Does tongue-tie affect speech?
If you've been wondering about the relationship between tongue-ties and speech delay, you've come to the right place. As a speech therapist, I'm here to help you understand the potential impact of tongue-tie on speech development and what you can do to help your child if you suspect a speech delay.
Before getting started, I have a very important reminder!
Speech errors are common among toddlers and preschoolers. Research has revealed that many children who are referred for speech concerns associated with tongue-tie actually have age-appropriate speech errors, which may not be directly linked to tongue-tie.
You can learn more about when children learn to pronounce speech sounds and age appropriate toddler speech errors on the blog.
In this post, we'll explore the question, "Do tongue-ties cause speech delay?" We'll also dive into:
What is tongue tie?
Let's start by understanding what a tongue-tie is before we discuss its impact on speech. A tongue-tie, also known as ankyloglossia, occurs when the tissue connecting the underside of the tongue to the floor of the mouth (called the frenulum) is shorter or tighter than usual. This can limit the movement of the tongue.
Did you know?
Interestingly, we also have similar bands of tissue called labial frenulum that connect our upper and lower lips to our gum line. You can feel it by running your tongue along the outside of your teeth! Sometimes these labial frenulum can also be tight and require correction.
What does a tongue-tie look like?
The way tongue-tie looks can vary depending on how severe it is. In some cases, the tissue that connects the tongue to the floor of the mouth (frenulum) may reach all the way to the tip of the tongue, making it harder for babies to move their tongues and causing a heart-shaped or notched appearance when they stick their tongues out. The frenulum may also seem tight or tense, limiting the tongue's ability to move up or from side to side. Sometimes, tongue-tie can make it challenging for babies to lift their tongues to the roof of their mouths or stick them out past their lips.
However, it's important to remember that the way tongue-tie looks alone may not always mean intervention is necessary. To assess how tongue-tie affects function and determine the best course of action, it's crucial to consult with a healthcare professional such as a pediatrician, dentist, or speech therapist.
How common are tongue-ties?
Tongue-ties are quite common and can occur in approximately 4-10% of the population (Salt et al., 2020).
It's important to know that there is often a genetic component to tongue-ties. This means that if you have a child with a tongue-tie, there is a higher chance that their siblings may also have a tongue-tie. It’s also important to remember that not all tongue-ties cause significant issues or require intervention, so a different plan may be recommended for each of your children.
Do tongue-ties always affect speech development?
Now, let's address the main question: Do tongue-ties cause speech delay?
While tongue-ties can contribute to speech difficulties, it's important to understand that they are not always the cause. Some children with tongue-ties experience normal speech development, while others may have difficulties pronouncing some sounds.
Tongue-ties can potentially affect speech by hindering tongue movements necessary for clear articulation of sounds. These difficulties may manifest in a variety of ways, such as difficulty with certain sounds (e.g., "d," "t," or "s") or less clear pronunciation (referred to as speech intelligibility) which makes it harder for other people to understand what a child is saying. However, it's crucial to remember that every child's speech development is unique, and not all speech delays can be attributed to tongue-ties.
Tongue ties do not impact language development
Having a tongue-tie can make it difficult for your child to say certain sounds, but it won't have an impact on their overall language development (read more about the differences between speech and language here). To explain it simply, speech involves what happens in the mouth, and a tongue-tie can affect speech. However, language development takes place in the brain and is not influenced by a tongue-tie.
So, although your child may struggle with certain sounds, it's essential to remember that their ability to comprehend and learn words will not be affected.
Considering a tongue tie release
If you suspect that your child's speech is being impacted by a tongue-tie, it's crucial to seek guidance from medical professionals who specialize in tongue-ties. I would recommend consulting with several professionals from the following list:
Pediatrician
Ear Nose & Throat doctor (ENT)
Dentist
Lactation consultant
Speech-language pathologist
Myofunctional therapist.
