Do Tongue Ties Cause Speech Delay? What Parents Need to Know
Alexis Irazoque, M.S., CCC-SLP
At Expressable, we often hear from parents asking, “Do tongue ties cause speech delay?” It’s a common concern, and there’s a lot of conflicting information out there. Some believe that a tongue tie (also called ankyloglossia) directly leads to speech delays or disorders, but what does the research actually say?
If you’re wondering whether a tongue tie could be affecting your child’s speech, or what steps to take next, you’re not alone. In this article, we’ll explore what the evidence shows, when treatment might be needed, and how speech therapy can help. Let’s dive in.
Do tongue-ties cause speech delay?
The short answer is no, tongue ties do not typically cause speech delays. Research has not found strong evidence that a tongue tie affects a child’s ability to produce speech sounds or be understood by others. Even sounds that require the tongue to lift, like /l/ and /r/, or extend forward, like /th/, can usually be made without difficulty, even when the tongue tip is restricted.
While some studies have suggested a possible link between tongue ties and speech difficulties, these studies are limited and inconclusive. There is also no clear evidence that tongue-tie surgery improves speech. Because every child is different, experts recommend consulting a speech-language pathologist before considering surgery like a frenotomy or frenuloplasty. In many cases, speech therapy alone is enough to support clear speech development.
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Screener for childrenWhat is a tongue-tie?
A tongue-tie occurs when the lingual frenulum (the small band of tissue under the tongue) is too short or tight, limiting tongue movement. This condition, also known as ankyloglossia, can sometimes affect feeding, speech, or oral function.
How common is tongue-tie?
Tongue-tie occurs in 2% to 10% of babies. In 2020, a panel of expert pediatric otolaryngologists from the American Academy of Otolaryngology said that more children were diagnosed with tongue-tie over the last decade than ever before. This is due to various reasons, such as:
Increased focus on the benefits of breastfeeding
More social media posts and websites related to tongue-tie
An increase in the number of medical professionals, specifically dentists, who treat tongue-tie
What causes a baby’s tongue-tie?
Tongue-tie is three times more common in males than females. It’s been noted to run in families and to be associated with certain genetic disorders. However, the exact cause of most tongue-ties is unknown.
Signs of a tongue-tie in children?
Here are some common signs and symptoms you might see in a person with a tongue-tie:
Difficulty lifting the tongue to the upper teeth
Trouble moving the tongue side to side
Difficulty sticking the tongue out past the lower front teeth
A tongue that looks notched or heart-shaped when your child sticks it out
Difficulty chewing age-appropriate solid foods
Gagging or choking on foods
Pocketing or holding food in the cheeks
Can a tongue-tie cause other problems?
Tongue-ties can contribute to many problems, including breastfeeding difficulties in newborn babies, speech articulation problems, and poor oral hygiene.
Let’s discuss some real-life examples of these potential concerns:
Breastfeeding problems: A tongue-tie may cause a baby to chew rather than suck, leading to poor nutrition and failure to thrive.
Speech difficulties: It's possible for a tongue-tie to interfere with a child’s ability to make certain sounds, although this isn’t always the case.
Oral hygiene: A tongue-tie can make it hard for a child to clear food from their teeth, which can contribute to tooth decay and gingivitis.
Social concerns: Sometimes a person may feel embarrassed about their difficulty with certain everyday tasks, such as licking an ice cream cone.
How is a tongue-tie treated?
According to the Mayo Clinic, a lingual frenulum can loosen over time, which can resolve the tongue-tie problem altogether. In other cases, a tongue-tie can persist without causing any problems.
However, if a tongue-tie is causing concern, there are a few treatment options. For example, working with a lactation consultant can help a baby breastfeed more easily. And a child with speech sound concerns would benefit from speech therapy.
There are also surgical treatment options for infants, children, and adults. The two types of tongue-tie surgeries are frenotomy and frenuloplasty.
Frenotomy
A frenotomy can be done in the hospital nursery (for infants) or in the doctor’s office (for children and adults) with or without anesthesia. In a frenotomy, the doctor uses sterile scissors to snip the lingual frenulum. It’s usually described as quick, with minimal discomfort. A newborn baby can actually breastfeed immediately following a frenotomy!
Frenuloplasty
A frenuloplasty is typically recommended if the tongue-tie requires additional treatment or if the frenulum is too thick to be snipped in a frenotomy. Doctors use general anesthesia and surgical tools for a frenuloplasty, and dissolvable stitches are needed. Tongue exercises may also be recommended to improve tongue movement and reduce the risk of scarring.
Complications from these surgeries are rare, but they may include bleeding, infection, damage to the tongue, or scarring.
With all of this information, it is important to know this: Tongue-tie revision, or surgery, is not recommended for the purpose of preventing any speech problems.
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Free consultationCan speech therapy help a child with a tongue-tie?
If a child with a tongue-tie does have speech problems, a speech therapist can try to help the child improve their speech sounds before any tongue-tie surgery is recommended. First, the speech therapist will complete a thorough evaluation to determine if there are other reasons for your child’s speech issue.
Speech therapy will likely be recommended to see if treatment helps the child. The speech therapist will assess whether your child can make certain sounds after they’re given instruction, or if they are physically unable to do it because of a tongue-tie. If this is the case, your speech therapist may recommend following up with your pediatrician to discuss tongue-tie surgery.
It’s important to know that speech therapy may still be needed after surgery to continue learning to make the sounds that were affected by a tongue-tie.
What parents and caregivers need to know about tongue-ties
If you suspect your child has a tongue-tie that is affecting their feeding, speech, or oral function, talk with your pediatrician. They can assess your child and provide guidance. The American Academy of Otolaryngology also recommends consulting a speech therapist before considering any surgical procedure.
As we’ve discussed, research does not support tongue-tie surgery as a necessary step to prevent speech problems. Instead, it’s important to look at the bigger picture – how the tongue-tie is affecting your child’s daily life. A speech therapist can help determine whether therapy, surgery, or a combination of approaches is best for your child.
Do you have questions about tongue ties and speech? Our experienced speech therapists are here to help. Schedule a free consultation with one of our specialists to get expert guidance and support for your child’s communication development.
