ABSTRACT
The concerns of otolaryngology are reflected in the frequent difficulties with decannulation following tracheostomies. The concerns of psychology are reflected in the techniques of conditioning and behavioral modification which were used to resolve the decannulation difficulties. Problems in decannulation or tracheostomy addiction are less prevalent today than they once were, primarily because of the decrease in the number of tracheostomies performed, which in turn results from a decrease in the prevalence of diseases which frequently required tracheostomies, for example, polio, diphtheria, etc. However, problems with decannulation have persisted over the years without the discovery of any universal solution. Most of the attempts to solve the problem of tracheostomy addiction have relied upon the passage of time and growth and maturation of the child. The ideas of conditioning of autonomically mediated and involuntary behavior go back to 1903 and the famous case of Pavlov and the conditioned salivating reflex of his dog.
