Children with a tracheostomy: Global speech-language therapists' practice.

Area of Science:

• Speech-language pathology
• Pediatric medicine
• Respiratory care

Background:

• Speech-language therapists (SLTs) are integral to pediatric tracheostomy multidisciplinary teams (MDTs).
• Inconsistent tracheostomy care causes frustration and delays interventions.
• International SLT practices in pediatric tracheostomy are not well-documented.

Purpose of the Study:

• To explore global training, clinical practices, and roles of SLTs working with pediatric tracheostomy patients.
• To identify perceived knowledge, skills, and barriers faced by SLTs in tracheostomy care.
• To understand international variations in SLT involvement in pediatric tracheostomy.

Main Methods:

• A global survey was conducted among 92 SLTs across 6 continents and 19 countries.
• Survey included Likert scale and open-ended questions on training, practice, and roles.
• Data gathered on SLT confidence, perceived MDT understanding, and practice barriers.

Main Results:

• SLTs expressed high confidence in communication and feeding but lower confidence in tracheostomy care skills (e.g., suctioning, cuff deflation) and specialized equipment.
• Formal competency training was infrequent, though supervision was generally available.
• Barriers included staffing shortages, lack of guidelines, and limited access to resources like speaking valves and FEES.

Conclusions:

• SLTs possess experience and confidence in managing pediatric tracheostomy patients.
• Significant international variation exists in the SLT role and access to education.
• A need for formal policies and standardized training to guide practice is evident.