The Speaking Valve Part 1: A bridge to recovery
By George Barnes MS CCC-SLP
Part 1: A Bridge to Communication
I have a 2-year-old son named Julian. Toddler’s get a bad rap. And it’s not fair. Imagine being trapped inside a wonderful mind with all sorts of creative thoughts and urges for expression that are boiling with potential just aching to come out. And you just don’t have the words to express them. Torture right? It’s no wonder they are constantly throwing hurricane-strength tantrums.
Now let’s think about an adult who has suffered a traumatic injury requiring tracheostomy. This person, let’s call her Barbara, has had the ability to communicate without issue for 63 years. Now, she can’t even make a sound. Barbara is frightened. She is anxious. And every time somebody comes into the room to examine her, change her, or move her around, she has about 25 questions, comments, and grievances she’d like to express in full force. But she can’t. Because Barbara has become mute. You guessed it- here is where the speaking valve (SV) comes in.
What is a speaking valve?
The SV is a small piece of plastic that fits over the trach opening. The valve allows air to come in through the trach during inhalation (as it normally would), but upon exhalation, it diverts the air away from the trach opening and up through the upper airway where it flows through the vocal folds, pharyngeal space, nose, and mouth. Ah, a breath of fresh air. After tracheostomy, some people haven’t had steady airflow into their upper airway for weeks, if not months. With this newly diverted airflow comes the ability for Barbara to talk again. To tell her husband that she loves him. To tell the nursing staff where and when she is having pain. To ask her doctor when she’ll be going home.
Why it matters:
It’s hard to completely put ourselves into Barbara’s shoes because, honestly, it’s hard to imagine not being able to communicate. John Stuart Mill said, “Language is the light of the mind.” How bright is that light? About 20,000 words a day worth of brightness on average (Brizendine, 2007). The words we use are a reflection of who we are, what we stand for, and are the most useful tool we have to express our thoughts, emotions, and to build relationships. It’s easy to argue that without our words, we lose ourselves. In that context, SLPs have the opportunity to use the SV to bring a person back to the world.
Next week, I’ll discuss the impact of upper airflow and how I do my initial assessment of the SV.
Reference: Brizendine, L. (2007). The Female Brain (Illustrated ed.). Harmony.
