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Let your mats

do thetalking

training

SPEECH & LANGUAGE THERAPY IN PRACTICE SPRING 200218

eing able to communicate views and feelings is central to

being able to access all forms of health and social care yet,

so often, the professionals involved do not have the tools

or resources to directly support and communicate withclients with communication impairment. Talking Mats

(Murphy, 1998; Murphy, 2000; Cameron & Murphy, 2001) is a visual

framework that uses picture symbols to help people with communica-

tion difficulties. It has potential for a wide range of people and is an

approach that helps them to think about topics in a different way, while

also providing them with a means of expressing their views more easily.

Talking Mats as a tool is only as successful as the practitioner who

uses it. A number of people in Forth Valley had expressed interest in

learning more, so we sent a flier to them and developed multidisci-

plinary training courses, two of which are described here. Figure 1

illustrates the wide range of professionals who participated in these

two courses. They worked with a range of clients, including children,

young people, adults and the frail elderly, in a variety of settings. The

difficulties their clients presented with included learning disability,

stroke, degenerative neurological illness, challenging behaviour, head

injury, mental illness, dementia and language disorder. As places were

limited to seven people per course, it was emphasised that participants

had to commit to both mornings and to be willing to undertake to video

their use of Talking Mats. Thirteen of the fourteen who attended com-

pleted their Talking Mat and evaluation form. One participant had diffi-

culties getting permission to interview a client using the video.

The course was designed to ensure that the participants could apply

the information learned directly to their workplace as, if new skills are

to be transferred to the workplace, trainees must feel that the course

is relevant to their job (Axtell et al, 1997).

Each course involved two mornings with a month’s interval in between.

Each participant was given a pack of materials which included:

• plan of each session

• action sheet

B

 s e e 

  w  w  w.

 s  p e e c  h

  m a g.

 c o  m

  i  n s  i d e

   f  r o  n  t

 c o  v e  r

When investigating peer interaction of adult AAC users ina residential setting, the research team needed a toolwhich would allow the users to express their views on thefindings, which included residents ignoring each otherand talking to staff rather than other residents.Boardmaker™ pictures with Velcro™ on the back placed ontextured doormats allowed the users to build up andamend a picture of their own views and feelings. TalkingMats have now been used with a variety of people of allages who need support in addressing complex issues.

Catchup

Figure 1 - course participants by occupation

Group A Group B

nursery nurse service development officer

occupational therapist nurse

teacher dietitian

speech and language therapist occupational therapist

social worker occupational therapist

day centre officer social care worker

advocacy worker day centre officer

Figure 2 - Evaluation Grid: feedback from course participants

What did you think about ....

The background to the mats 6 7

The number of people in the group 12 1

The venue 4 6 2 1

Course organisation 7 6

The timing of the sessions 6 4 2 1

The length between sessions 7 5 1

Doing your own mat 9 3 1

Creating your participant’s mat 7 3 3Course leaders’ presentation 12 1

Handouts 10 1 2

Videoing your participant’s mat 2 5 3 1 2

Sharing your video with others 3 4 3 3

Therapy tools are only as successful as thepractitioner who uses them so, when you have

a good tool, you want to ensure people are

making the most of its potential. Joan Murphy and

Lois Cameron have developed a winning format

for multidisciplinary training in the use of

‘Talking Mats’. Here, they tell us how.

if you• offer training

• doubt the value of video• want to enable people to

express their views

Read this

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training

• issues to consider

• practicalities to consider

• templates of picture symbols

• what to do after session 1

• video observation framework

• evaluation form.

The first session provided background and ademonstration and video of the mats being used.

Following this, the participants used the Talking

Mats with each other and then worked in small

groups to develop the materials needed to create

a mat to use in their own work setting.

Successful useWe covered a number of issues which are central

to the successful use of Talking Mats including

consistency and complexity of language, the use

of open questions, acquiescence, timing, access,

areas to sub-mat, obtaining consent and reflecting

on your own communication style. The participants

were expected to video their use of the Talking

Mats with a client between the two sessions.

own mat in their own work environment provided

them with a steep learning curve that they all

found helpful.

• Many participants did not initially like the thought

of using the video. Comments included:

‘uncomfortable but vital’ ; ‘it was good once it 

was over’ ; ‘it is not something I particularly liked 

doing but it is a very valuable tool and I appreciated 

being able to view the other videos’ . Despite this

expressed dislike, it was clear that the use of the

video was a crucial part of the learning process.

• In response to the question, ‘What aspect of the

course was most useful?’ eleven of the thirteen

cited making their own video and the group

discussion that arose from watching them.• The feedback on the amount of time available

during the sessions varied between the two

groups. One group felt that session 1 had been

too rushed while the other commented that

there was not enough time in session 2.

• One person commented, ‘That doing the mats

together was the most effective warm up exercise

I had experienced, you really got to know the

other course participants quickly’.

Course participants then told us how they used

the Talking Mats with specific clients/ patients.

This included

• to make choices

‘It helped my client think about the possible

options available - it opened her mind out’; ‘I used

it with a child who tended to follow other chil-

dren’s lead. You got to know what he was thinking

and the mats helped him make his own decisions.’

• keeping on topic‘It helped a young man with Asperger syndrome to

 stay in reality and stopped him going off at tangents.’ 

• communication‘It took the pressure off verbal interaction

through the focus on the mat.’ 

• advocacy‘It increased equality between the two partners as

it’s predominately a visual language system which

makes the more verbal partner throw away the

 security and reliance on their verbal skills.’ 

