Tongue-Tie

Tongue-Tie
Mrs. Maya Sanghi, Speech and Language Pathologist

Sometimes children have difficulty in speaking. There could be many possible causes, one of which is a condition called tongue-tie or ankyloglossia. This condition is caused by a physical defect in the tongue.

What is tongue-tie

There is a cord of tissue that extends from the mid-portion of the floor of the mouth to the midline of the inferior surface of the tongue blade. This is known as the lingual frenulum in medical terminology. This tissue is considered important for speech as it is assumed to give mobility to the tongue. Tongue-tie or ankyloglossia refers to a condition where this tissue is short, thereby restricting the mobility of the tongue. 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, n, th, sh, and z. These sounds are likely to be defective in a child with tongue-tie.

Testing for tongue-tie

Parents can do a little test at home to determine whether their child who has difficulty speaking has got tongue-tie. They could either make their child imitate them or stick a sticky chocolate on both the upper lip and lower lip and watch his natural reflex as he tries to lick off the chocolate. If they suspect that their child may have tongue-tie, it would be advisable to consult a specialist in person.

Does tongue-tie necessarily affect speech

The tongue is known to have tremendous compensatory ability. Speech therapists have observed that many children with the medical condition of tongue-tie do not have any speech problems. This is because often tongue-tie does not affect the range of tongue movements significantly and the child learns to compensate either naturally or with the help of a speech pathologist. If a child can protrude his tongue beyond the lower lip and elevate his tongue to touch the upper lip with his mouth half open, the likelihood of the child experiencing a speech difficulty is quite low. The ability to compensate varies from child to child.

Does tongue-tie require surgery

Surgical intervention is considered only if an ENT surgeon along with the speech pathologist indicates that it is necessary after a clinical evaluation. Often, a trial period of speech therapy can be considered before going in for surgery. The surgical procedure to correct this condition is extremely simple. If the child is co-operative, it could even be done under local anaesthesia. Therefore, mothers need not be overly concerned if this condition is the sole cause for the child's speech problem.

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