The influence of long-term tracheostomy on speech and language development in children.

BACKGROUND: Individuals diagnosed as having primary neurological disorders have a high incidence of abnormal speech and language development. However, results in cohorts where this group are excluded are controversial. With no coexisting neurological impairment, some suggested that tracheostomy has little influence on speech development, whilst others showed a clear pattern of language disability. The aim of this study is to evaluate the influence of tracheostomy on speech and language development.

METHOD: Retrospective study using standardised outcome measures.

RESULTS: A series of 39 paediatric tracheostomies was studied. In the group where children had neurological disorders, 94% showed no language or delayed language development. In contrast, of the group of children without a neurological impairment, 60.9% had normal speech and language development. The median age at the decannulation in those children with delayed speech was 23 months, whilst in those children with normal speech it was 14.5 months.

CONCLUSION: Tracheostomy affects speech and language development in those with and without neurological disorders. Crucial factors affecting speech and language development within the neurologically normal group are age at the tracheostomy, and the duration of the tracheostomy until decannulation. Achieving earliest decannulation improves the chance of a normal speech and language development.