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Conclusion Low vocabulary size, low inhibitory control, poor speech perception, and the absence of early phonetic differentiation are not necessarily limiting factors in predicting /ɹ/ growth in individual children in the age range we studied.Purpose Upper airway patency is crucial in a patient's ability to tolerate a one-way speaking valve (SV). Traditional assessment of airway patency is mainly subjective. We developed four noninvasive methods to assess patency (leak volume, transtracheal pressure [TTP], end-tidal CO2, and Mallampati s