A speaking valve, commonly called a Passy Muir valve, is a cap that can be put over the trach cannula to allow patients to vocalize more.
Patients often have to practice wearing the Passy Muir valve, and may be more fatigued or have more coughing at first.
The Passy Muir website has a practical and interesting troubleshooting page. Of course, take the company website with a grain of salt, but I did find it helpful overall for understanding the applications and patient perspective better.
Are there contraindications to using a speaking valve?
Yes. Patients with an an inflated cuff, fome cuff trach, history of laryngeal masses, stenosis, total laryngectomy, or thick copious secretions should hold off on a speaking valve.