity:

How do I know who I am? This is learned from actions, behaviour and language firstly with parents and family, then with friends.

For people who have difficulty interacting, this becomes much more difficult. There is a danger that others construct their identity.

A participant on our online training wrote about her experience of doing a Talking Mat for the first time with a girl who uses augmentative communication. She has a severe difficulty expressing her ideas and thoughts.

The topic was leisure activities and the top scale was things I like to do/ don’t like to do. She did this quickly and with no great surprises. The listener felt she didn’t get particularly useful information.

So she repeated the topic but with a different top scale. Things I am good at/Things I’m not good at.

Not surprisingly there was overlap with the earlier attempt. i.e. the things she felt good at, she liked which included horse riding.

Again the listener felt there was more conversation to be had! The thinker coped easily with another change of top scale which was things I want to get better / don’t want to get better at.

This time when the option of horse riding was handed over, the thinker became very animated, nodding in agreement. Not only did she want to improve her horse riding skills but wanted to learn about looking after horses. Her family had no idea that actually she didn’t just like riding but saw herself as a rider. This was part of her identity.

As Assoc. Prof. Ida says, Talking Mats offers a possibility to talk about who you are, and get other peoples’ responses.

If you are interested in accessing Talking Mats training we offer a variety of options, including online – check these out here:  https://www.talkingmats.com/training/

Talking Mats is now used in many countries all over the world.  As part of our #TMis21 blog series, we wanted to share this great example of Talking Mats being used in Germany.

In March 2019 Prof. Dr. Norina Lauer (OTH Regensburg) and Elena Maxheimer held a lecture and a workshop about Talking Mats at the “aphasia days” in Wuerzburg, Germany.  Many thanks to Norina and Elena for sharing information about the “aphasia days” for this blog post.

The “aphasia days” are a large congress – unique in Europe – for people with aphasia, family members and speech and language therapists (SLT). Every year around 600 people from Germany, Austria, Switzerland and Hungary are coming to this event. There are talks, workshops and podium discussions held by participants with aphasia, family members or SLTs. In front of approx. 150 listeners Norina and Elena gave a lecture about Talking Mats and the results of Elena’s bachelor thesis, in which she worked with people with aphasia, who learned to use Talking Mats.

In a three-hour workshop at the “aphasia-days” Norina and Elena taught nine people with moderate to severe aphasia how to use Talking Mats. All persons brought their own tablets and logged into their own account. They where shown how to choose a topic and a top scale and practiced in teams of two. All of them conducted several sessions with different topics and switched partners a couple of times. They had a lot of fun talking about things that matter to them and learn more about their peers. At the end of the workshop they were able to use Talking Mats themselves and are going to use it with their relatives and friends at home. As the workshop was very well received by the participants, it is likely to be repeated at the next “aphasia days” 2020.

If you would like to find out more information about Talking Mats in Germany, and the Digital Talking Mats app which is now available in German, check out https://www.talkingmats.com/talking-mats-in-germany/  and https://www.talkingmats.com/german-digital-talking-mats-with-people-with-aphasia/

Our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019.  Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Rachel Woolcomb, our Talking Mats OT Associate, shares a recent personal experience where she used Talking Mats to support a difficult conversation:

The vision of Talking Mats is to improve the lives of people with communications difficulties. I have been reflecting recently on the definition of ‘communication difficulties.’

When I first heard about, and started to use Talking Mats 10 years ago, my perception was that it was fantastic for those that could not speak but I must admit I didn’t really consider using it with people who, such as myself, could use their voice to communicate.

Over the years as my understanding has developed, and I have looked further into the use of Talking Mats as a ‘thinking tool’ I have come to a different conclusion.

I would like to suggest that at some points in our lives, each one of us is likely to experience a communication difficulty. I don’t mean that we cannot physically speak, but that we cannot express what we really want to say in words. Perhaps a topic is too difficult to talk about with someone so we don’t bother, or we are overwhelmed by the subject that we don’t really know where to start.

One such subject is that of death and dying.

We know it will happen to us all one day but to talk openly with loved ones, is for some reason, too much to comprehend, too emotive, or considered bleak.

