My care my voice

Thank you to Lisa Jackson, Specialist Speech and Language Therapist with Stockport NHS FT for this blog.

How inclusive is your approach to therapy goals or decisions around communication support for clients? Lisa describes a situation that most therapists, support workers will have encountered over the years and offers a way to listen to the most important people in the therapy process.

I have been a speech and language therapist for 14 years working for the NHS. My caseload consists of primary and secondary aged children who have a range of communication needs. I specialise in the area of Alternative and Augmentative Communication (AAC) and, as a Talking Mats Licensed trainer, I am passionate about capturing the voice of the children, young people and their families.   

Like many professionals, I strive to work in co-production with the service user and the team around them to provide holistic intervention. There are many barriers which can affect a professional delivering a truly person-centred approach and often decisions regarding interventions are completed without consulting the client and their family. 

Talking Mats is a powerful tool to capture the thoughts and opinions of the children and young people. It enables service users to engage in conversations and most importantly, empowers them to influence change and the interventions they receive.  

Case Study: Matthew : age 17 years.  An AAC user and keen gamer. 

• Matthew has a syndrome that affects his cognition, motor skills, social skills, and speech and language.   

• He communicates using a variety of methods including speech and gesture.  

• He recently received an iPad with a text based communication app to augment his spoken communication. 

In Primary School Matthew was given a paper based communication book but it was noted that he did not often use this.  

In Secondary Matthew was assessed for and given an electronic communication device.  He kept this when he transitioned to College. 

At College, staff noted he didn’t take his device out of his bag.  This contrasted with home where Mum said he used it to aid his communication. At this time Matthew was becoming less engaged in Speech and Language Therapy and his awareness of his communication difficulty was increasing. 

On reflection it became clear that Matthew had never been actively involved in the decision-making process around his communication.  Therapy had always “been done to him” and targets had been set “for him” which had led to AAC abandonment in the past. 

The key points Matthew shared were: 

This demonstrates the importance of gaining the voice of the service user as his reluctance to use his device had been misinterpreted as him not wanting to use it. After exploring his views, this was found not to be the case. 

Matthew was then asked what he wanted to happen from the information given and he independently set his own outcomes for therapy: 

• To widen his friendship circle.  

• To learn to start conversations. 

• To have support with access to gaming.  

• To meet other people who use AAC.  

Following the conversation, the desired outcomes and how they were going to be achieved were discussed with Matthew and the team. THe focus of therapy changed to work on his social skills. The outcomes have been added to his Education Health Care Plan (EHCP). He was signposted to gaming charities and social events for people who use AAC.  

Conclusion  

Without using Talking Mats, the outcome for Matthew could’ve been very different, with his thoughts not being acknowledged or explored appropriately.  Talking Mats has given Matthew a voice to communicate his wishes. Talking Mats empowered Matthew to generate his own outcomes, to influence and drive the focus of his intervention.  

Our Advanced Online module is available to anyone who has completed Foundation Training.

If you are interested in becoming Talking Mats Foundation trained: