This year the Scottish Government recognised the value of using Talking Mats as a conversation framework to enable people with learning disability to reflect on their lives and express their views including raising any areas of concern. One of the key themes from the national Scottish strategy for people with learning difficulties ‘Keys to Life’ is to keep people safe, but it was also recognised that the Talking Mat that had been designed could also help with other themes –
Helping people with learning disabilities stay in control
Shift the culture and ensure care is genuinely person centred
Evidence that the views of people with learning disabilities have been taken into account
Support people to cope with adversity and loss and enhance resilience
Address health inequalities and reduce early deaths
The Scottish Government has funded a 3 year project which we are calling Keeping Safe.
This project will
Produce a new resource based on the feedback from earlier projects This has 3 topics of conversation . Firstly ,How people are feeling about their Health and well-being secondly, their relationships. For people who are able to think and express their views at a more abstract level the resource has a third topic and gives them space to reflect on their thoughts and feelings.
Train staff in the 14 health boards across Scotland to use Talking Mats and this resource specifically. This training will be provided jointly with KASP so staff can be supported to think through how they respond appropriately to any concerns that may arise
Ensure that all health board areas have accredited trainers who will be able to lead ongoing training and sustain use of the resource
If you work with adults with learning disabilities in Scotland and would be like to be part of this exciting initiative please contact us at firstname.lastname@example.org.
The final part of my keynote talk at the AAC Conference in Helsinki last month focused on what we mean by communication effectiveness.
It is important to be able to determine the effectiveness / success of an interaction between two people, whether they are politicians, parent and child, husband and wife….. people using AAC systems or people using their own speech.
When I carried out a literature search of peer reviewed journals for my PhD in 2009 I could find no clear definition of communication effectiveness. Some people thought that effectiveness was synonymous with ‘word intelligibility’ or ‘correct syntax’. Others defined effectiveness in terms of the number of words produced on an AAC device. One publication even suggested that effectiveness was demonstrated by someone taking responsibility for charging their AAC device!
The main focus of all the papers I found, which mentioned communication effectiveness, was on needs and wants and only 3 papers cited social closeness as important (click here to read previous blog).
However, some publications did give useful pointers. Light (1988) emphasised that effective communication depends on 2 way interaction and that the partner is a major factor in the success or failure of communicative interactions. Lund (2006) described adequacy, relevance, promptness and communication sharing as key indicators. Ho et al (2005) highlighted satisfaction – partners’ feeling of how well they communicated during the conversation. Locke (1998) stressed that determining the success of any communication is a subjective undertaking as ‘Communication is not a mathematical formula of phonemes, morphemes and syntax, but rather includes casual conversation such as gossip’.
The Talking Mats team has tried to capture what we believe are the essential factors in determining communication effectiveness. We have produced a simple tool – the Effectiveness Framework of Functional Communication (EFFC) which can be used to chart key factors in an interaction on a 5 point scale and give an overall indication of whether the conversation is effective or not.
We have used the EFFC in several of our research projects and show participants how to use it during our training workshops. In Finland I tried it out with the audience of 200 AAC professionals using 3 video examples of different AAC conversations. The resulting scores were amazingly in agreement suggesting that this is a reliable tool.
The Talking Mats Team is increasingly asked to help ascertain a person’s capacity to express their views from a non-biased perspective. We are also asked to carry out service evaluations and are therefore developing independent consultancies to individuals and organisations. Our team of experienced Speech and Language Therapists, who have an in-depth knowledge of communication difficulties, are well equipped to do this.
The following are examples of independent consultancies which we have been asked to carry out:
A lawyer asked us to work with a man who had had a severe stroke to ascertain his capacity to make decisions ranging from simple ones such as where he would like to go on holiday to complex ones such as who should control his finances. Using Talking Mats we were able to determine that he could make decisions about simple, concrete situations but wished his wife to make more complex decisions such as finances. check
A Social Work department asked us to work with a woman with dementia and aphasia who had been sectioned. They needed to ascertain if she could understand why she could no longer live in her own home. We worked closely with her social worker and through using Talking Mats ascertained that she was unable to give informed consent.
A Health Service facility asked us to evaluate the degree to which their patients felt involved in their care planning.
A Care Home asked us to use Talking Mats with a 91 year old resident with dementia to find out her views about receiving dental treatment. There had been problems in the past and both the staff and her son were unsure if she understood the reasons and implications for dental treatment. Using Talking Mats, she was able to explain her thoughts about her teeth and dentures and clearly said that she was unhappy about opening her mouth for the dentist but that if her son were with her she would feel much better. We received this comment: “If you were to show the first few minutes without Talking Mats you would have thought this lovely lady lacked capacity, however the change and her engagement is noticeable.”
The following points explain with whom and how we can carry out the Talking Mats consultancy:
Children or adults
Family members, friends, professional staff
Individuals or groups
With or without a carer present
At a venue and time which best suits the individual
On any topic – we already have a comprehensive range of topics for both adults and children – but can create tailored symbol sets for any situation
To find out someone’s views on a particular topic or situation at a specific point in time
To help determine the capacity of an individual to make their own decisions
To compare someone’s views over time
To compare different people’s views e.g child and parent, person with dementia and carer
We provide a detailed report with a copy of the person’s completed mat/s
To find out how we can help you and for discussion of costs please contact us at email@example.com or phone us at 01786 479511