Speech for People With Tracheostomies or Ventilators
People who need help breathing may have a tracheostomy or be on a ventilator. There are ways to speak if you have these problems. Speech-language pathologists, or SLPs, can help.
On this page:
About a Tracheostomy
When you have trouble breathing, you may need surgery to help you. A doctor makes an opening in your windpipe, also known as your trachea. This opening is a tracheostomy. Air goes through a metal or plastic tube placed in the opening instead of your nose or mouth. Your need for a "trach," pronounced trayk, can be short-term or permanent.
Impact on Speech
When you talk, air moves from the lungs through the vocal folds. The air makes the vocal folds vibrate to produce sound that comes out of your mouth. You cannot speak this way when you have a trach. With a trach, air goes through the opening in your neck and not through the vocal folds. So, you cannot make sounds the same way. You might be able to say a few sounds but will soon run out of air.
Young children who need a trach do not get to practice making sounds. This can lead to speech and language delays. However, there are ways that both adults and children can talk with a trach.
Ways to Talk With a Tracheostomy
When you block the trach tube opening with your finger, air will go up to your mouth. You can use this air to speak. Not everyone can use this method. It can be hard for you to get enough air to breathe. You may not have enough strength to speak. Or, you may have a cuff on the inside of the tube. This cuff may not let air go up through the vocal folds.
You may be able put a valve on the outside of your trach tube. The valve lets air into the tube. It then closes so the air goes out your mouth and nose. You can use this air to speak.
Not all valves are the same. It is important to find one that works best for you.
Talking With a Ventilator
Some people need more help breathing. You may have a ventilator attached to the trach tube to control your breathing. You can still talk if air can get through your vocal folds. However, your voice will sound different. The ventilator pushes air out of your body in cycles. In between each cycle, you will not have air to speak. So, your speech may sound choppy or get louder and softer. It may be possible to use a speaking valve with a ventilator.
Speech and Swallowing
An SLP will help with speech, language, and swallowing problems. The SLP will work with your doctor or respiratory therapist to find ways for you to speak. The SLP can help find other ways for you to communicate if you cannot speak. This may include writing, pointing to pictures on a board, or using a computer. These options are
augmentative and alternative communication, or AAC.
The SLP can also help you eat and drink safely. This may include eating different types of food or swallowing in different ways.
A tracheostomy or ventilator can save your life. Being able to communicate with your caregivers and family is important. SLPs can help. To find a speech-language pathologist near you, visit