What You Need to Know About Tongue Tie and Speech Development
Tongue tie, or ankyloglossia, is a common congenital abnormality that is detected after birth. Tongue tie is when the frenulum (the band of tissue that connects the bottom of the tongue to the floor of the mouth) is too tight and short, restricting tongue movement. In general, an individual with tongue tie can not protrude their tongue beyond the edge of the lower gums or teeth. When they attempt to stick their tongue out the tip becomes notched in the middle, resulting in a heart shaped edge. Additionally, a person with a tongue tie is not able to touch the roof of their mouth with their tongue.
Tongue tie may affect a baby's ability to efficiently breastfeed, depending on the severity of the issue. A baby with a tongue tie should be evaluated by an ENT if he or she is having difficulty latching while nursing.
The severity and effects of a tongue tie tend to change as a child's mouth grows. According to Ann Kumar, Speech Language Pathologist, during the first 4 to 5 years of life, the oral cavity changes significantly in shape and size. As a child's mouth grows, the frenulum recedes, stretches, and may even break, allowing for more tongue mobility.
While it may impact breastfeeding, there is no evidence that tongue tie affects speech development. In fact, several authors have published articles refuting the idea that ankyloglossia affects speech. Despite all this research, many professionals, including Speech Language Pathologists, ENTs, and pediatricians still believe that tongue tie is likely to cause speech impairments. In reality, tongue restriction does not impact one's ability to formulate speech sounds that require tongue tip elevation such as “t”, “d”, and “n”. These sounds can be produced with very little tongue tip elevation or movement. Even the “s” and “z” sounds can be made the tongue tip down with very little, if any, sound distortion. The “l” sound requires more tongue tip elevation; however, it can also be made with the tongue tip down and the mid portion of the tongue against the roof of the mouth (alveolar ridge). The “th” sound requires the most tongue tip elevation, which can also be produced with the tongue tip pressed down or against the bottom teeth.
When a Speech Language Pathologist evaluates a child who has a tongue tie, he or she will pay particular attention to those sounds that require maximum tongue mobility. Tongue tie may be a contributing factor to speech impairments, if the child is unable to make the sounds with the mentioned alternative tongue positions. If a child has oral motor difficulties, tongue tie may be a contributing factor. It is possible for a child to have a tongue tie and speech impairment, yet it does not mean the tongue tie causes speech sound impairments.