We were recently involved in a discussion about the merits of symbols versus photographs to support communication, a topic which we have spent some time considering over the past few years.
We have also found an excellent small book titled ‘Too late to drive’ by Helen J Bate and published by Pictures to Share C.I.C. In it Helen discusses the meaning of pictures and visual perception in relation to dementia. There are some excellent quotes such as ‘Recognition is not the same as relevance, and relevance is what is important to us when we have dementia’ and ‘The images that really talk to people are produced with a skill and an understanding of the visual image as a method of unspoken communication’..
Our gut feeling is that for many people who use Talking Mats (who we refer to as ‘thinkers’), symbols may be more helpful than photographs and, although we have not carried out any academic research, we have lots of anecdotal evidence from a number of practitioners about some of the pitfalls of using photos. Here are a few:
The ‘thinker’ tends to get caught up in the detail of a photo e.g. Australian colleagues told us about using photos of different rooms in a day centre but the ‘service users’ got caught up with seeing specific details in the photos rather than considering the over place
Sometimes a photo can be too specific e.g. we were told of a person with dementia who was shown a photo of cornflakes to represent breakfast but could only focus on the cornflakes
The ‘thinker’ may be distracted by a photo of a real object e.g a person with learning disability fixed on the make of a particular car instead of considering transport
We are always wary of using photos of real people as it may be too sensitive for the ‘thinker’ – symbols appear to reduce the emotion impact of the image and be easier for people to comment on
If the person in the photo has changed, for example their hairstyle or glasses, this can confuse the ‘thinker’
If the ‘thinker’ has been involved in the place or event in the photo this can affect their views whereas a symbol is more neutral
Sometimes the clarity and quality of home taken photos can be poor.
Commercial photos like Photosymbols are good quality but we are aware that they tend to be used repeatedly, sometimes for quite different meanings
Here is a link to a previous blog which gives some additional information about the development of the Talking Mats symbols.
Academic research evidence on visual images and communication is limited and Helen suggests that that ‘If the academic world wants to explore or challenge anything [in these pages] then at least the conversation has begun’. We would welcome any further information, references or comments.
The inability to make a decision could be because of a learning disability, mental health problems, brain injury, dementia, alcohol or drug misuse, side effects of medical treatment or any other illness or disability. Click here for further information.
Both the Mental Capacity Act (2005) in England and Wales and the Adults with Incapacity Scotland Act (2000) identify the following components which determine whether or not someone has capacity to make their own decisions.
There are a number of additional assumptions that are central to determining whether or not someone has the capacity to make their own decisions:
• Every adult has the right to make decisions unless proved otherwise
• Everyone should be supported to make their own decisions
• People should be given the support they need
• People are entitled to make their decision – good or bad
• Each individual has a different capacity to make decisions about different aspects of their life.
We have been running seminars on how Talking Mats can be used to support a person’s capacity to make decisions.The diagram below illustrates some of the comments we received form participants at a recent seminar about the benefits of using Talking Mats to support decision making.
Click on the diagram to enlarge.
The process of completing a Talking Mat helps people retain their view and if they have memory problems the picture of the mat is a good prompt to enable recall.
Its worth noting that our brain processes visual images 60,000 faster than text!
Thanks to Helen Beltran for this thought provoking blog.
I am an Accredited Talking Mats Trainer and have just finished a great week of training in my local area, Inverclyde, Scotland. This was the first time I had given out symbol sets to everyone who completed the training. What difference did it make?
Everyone was able to see the symbol sets during the training and was really positive about the images and the design. I was concerned at the time that this would stop them really engaging with the process and individualising their mat. I was so pleased when they came back with videos that showed that they had selected the most appropriate options for their communication partner, they had removed those that were too abstract, they had thought about using photos, they had added symbols they had produced themselves. They had made the resources their own!
We talked about this as a group and all the participants felt that the symbol sets were going to allow them to get going with Talking Mats. They would then develop their bank of symbols, by making their own and buying further packs. Some participants told us that they felt having the symbol sets was allowing them to bring supportive colleagues on board who had not yet done the training and was combatting the negative attitudes of the vocal few who had the ‘not more work for us to do’ attitude!
They left with their symbol sets – full of ideas, not just about Talking Mats but about offering choice, hearing the individual’s voice, reducing vulnerability, relationship building and empowerment.
It has often struck me that some people are very much at home making picture resources and making their communication more visual, while others find it a real challenge. Is it reasonable for us to expect everyone to produce their own resources from scratch? Is the barrier to the use of visual communication the making of the resources, rather than the motivation to use them? On the other hand, is the making of the resources the only way to make sure that the supports meet the individual’s needs? What about the costs involved in buying in? Do those who are embracing visual communication need help with resources in order to spread good practice?
We are delighted with the response to our new Talking Mats symbols. They created a real buzz at the ISAAC (International Society of Augmentative and Alternative Communication) Conference in Lisbon last week.” Its so good to see something fresh and engaging” , “These are awesome”
Over the past few years we have been looking at symbols in a new way and have used our specialist skills from clinical practice, research and language structure to underpin their development. These skills, in partnership with a leading comic artist, www.adammurphy.com , have enabled us to design our symbols, making sure that they are:
Attractive and fun
Simple but represent concepts clearly
Distinguish between concrete and abstract concepts
Show full body, not stick figures
Acceptable in terms of age and ethnicity
Balanced between male and female
Provide additional visual clues within topics to support understanding
Talking Mats does not require people to select and ‘name’ symbols – the important feature is that the symbols act as a support to hang meaning on. In this way people can understand and use the symbols to express their views .
To determine the size and colour of the symbols, we have used a pragmatic approach as follows:
A search of the literature showed that very little empirical research has been written about optimal symbol size and colour for different client groups. However several leading graphic and cartoon designers use yellow as this is easily recognisable, attractive and ethnically neutral e.g. Simpsons, Lego
Our artist advised us that cool colours such as blue recede into the background visually whereas warm colours such as yellow stand out more
We believe it is important to include text as this provides additional input for many people e.g. many people with dementia can read.
From discussion with colleagues and reading learning disability literature we decided that Arial, san serif point 14 would be the clearest font
We experimented with various sizes, using very large symbols on one dementia project. However we found that very large symbols are too distracting and limit the number of symbols that can be used on a mat. Following piloting with older people in care homes we determined that the optimal size for using with Talking Mats is 5.5 square cm.
We ran focus group discussions with speech and language therapists, people with learning disability, people with aphasia and people with dementia. The focus groups presented participants with symbols of different styles, size and colours. The resulting responses plus our literature search led us to the current symbols in terms of design, size and colour.
We then piloted the symbols in several settings including a day centre with adults with complex physical and cognitive disabilities, a care home with people with dementia and a secondary school with children with additional support needs. In all of these setting almost all participants were able to see, recognise and use the symbols appropriately.
We made a conscious decision not use photos because photos often have too much detail on the one hand or conversely can be too specific… but that’s a topic for another blog!
We are constantly extending the range of symbols and are currently working on a resource for helping people to consider their Eating and Drinking. We are also working on providing additional visual clues within topics to help people understand concept more easily e.g. emotions are represented within a cloud border. e.g this poor guy is feeling guilty
We are really excited that our new symbols are now being used by 2 organisations outside the field of disability to help students and graduates reflect on their skills,strengths and weaknesses.