I am very fortunate enough to have grandparents in their 90’s however the conversation about their wishes for the future goes unspoken. It is a challenge for my parents to raise the issue therefore it remains the big unknown.

This is a common problem. In 2009, The National Council for Palliative Care wanted to address this issue and set up the Dying Matters Coalition in England and Wales, to help people talk more openly about dying, death and bereavement and to make plans for the end of life.

Talking Mats have produced a set of topic cards called ‘Thinking Ahead.’ https://www.talkingmats.com/product/thinking-ahead/

These were created in consultation with Strathcarron hospice to help people with advanced illness or long term conditions to think ahead and plan for the future. The three topics in the set are: Affairs, Care and Treatment and Personal Values.

My Mum was interested in my role with Talking Mats and wanted to understand what it was all about. We had already started to talk about the challenges of having difficult conversations, especially about death, and therefore over a drink, in a relaxed coffee shop, we embarked on a journey of discovery using a Talking Mat. My Mum as the Thinker and myself as the Listener .

She used the Talking Mat to help her think about things she had not considered and was able to make plans about what she wanted to do next. I heard her wishes and her thoughts, on why certain things were important to her. It was a very special time, facilitated by a Talking Mat.

My challenge to you as readers of this blog is to ask yourself ‘what do I have difficulty talking about’ – A Talking Mat just might be the answer!

Another resource you might find helpful is ‘Let’s Talk about Death and Dying’ –  www.ageuk.org.uk

Rachel will be running a ‘Talking Mats as a Thinking Tool’ workshop at our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019. Dr Sally Boa from Strathcarron Hospice will also be running a ‘Talking Mats in End of Life Care’ workshop at this event. Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

At Talking Mats, we offer a range of training models https://www.talkingmats.com/training/ that are tailored to suit individual teams and/or organisations and that help them develop their services to people with communication disability.

The one which best supports participants to embed Talking Mats in their practice /organisation is the Enhanced Talking Mats training https://www.talkingmats.com/training/bespoke-training-for-organisations/. This course is run over 2 days with the second day usually 4 months later supporting staff reflect, refresh and extend the implementation of Talking Mats with their clients. It includes an evaluation of the participants’ views of their interaction with ‘thinkers’ before and after the Talking Mats training. Participants are asked to complete a short questionnaire designed by the Talking Mats team on Survey Monkey prior to the first training day.

In November 2018 Joan Murphy ran the first day of an enhanced course in Welshpool, North Powys for 12 NHS staff including (Click to enlarge):

Over the next few months participants were asked to use Talking Mats and bring case studies to the follow up day. They were also asked to complete the survey before the second day which was held in March 2019.

The following graphs show the comparison of the pre- and post- training evaluations. (Double click to enlarge the figures):

Figure 1 Pre talking Mats training – November 2018

Figure 2 Post Talking Mats training – March 2019

In addition, participants were asked to add any comments. Here are a sample of them:

It allowed me to identify areas that mattered most to the person in terms of what they wanted to work on in therapy. It showed me that what I thought was the most severe aspect wasn’t always what was having the biggest impact. 

• Now have understanding of hobbies/likes to interact with on the ward to engage in therapy and reduce anxiety/boredom. 
• Brought up something important to them which probably would not have surfaced without TM. 
• Used to make patient-centred goals as opposed to goals set with family therapist. 

In conclusion, if any organisations are looking for Talking Mats training, we would encourage them to consider booking the enhanced course to support them to use Talking Mats to its best effect.

Our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019.  Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Last week, Laura Holmes, our NW England Associate, had the pleasure of interviewing our inspirational Founder, Joan Murphy. Joan will be retiring after our Talking Mats 21 event on 15^th August 2019 and so this was a great opportunity to find out more about her Talking Mats experiences:

Are there any stand-out moments for you, from your Talking Mats time?