They were all given the opportunity to meet with

either of us individually between the sessions and

some made use of this; for example, one wanted

to discuss how to adapt the ‘starter topic’ as her

main topic was related to food.

The second session provided the participants with

the opportunity to use their videos and photographs

of the completed mats as a focus for discussion,

reflection and consideration of future implications.

Some of the issues raised were mat preparation,

obtaining permission, the training topic, client’s

reaction, participant’s reaction, language level

and use, quality of information and outcomes.

The final part was an open discussion of the par-

ticipants’ views about the course. All made specific

comments about how useful it had been, how

much they had enjoyed it, and how they would use

the Talking Mats in their own workplaces. Figure 2

shows the responses to the evaluation form but

some of the answers were particularly helpful to us

in planning future workshops. For example:

• The insistence that course participants do their

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training

• language input‘It makes you think about the level of the language

 you need and the type of language you use.’ 

• consultation‘The mats supported education’s policy of consul-

tation with pupils.’ 

• confirmation‘It confirms what the client is thinking.’ 

The range of applications for the Talking Matsdescribed by the participants was wide, as shown

in figure 3 which links specific quotes from the

different professions attending the course with

their views about the potential uses.

Time for reflectionWe were successful in training a multidisciplinary and

diverse group of staff to use Talking Mats. Key to this

was the focus on the development of a practical tool

that was useful in the participants’ own workplace

and which gave time for reflection and development

of course members’ own communication skills. The

participants were ultimately able to use Talking Mats

successfully for a variety of clients in different settings.

This course provided a clear a structure which

built confidence and enabled the participants to

develop skills in the use of Talking Mats. We have

altered the format in response to the feedback so

that, to help us achieve more in the time available,

we no longer spend part of the training session

producing the symbols. We are now providing

more flexible formats depending on the needs of

each training group, tailoring training to specific as

well as multidisciplinary groups and running full

day training courses for people further afield.

For further information about Talking Mats and

our work at the AAC Research Unit, see our web

site: www.aacscotland.com.

 Joan Murphy and Lois Cameron are both Speech and 

Language Therapists with Forth Valley Primary Care

Trust and also work as research speech and language

therapists at the AAC Research Unit, Psychology 

Department, University of Stirling, Stirling FK9 4LA.

ReferencesAxtell, C.M., Maitlis, S. and Yearta, S.K., (1997)

Predicting immediate and long term transfer of

training. Personnel Review 26 (3), 201-213.Cameron, L. & Murphy, J. (2001) Views of young

adults at the time of transition. Communication

Matters Journal 15 (1), 31-32.

Murphy, J. (2000) Enabling people with aphasia to

discuss quality of life. British Journal of Therapy 

and Rehabilitation 7 (11).

Murphy, J. (1998) Talking Mats: Speech and lan-

guage research in practice. Speech and Language

Therapy in Practice, Autumn, 11-14.

ResourcesBoardmaker™ software is available from Don

Johnson Special Needs Ltd, 18 Clarendon Court,

Calver Road, Winwick Quay, Warrington WA2

8QO, tel. 01925 241642.

• Do I ensure what I offer is relevantto the participants’ jobs?

•Do I use warm-up activities that

also showcase what I am

advocating?

•Do I allow opportunities for

participants to reflect and

consult me at a later date?

Reflections on training

Figure 3 - Potential uses of mats identified

Profession The mats’ potential for their workplace

occupational • could use it to look at patient involvement in goal setting and measurement of achievementtherapists • could help you prioritise and review goals that are truly patient centred

• outcome measures• could use to look at pain and pain relief• could use for initial interviews.

nurse • useful for those who can communicate verbally and for those who cannot.

dietitian • useful to explore issues re-compliance with dietary advice and motivation for change.

advocacy worker • I think it has the potential to help both myself and advocates get to know people who have significantcommunication challenge.

speech and language • very useful with my dysphasic patientstherapist • concrete, visual, not reliant on the verbal.

secondary teacher • the mats have an empowering value• could also use them to plan group activities together.

nursery worker • it will enable all children to participate in planning for themselves.

day centre officers • the possibilities of use are endless• will help service users make decisions.

social worker • I can use it in working with young people with learning disability and / or communication difficulties and with young children• key tool for future needs assessment• also for children going into foster care.

service development • will use to evaluate a day services project.officer

social care worker • will benefit new residents so we can learn about them, their abilities• to explain feelings as things change for them.

Win a Talking Mats and Learning Disability package!From the authors of Let your mats do the talking comes a new video and book package on the use of TalkingMats, specifically designed for those working with people with a learning disability. The normal retail priceis £50, but Speech & Language Therapy in Practice has TWO copies to give awayFREE to lucky readers, courtesy of Joan Murphy and Lois Cameron.For people with a learning disability choices can often be limited, and it can be difficultto ensure their voice is heard. This is particularly true for those with a learning dis-ability who also have communication impairment. This new resource incorporatesthe thoughts, ideas and discussions which have evolved from both authors’ clinicaland research experiences since Joan Murphy developed the original Talking Matstraining package. The video demonstrates Talking Mats being used by three differentpeople and the accompanying book provides clear guidelines for using TalkingMats plus sections on implications and uses with examples from real life.To enter simply send your name and address marked ‘Speech & Language Therapy inPractice - Talking Mats and Learning Disability offer’ to AAC Research Unit, Departmentof Psychology, University of Stirling, Stirling, FK9 4LA. The closing date for receipt ofentries is 25th April and winners, drawn randomly, will be notified by 30th April.‘Talking Mats and Learning Disability’ is available for purchase from the aboveaddress, or contact joan.murphy@stir.ac.uk. (See also www.aacscotland.com.)

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