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Tracheotomy Resources

Speech / Communication Skills

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Normal Speech and Language Development | Effects of a Tracheotomy on Communication | Elements of Communication l What If My Child Can't Talk?

Normal Speech and Language Development

Your child's tracheotomy tube could have an impact on his / her speech and language development. Here are some indicators for normal speech and language development.

Newborn – 12 months: The child is listening to you and understanding the words you say. He or she is practicing speaking by cooing and babbling.

12 months: The child may have even said a word or a few words.

12-18 months: The child is increasing the number of words he/she can say. He or she may have two word utterances such as "more juice."

18 months-2 years: The child is more verbal and speaks with three to five word sentences.

3 years-4 years: The child is perfecting his or her language. He or she should be able to be understood by a stranger and be able to tell a story that happened to him or her in the recent past.

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Effects of a Tracheotomy on Communication

Having a tracheotomy may have an impact on your child's ability to talk. Some of those reasons might be:

  1. If the laryngotracheal space is very small or scarred, your child will not be able to pass enough air up through the vocal cords to make sounds.
  2. If the vocal cords are scarred, the sound from the cords may be hoarse or raspy. If one or both of the vocal cords cannot move, your child's sounds will vary based on the position of the vocal cords.
  3. Often, the need for a tracheotomy is seen in children with other problems. If your child was born early, he or she may have problems with language. If your child has a history of head trauma, or injury to the spine, there may be a neurologically based reason for your child's difficulty with communication.
  4. The size of the tracheotomy tube needed to keep your child's airway safe may decrease the amount of air that can pass up through the vocal cords to make speech.

It is important to remember that the removal of your child's tracheotomy tube may not be the answer for your child's problem with talking.

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Elements of Communication

Your child may be tested by a qualified speech therapist in these areas of communication:

  1. Receptive Language: This is the understanding of the spoken, written or signed word.
  2. Expressive Language: This is the telling of thoughts through speech, writing, or signing. It is the thinking process of putting words together and knowing words.
  3. Speech or articulation: This is the sound used to make language.
  4. Voice: This is the quality of the sound made by the vocal cords
  5. Fluency: This is the rhythm of speech, how it flows.

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But What If My Child Can't Talk?

Having mild to severe problems with talking does not mean being unable to communicate. Giving your child a solid language base is very important. There are many options that can help your child to communicate:

  1. Sign Language: Sign language is not only for children who cannot hear. If your child does not have the voice to communicate his / her needs well, then he / she can sign his / her needs and thoughts.
  2. Artificial Larynx: This device is usually for older children who has some experience with verbal communication. The device helps the sound made by the child get up into the mouth as the child mouths out the words.
  3. Augmentative Communication Device: This device is more like a computer. The child selects the word on the board, and the computerized voice says the word selected by the child.
  4. Picture Communication Board: This can be made for the child with different pictures or personal objects. By pointing to the object, he / she communicates his / her needs or thoughts. The child can help in the making of his / her personal picture board.
  5. Speaking Valve: This is a valve that is placed on the tracheotomy tube. It allows the child to inhale through the valve and upon exhaling, the valve closes allowing air to pass through the vocal cords. IT IS NOT FOR ALL CHILDREN WITH TRACHEOTOMIES, and does not work well for children who continue to have stenosis above the tracheotomy. It is only used with your ENT doctor's permission after a recent Micro L&B, and after the child has been monitored by the nurse to be sure he / she can tolerate wearing the valve.

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Rev. 7/07