Tracheostomy care is a highly specialised clinical area, but when it comes to infants and children, the complexities multiply. Pediatric care requires a completely unique approach that accounts for anatomical differences, developmental milestones, and family dynamics.
In this episode, Louise Edwards, Clinical Specialist Speech and Language Therapist and PhD candidate, joins us to explore the realities of pediatric tracheostomy care from an SLT perspective. Together, we examine the core clinical priorities, unpack the key differences between pediatric and adult management, and discuss the often-overlooked challenges of transitioning young people with complex needs from pediatric to adult services.
Pediatric vs. Adult Care: Understanding the critical physiological, anatomical, and developmental differences clinicians must recognize.SLT Clinical Priorities: Establishing communication, developmental feeding, and swallowing safety in infants and children with a tracheostomy.The “Trach” vs. The Underlying Condition: Teasing apart how much swallowing and feeding difficulties are caused by the tracheostomy tube itself versus the child’s broader medical and developmental profile.Transitions to Adulthood: Practical considerations for the multidisciplinary team to ensure young people and their families don’t feel lost when moving into adult services.The Future of Care: A forward-looking discussion on hoped-for advancements in family support and clinical care over the next five years.Global Tracheostomy Collaborative: not SLT specific, but they have a great website and provide research and webinars focused on supporting people living with a tracheostomy and their families across the age, as well as healthcare professionals.Royal College of Speech & Language Therapists Tracheostomy Clinical Excellence Network: UK based network of SLTs (and other HCPs) looking at tracheostomy across the age range. Often run virtual study days/webinars.National Tracheostomy Safety Project (NTSP): paediatric guidance and trainingMiles et al. (2025). Children with a tracheostomy: Global speech-language therapists’ practice.Streppel et al. (2019). Swallowing problems in children with a tracheostomy tube.Pullens & Streppel. (2021). Swallowing problems in children with a tracheostomy.Gupta et al. (2026). Impact of Tracheostomy on Dysphagia in Children.Lee et al. (2025). Incidence of Pediatric to Adult Transition Among Tracheotomy Patients.Ongkasuwan et al. (2014). The effect of a speaking valve on laryngeal aspiration and penetration in children with tracheotomies.Brooks et al. (2020). Passy muir valve tolerance in medically complex infants and children: Are there predictors for success?