Tongue tie

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"Tongue-Tie" Article written for the "Expert Column" for the Golden Gate Mother's Group

Written by Kim Scott Deland, M.S., CCC-SLP, Speech Pathologist 

Q. My son has a short frenulum (tongue-tied). When he was a baby his pediatrician said if it didn’t interfere with his feeding, then it’s not a big deal. At the time my husband wanted it to be clipped, but I didn’t. Now my son is having speech issues, and my husband thinks we should get it clipped sooner rather than later. Has anyone had any experience/have any input on my situation?

A. When a child has a restrictive or tight frenulum, it can impair the ability of the tongue to move properly, affecting the child’s speech development. As well as having a speech function, the tongue is needed for sucking, chewing, swallowing, eating, drinking, sweeping the mouth for food debris, etc. Tongue-tie can resolve in early childhood if the frenulum “loosens” by itself, allowing the tongue to move freely for eating and speech. However, in some cases, the child may need to have an operation (frenectomy) to release the tongue. In order to develop speech, the tongue needs to make an amazing range of movements: tip-elevation, grooving and protrusion. The tongue should be able to make a range of movements in all directions for the articulation of a number of sounds, particularly l, r, t, d, s, n, th, sh and z. These sounds are likely to be distorted if a child has limited range of lingual movement. If a surgeon and a speech pathologist agree that surgical intervention is required, the surgical procedure to correct this condition is very simple. If the child is cooperative, it could even be done under local anesthesia. Therefore, mothers need not be overly concerned if this condition is the sole cause for the child’s speech problem. In my experience, I have seen many children who have undergone several years of speech therapy with little or no improvement until the tongue-tie is corrected. I almost always recommend surgery to avoid this situation. Speech therapy can be expensive and frustrating for a child if there is little or no progress. I recommend children get the surgery as early as possible because delaying surgery may result in the child needing more intensive speech therapy after surgery to correct any altered speech patterns. If surgery is done before speech develops, it is more likely that speech therapy will not be necessary. 

■ Kim Scott DeLand, M.S., CCC-SLP, Speech and Language Pathologist, is the owner of Speech Therapy 101. She can be reached at [email protected]

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