Speaking valves are devices used to assist infants and children with tracheostomies maintain optimal respiration while redirecting airflow for production of voice. In infants, this promotes the development of early speech and language milestones. In verbal children, this restores their ability to speak at a louder volume with increased intelligibility. The benefits of using speaking valves with tracheostomy or ventilator-dependent patients include enhanced communication, improved clinical outcomes and increased quality of life and safety for patients. Speaking valve use has been shown to promote improved respiratory status, increase speech intelligibility, reduce ventilator dependence, improve swallow function, reduce risk of infection and reduce tracheostomy-dependence. The use of a speaking valve can also facilitate optimal development in tracheostomy dependent children who are already at increased risk for speech and language delays. In addition, speaking valves can add to a patient and family's quality of life and quality of care. By increasing patients' ability to effectively communicate with family members and their medical team, speaking valves are enhancing patients' ability to be active in their care. This can reduce the anxiety, fear and frustration commonly reported by individuals who lack a means of communicating. This session will describe the benefits of using a speaking valve with tracheostomy-dependent patients, candidacy criteria and assessment procedures and the role of the speech-language pathologist in speaking valve trials and usage.