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Long-term ventilator-dependent children: a vocal profile analysis
1Department of Speech Therapy, Great Ormond Street Hospital for Children NHS Trust, London, UK.
Purpose:
Ventilator dependent children need to be able to communicate effectively to be able to re-integrate into society. This study was performed to see if the Vocal Profile Analysis can be used to assess the voice quality produced by speaking aids in ventilated children, and therefore help to direct speech therapy input.
Methods:
This study attempted to evaluate vocal function using a perceptual rating scale in four ventilator-dependent children fitted with the Passy-Muir Tracheostomy Speaking Valve. The children were at different stages of speech development and had either intact or abnormal cognitive function. The evaluation was performed independently by three trained speech therapists blinded to the child's underlying diagnosis.
Results:
Although speaking aids enhanced verbal communication skills, most of the subjects still displayed marked abnormalities of speech. There was significantly greater agreement among the trained observers when assessing children who were cognitively intact at the time of the study. The older child with intact cognitive function achieved near normal speech potential with the speaking valve.
Conclusions:
The Vocal Profile Analysis is a useful tool for assessing vocal characteristics in ventilated children with intact cognitive function. Near normal speech can be attained with speaking aids, provided a certain stage of speech development has already been attained.