In 1974, children who received tracheostomies early in life
were reported to be “withdrawn in character and of poor academic
and recreational standard.”35 Singer et al6 reported
developmental outcomes at an average of 5 years in a cohort
of 130 infants from 2 hospitals who received tracheostomies
before 13 months of age during 1972-82. Twenty-nine
percent died before follow-up and 45% of survivors were
classified with intellectual disability or neurologic handicap.
In a single-center study of 41 infants with tracheostomies,
83% required tube feedings, 97% had abnormal muscle
tone, 36% had cerebral palsy, and 24% required hearing
aids at a mean age of 27 months.7 Among those evaluated after
12 months of age, only 16% had average skills and 68%
had significant developmental delays. In a questionnairebased
study of functional status in former very preterm infants
with tracheostomies, parents reported deterioration
over time, especially in the areas of responsiveness, activity,