How will a child with tracheostomy communicate?
Because the tracheostomy diverts the flow of air through the tube rather than the mouth, your child will not have a voice or cry in the same way that they did before surgery. However, they will understand you in the same way that they would without a tracheostomy, and you will finds ways of communicating with each other.
In babies, parents will see the baby's facial expressions to help them know what the baby is feeling. Older children will grab your attention, point, write, use tablets, or communicate with sign language.
It is important to understand that a tracheostomy doesn't affect your child's ability to listen, understand, or learn, and does not affect their intellectual function. If the tracheostomy is removed in the future, your child will very quickly catch up and communicate as though they never had a tracheostomy. And while the tracheostomy is in place, a variety of different tactics can be used to help you and your child communicate.
Many children are actually able to talk even with a tracheostomy. If there is air travelling past the tube into the mouth, your child will be able to vocalise. The size of the tube matters here. A relatively small tube may allow a voice, but might make breathing or secretion management problematic. A larger tube will be great for breath and secretions, but will diminish ability to talk.
Some children use a speaking valve. This is an attachment that fits onto the outside end of the tracheostomy tube. It allows the child to breathe IN via the tracheostomy tube, but the valve diverts air towards the mouth when the child breathes OUT. This allows the child to produce a sound and therefore allows talking. A speaking value itself won't make a child talk though: talking requires signals from the brain and control of lip and tongue movement as well. Therefore, in order to talk, more than just the speaking valve is required. Also, not all children are suitable for a speaking valve; it can be difficult in babies and in children with a blocked airway.
On the other hand, speaking valves add much more than just talking. They allow air to travel through the voice box and the mouth, and can help improve sensation and management of secretions. Therefore, the benefits of a speaking valve are greater than just talking.
In order to use a valve, your child needs to have a comprehensive assessment by a speech and language therapist experienced in tracheostomy and valve care.
Actually, involvement of a speech and language therapist in communication and tracheostomy care is crucial as a whole. They are the experts in communication and will be able to help you find the best ways of communicating with your child.