At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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The object of the present paper is to define by histological methods the exact limitations of the visuo-sensory area of the human cortex cerebri. The investigation to be described has occupied upwards of three years. It was commenced during the summer of 1896 in the pathological laboratory of the County Asylum, Rainhill, Lancashire; it was continued during the next three years in the physiological laboratory of Mason University College, Birmingham; and it has been completed in the pathological laboratory of the London County Council at Claybury. Owing to the remarkable facilities for research granted to workers in the last-named laboratory, it has been possible to bring this investigation to a much more rapid conclusion than would otherwise have been possible. A general summary of the paper follows this introduction, and it is succeeded for convenience of reference by a list of the sections into which the paper is divided.

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