The Passy-Muir Speaking Valve is available for adults and children with tracheostomy tubes in place, intact vocal folds and an unobstructed airway. This allows the individual to inhale through their tracheostomy tube and exhale through their larynx, setting the vocal folds into vibration, and creating voice. The Speech- Language Pathologist will evaluate if the individual can tolerate and benefit from speaking valve use. The individual and/or family will be trained in valve use and care if voicing can be obtained and respiratory status remains stable during evaluation.