Talking Mats are now used in many countries across the world and it has been great to have the chance to travel widely. One particular moment which stands out for me was during one of two trips I made to China with Sally Boa. I was asked to demonstrate Talking Mats with a man who was in hospital having had a stroke. He had no speech and was using a wheelchair. I used Talking Mats to find out what the man felt he could/ couldn’t do. The man shared that he felt he could walk. I had to present the symbol three times as the family members and medical staff watching were adamant that the man could not walk. On the third time, the man pushed the table, moved his wheelchair back then stood up and walked around the room. His family and medical team were completely shocked and realised that no-one had actually thought to ask him if he could walk. This was a massive turning point both for the man – and also for his family and medical team, who could now see the power of using a Talking Mat.

Have you done any Talking Mats yourself that helped you to make an important decision for you or your family?

Absolutely – quite a few! My husband and I both used Talking Mats for our Power of Attorneys and shared them with our lawyer and grown-up children. My husband and I also used Talking Mats to talk about the Scottish Referendum as we had opposing views – it really helped as it made us listen to each other without interrupting. We then went on to use the mats as part of a presentation. Various members of my family have used mats to explore personal issues and decisions 

What are the top tips you have gained from your Talking Mats journey – from working in the NHS and then more recently as a social enterprise?

You have to have humour. And be able to listen. It has been essential to be able to work in partnership with Lois and the other Talking Mats team members. The team are such nice people to work with and we have lots of laughs. Setting up as social enterprise was vital for Talking Mats – in terms of having the freedom to be creative. It felt as though someone had a big rubber band which was able to be released. It was a huge risk and there have been lots of leaps of faith along the way.

Do you have any top tips for people using Talking Mats in the Listener role?

Be quiet – and Listen! It’s also important to feel relaxed and to have a sense of humour whilst using it. A Talking Mat is not a test – it is serious, and can be used to explore difficult issues, but it should be fun.

Talking Mats is a low-tech AAC system – do you think it has a place in the modern world?

It is absolutely crucial! Low-tech resources are fundamental in terms of being able to have and develop conversation skills and social closeness.

What do you want for Talking Mats in the next 10 years?

World Domination! Talking Mats has the potential to be used everywhere in the world, by everyone. However I would like to see Talking Mats continue to have a small core team, but increasing Licensed Trainers across both the UK and the rest of the world.

Our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019.  Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Many thanks to Jenny Trott for our new guest blog about her interview with Talking Mats Director, Lois Cameron – Jenny’s video provides some great information about the Talking Mats approach and our original and digital resources:

A year ago I started my YouTube channel (www.youtube.com/jennytrott) as a way of supporting parents and carers with information and inspiration. As a parent of a disabled child myself I knew that one of the best ways to find out things is from other parents, and YouTube was just a different and new way to do that. To date I have published nearly 50 films about subjects ranging from Self Directed Support to Rebound therapy, and including interviews with parents, professionals and disabled people.

Quite early on I knew that I wanted to make a film about Talking Mats. I had used Talking Mats when I worked with people living with dementia, and I knew that my son’s school were using them too. I had seen the benefits of this innovative communication tool but I also knew that many parents and carers didn’t really understand it because they hadn’t been given the right information.

Lois was kind enough to agree to join me in front of the camera, so in April I visited Talking Mats in Stirling with my tripods, microphones and cameras. It can be a bit daunting interviewing someone I’ve not met before but Lois instantly put me at ease and had the great idea of demonstrating a Mat rather than just talking about it. It was so interesting, experiencing using a Mat first hand and it helped to show the viewers what Talking Mats is really about.

You can view the video here: https://youtu.be/Fmyt1fE-_U8

The feedback from the film has been great, both from professionals, parent carers and SLT students; lots of lightbulb moments; “ah, now I get it”!

I am still making films but less frequently as I am now also setting up a social enterprise, Mecoco (www.mecoco.org) here in North Ayrshire.  We’ll be offering work experience and volunteering opportunities to disabled people to work alongside us making candles and melts. I am sure Talking Mats will be invaluable in our workshop!

If you’d like to find out more about accessing Talking Mats training take a look here- https://www.talkingmats.com/training/  – we offer a range of options including online, and bespoke training for organisations, as well as advanced courses and specialist seminars for those who have already accessed Talking Mats Foundation Training.