Experience of the school-aged child with tracheostomy

Patel, Mihir R.; Zdanski, Carlton J.; Abode, Kathleen A.; Reilly, Cynthia A.; Malinzak, Elizabeth B.; Stein, Jacob N.; Harris, William T.; Drake, Amelia F.

doi:10.1016/j.ijporl.2009.03.018

« Previous Next »International Journal of Pediatric Otorhinolaryngology
Volume 73, Issue 7 , Pages 975-980, July 2009

Experience of the school-aged child with tracheostomy

Mihir R. Patel
- Department of Otolaryngology – Head & Neck Surgery, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
Carlton J. Zdanski
- Department of Otolaryngology – Head & Neck Surgery, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
Kathleen A. Abode
- Department of Pediatric Pulmonology, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
Cynthia A. Reilly
- Department of Pediatric Pulmonology, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
Elizabeth B. Malinzak
- Duke University Medical Center, Durham, North Carolina, United States
Jacob N. Stein
- Emory University, Atlanta, Georgia
William T. Harris
- Department of Pediatric Pulmonology, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
Amelia F. Drake
- Department of Otolaryngology – Head & Neck Surgery, University of North Carolina Memorial Hospitals, Chapel Hill, NC, United States
- Corresponding author at: Department of Otolaryngology – Head & Neck Surgery, University of North Carolina Memorial Hospitals, 170 Manning Dr., Ground Floor POB, Chapel Hill, NC 27599, United States. Tel.: +1 919 966 3342; fax: +1 919 966 7941.

Received 22 January 2009; received in revised form 14 March 2009; accepted 20 March 2009.

Summary

Background

Little is known about the school experience of children with tracheostomy tubes. These children may represent a population that qualifies for special services in school. Understanding how tracheostomy affects school-aged children may provide information needed to develop programs that provide these children with invaluable experiences.

Objective

To understand what children with tracheostomies experience in school as it relates to tracheostomy care and how their condition affects academic achievement and social adjustment.

Methods

We identified a cohort of 38 eligible school-aged children with indwelling tracheostomy tubes for ongoing upper airway obstruction through the North Carolina Children's Airway Center. A questionnaire was developed to assess support of their medical condition throughout the school day. Twenty-three patients responded to the questionnaire.

Results

School experience for a child with a tracheostomy varied. Approximately half the children attended special needs classes, the other half were in mainstream classrooms. Speech services and Passy-Muir valves were used in 43% and 57% of cases, respectively. Over half the students were excluded from physical activity because of the tracheostomy. Most students missed at least 10 days of school for medical care in an academic year. Fifty percent of the students reported attending schools where school personnel had no training in tracheostomy care. In some cases, a trained nurse accompanied the child to school to help with tracheostomy care. In other cases, the child coped with tracheostomy care alone.

Conclusions

As children with special medical needs are increasingly incorporated into mainstream schools, it is important to understand the potential hurdles they face in managing tracheostomies. In particular, school personnel should have the ability to provide basic care for students with tracheostomies. Student speech and educational outcomes require further investigation and analysis.

Keywords: Tracheostomy, Student, Child, School, Speech, Quality of life