As you consider a possible tongue-tie diagnosis and correction plan, it's likely that you will be talking to multiple professionals on this list. It's important to note that they may not all provide the same recommendations. Trust your instincts as a parent and consider how your child's tongue-tie is affecting their daily life. Tongue-ties are often corrected in infancy when babies experience issues such as reflux, gas due to excessive air intake while nursing, difficulty latching, and painful nursing for both you and your baby.
While tongue-tie correction is often associated with addressing speech delays, there are other significant reasons to consider this intervention:
Breastfeeding Challenges: Tongue-ties can make breastfeeding challenging for both the baby and the mother. Correcting the tongue-tie can improve latch, feeding efficiency, and enhance the overall breastfeeding experience.
Dental Health: Tongue-ties may contribute to dental problems such as tooth decay, gum disease, and misalignment of teeth. Correcting the tongue-tie can promote better oral hygiene and help prevent potential long-term dental issues.
Overall Oral Function: Tongue-ties can impact various aspects of oral function, including swallowing, chewing, and oral hygiene. By addressing the tongue-tie, we can support healthy oral development and function throughout childhood and into adulthood.
Does releasing a tongue-tie improve speech?
The impact of tongue-ties and their release on speech has been the subject of ongoing research. Let's take a look at some recent findings:
According to a research study by Melong et al. (2021), the majority of children referred for speech concerns related to ankyloglossia (tongue-tie) had speech errors that were appropriate for their age - meaning their speech errors weren’t likely caused by their tongue-tie.
Similarly, a study by Salt et al. (2020) advises against tongue-tie revisions solely to prevent speech problems. The research has not yet provided conclusive evidence that tongue-tie releases improve speech production and age appropriate speech errors may resolve on their own.
In cases where tongue-tie releases are recommended for speech concerns, it is advisable to consider trying speech therapy before opting for surgery. Providing children with speech therapy may help them learn to pronounce sounds without relying on surgery (Messener et al., 2020).
Additionally, incorporating myofunctional exercises (specific exercises to strengthen the tongue and other facial muscles) after tongue-tie release has shown functional improvements in speech, feeding, and sleep for children (Baxter et al., 2020).
It's important to note that while research is a lengthy process, it's still a good idea to consult with medical professionals who can assess your child's individual situation. Relying on online information or anecdotes from friends may not provide the necessary context.
Remember, each child is unique, and their treatment should be tailored to their specific needs. Consulting with medical professionals and considering their recommendations can help guide you in making informed decisions about your child's tongue-tie and its potential impact on speech.
Let’s talk about what happens during a tongue-tie release
Let's talk briefly about what happens during a tongue-tie release procedure, keeping in mind that I'm not qualified to perform them (but I realize it really helps to understand the process as you may feel anxious or worried for your little one).
Healthcare professionals specializing in oral and maxillofacial surgery, otolaryngology (ENT), or dentistry are the ones who perform the procedure. There are two primary methods: frenotomy and frenuloplasty. Frenotomy is the most common and least invasive method, typically done on infants or young children using sterile scissors or specialized lasers to release the tight frenulum. Frenuloplasty is a more involved procedure performed on older children, adolescents, or adults, involving a small incision to release the frenulum. The actual procedure is brief, but the appointment may take longer. It's essential to consult with a healthcare professional to determine the appropriate method and ensure the safety and well-being of your child.
During the procedure, healthcare professionals may use surgical scissors or lasers, such as diode lasers or CO2 lasers, to release the tight or short frenulum. Surgical scissors provide precise incisions, while lasers offer controlled tissue removal with reduced bleeding. After the procedure, follow-up stretches are often recommended to maintain optimal tongue mobility and prevent reattachment of the frenulum. While follow-up stretches are commonly advised, healthcare professionals may provide variations in recommendations based on the extent of the release and individual circumstances. Consulting with a healthcare professional will provide specific guidance on post-procedure care, including the use of stretches or alternative approaches, ensuring the best outcome for your child.
Speech therapy following tongue-tie release
After correcting a tongue-tie, speech therapy may be recommended to help older children develop optimal speech and clear articulation. Although tongue-tie correction improves tongue mobility, it takes time for the child to readjust and learn proper tongue movements for speech.
