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In this paper, we document the effect of long-term tracheostomies on early communication development. Two strategies are used. Firstly, information is culled from the research literature on infant tracheostomies. It is noted that language acquisition appears remarkably resilient but that little is known yet about preverbal communication of aphonic infants or about their later use of speech during everyday activities. Secondly, general themes from normative studies of early communication development are abstracted and used to organize a case report that illustrates the communication development of an aphonic, neurologically intact infant. It is proposed that it is important to support the flow of communication between caregivers and infants using a variety of temporary means, including the introduction of augmentative conventional expressive systems, until verbal language is possible.

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