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ExtractTwo 8-month-old, Caucasian male infants with long-standing difficulties in decannulation following tracheostomy were subjected to a program designed to facilitate a return to normal breathing. Both infants had previously experienced numerous unsuccessful attempts a t decannulation; they possessed a tolerance for breathing normally for a period of less than five minutes. After a 3-week behaviorial treatment program, their ability to breathe normally rapidly improved when the tracheostomy cannula was occluded. At the end of treatment, the patients progressed from a tolerance of less than 5 minutes to 36 continuous hours of occlusion, and the cannula was successfully removed without complication. The patients have fared well since that time. SpeculationI t is hypothesized that the principles of conditioning and behavioral modification applied in this investigation offer a practical, effective solution to the problem of decannulation following tracheostomy. The unique advantages of the techniques employed include: (1) The patient is better prepared for decannulation by virtue of having the ability to breathe normally before such procedures are attempted, and (2) the longer periods of independent breathing by the patient indicate when decannulation may occur with predictable success.