A speech therapist will closely work with the child to address any remaining speech challenges or habits developed due to the tongue-tie. Through targeted exercises and techniques, the speech therapist will assist the child in strengthening and coordinating their tongue, lips, and jaw muscles to enhance speech clarity and articulation.
Speech therapy sessions may involve enjoyable activities, games, and repetitive speech exercises to gradually improve pronunciation skills. Regular communication between the speech therapist, child, and parents ensures that therapy goals are aligned and progress is effectively monitored.
With the guidance of a speech therapist, children who have undergone tongue-tie correction can optimize their speech abilities and achieve clearer speech.
Here are some other common questions parents ask about tongue ties:
-
A tongue-tie can make it challenging for your child to pronounce certain sounds, but it won't affect their overall language development. To put it simply, speech involves what happens in the mouth, and a tongue-tie may affect speech. However, language development occurs in the brain and is not affected by a tongue-tie. So, while your child may experience difficulties with specific sounds, it's important to remember that their ability to understand and communicate ideas will not be impacted.
If you have concerns about your child's speech or communication skills, it's always a good idea to consult with a speech therapist who can provide guidance and support. They can help address any speech difficulties related to a tongue-tie and ensure that your child continues to develop their language skills effectively.
-
Releasing a tongue-tie may or may not improve a child's speech. It is important to consult with trained medical professionals and consider speech therapy before considering surgery. Trying speech therapy first can help address challenging sounds before opting for a tongue-tie release.
After a tongue tie release, Myofunctional exercises have shown to be beneficial for children after a tongue-tie release, and speech therapy may be necessary to help them articulate sounds that were difficult for them.
In summary, a tongue-tie release is not always a quick and definitive solution to improve speech, and additional support may be needed to help children learn how to move their tongues and produce new sounds effectively..
-
A tongue-tie should not prevent a child from talking, but it may make their speech harder to understand.
-
Tongue-ties can be treated at any age. For babies who are having difficulty nursing, a tongue-tie release may be performed in infancy. However, it's important to know that toddlers, older children, and even adults can also undergo a tongue-tie release if it is clinically necessary and appropriate. The decision to pursue treatment will depend on the individual's specific circumstances and the guidance of healthcare professionals. If you have concerns about your child's tongue-tie, it's best to consult with a healthcare provider who can assess the situation and recommend the most suitable course of action.
Written By: Stephanie Hatleli, MS CCC-SLP
References:
Baxter, R., Merkel-Walsh, R., Baxter, B. S., Lashley, A., & Rendell, N. R. (2020). Functional improvements of speech, feeding, and sleep after lingual frenectomy tongue-tie release: a prospective cohort study. Clinical pediatrics, 59(9-10), 885-892.
Melong, J., Bezuhly, M., & Hong, P. (2021). The effect of tongue-tie release on speech articulation and intelligibility. Ear, Nose & Throat Journal, 01455613211064045.
Messner, A. H., Walsh, J., Rosenfeld, R. M., Schwartz, S. R., Ishman, S. L., Baldassari, C., ... & Satterfield, L. (2020). Clinical consensus statement: ankyloglossia in children. Otolaryngology–Head and Neck Surgery, 162(5), 597-611.
Salt, H., Claessen, M., Johnston, T., & Smart, S. (2020). Speech production in young children with tongue-tie. International Journal of Pediatric Otorhinolaryngology, 134, 110035.
© 2020-2023. Stephanie Keffer, MS CCC-SLP. All Rights Reserved.
The content offered on ToddlerTalk.com is for informational purposes only. Toddler Talk is not engaged in rendering professional advice, whether medical or otherwise, to individual users or their children or families. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor, speech language pathologist, or other health professional. By accessing the content on ToddlerTalk.com, you acknowledge and agree that you are accepting the responsibility for your child’s health and well-being. In return for providing you with information related to home speech and language practice, you waive any claims that you or your child may have as a result of utilizing the content on ToddlerTalk.com.