Since we've begun the vent weaning, Abby is not a big fan of the Passey-Muir (speaking) valve. Our speech-language pathologist checked Abby out and we both agree that she can do it...she is just choosing not to! The pulminologist thinks it might just be that she just doesn't feel like putting that much effort into pushing the air through (air goes in through the trach and out through the mouth using the PMV, which is sometimes hard for people) after she's already off the vent 4 hours a day. Nevertheless (that was for my GBC readers--thanks Joel!), we make her do it! The nurses usually take pity on her and just leave it off, but I try to get it on her for a while each evening so that she can practice pushing the air out of her mouth.
I have to admit that although she's throwing a tantrum, I do love all of the noise she's able to make! Her lungs are getting much stronger, because her cries are definitely louder these days!