Lurie Children's has speech-language pathologists on staff who specialize in working with patients who have a tracheostomy tube. Along with staff members in pulmonology, otolaryngology (ENT) and respiratory therapy, they determine whether a speaking valve may be appropriate for your child.
A tracheostomy tube is a medically necessary intervention that can impact a child’s ability to speak or swallow. The use of a speaking valve can assist with the restoration of the flow of air through the vocal cords and upper airway. The benefits of a speaking valve include, but are not limited to, improved voicing, improved taste/smell, improved swallowing and improved secretion management.
A speaking valve may not be appropriate for every child with a tracheostomy tube. Children may not do well with a speaking valve if, for example, they have bilateral vocal cord paralysis in the adducted position, if they are unable to tolerate cuff deflation or if they have complete upper airway obstruction.
During the Evaluation
During the evaluation, a speech-language pathologist and a respiratory therapist will first discuss your child’s medical history and their anatomy. Once a medical history has been taken, the therapists will monitor your child’s vitals. If your child is ventilator dependent, the Passy Muir Valve can be placed in line with the tubing. If your child is trach dependent only, they will use a device called a manometer along with the speaking valve to determine what speaking valve is best for your child. Once a valve has been chosen, your child’s vitals will be monitored while they wear the valve. After the evaluation has been completed, the therapists will review their plan and recommendations with you.
If your child’s tracheostomy was placed at an outside facility or their most recent bronchoscopy was at an outside facility, please bring any documents from these visits for the therapist to review.
Types of Speaking Valves
A Passy-Muir Valve is a speaking valve commonly used with both tracheostomy-only patients as well as patients who require mechanical ventilation. This valve redirects all of the air through the vocal folds. Learn more on the Passy-Muir Valve website.
The TRACOE Phon Assist 1 is a speaking valve for tracheostomy only patients. It is adjustable and may be appropriate for children who have some degree of subglottic stenosis or narrowing in their airway. Learn more on the TRACOE Phon Assist 1 website.
To Schedule a Speaking Valve Evaluation
To schedule an appointment, first obtain an order or referral from your otolaryngologist (ENT) or your pulmonologist. Then call 1.800.543.7362 (1.800 KIDS DOC) to schedule a speaking valve evaluation.