Posted on December 9th, 2024.  

  

You might have found yourself wondering about your child's speech or eating difficulties, and it's completely understandable to start this journey of exploration. From early feedings that seem unusually challenging to growing concerns about sound articulation, it's natural to seek answers. 

  

Among the many possibilities of what could be causing these challenges lies the often-overlooked yet vastly impactful presence of a tongue tie. Yet, not every parent is aware of this connection. 

  

Tongue ties, formally termed as ankyloglossia, may silently influence your child’s ability to experience the basic joys of eating and speaking, shaping experiences that could affect their confidence and social interactions along the way. 

  

As parents, it’s only natural to desire clear explanations about why your child has difficulty articulating or enjoying meals, paving the path for appropriate interventions. By learning about tongue ties and their ramifications, you equip yourself to make informed decisions about possible assessments or therapies, ensuring your child receives the support they rightfully deserve. It's an opportunity to foster progress in their development, guiding them towards smoother communication and worry-free mealtime experiences. 

  

What Is a Tongue Tie? 

A tongue tie, medically known as ankyloglossia, occurs when the string of tissue, called the lingual frenulum, that connects the tongue's underside to the floor of the mouth is too tight, too short, or too thick. Consequently, the movement of the tongue can be limited. 

  

Imagine trying to move freely with your hands tethered together. While this might sound a bit drastic, it's not far from how children with tongue ties experience challenges in freely moving their tongues, which is quite critical for activities like eating, speaking, and even swallowing. It's an anatomical variation that can vary in severity and visibly affects everyone a bit differently. 

  

When we go deeper into the types of tongue ties, it becomes more intriguing yet understandable. In clinical practice, tongue ties are generally classified into two categories: anterior and posterior.  

• An anterior tongue tie is conspicuous and located towards the front of the tongue. Parents often spot these during regular check-ups or while observing everyday activities like eating. The tongue tip may resemble a heart-shaped notch at the center when protruded.
• A posterior tongue tie is much subtler, limiting complete elevation of the remainder of the tongue (middle and back portions), making it less easily noticeable but equally impactful. That is, the ability to simply stick the tongue tip out does not automatically eliminate a restriction/tongue tie because movement of the rest of the tongue must also be taken into consideration.

  

Interestingly, anterior restrictions almost always have a posterior component. If the anterior tie is released during infancy but remains incomplete, the mid and posterior parts can continue being restricted, affecting various functions. It’s fascinating how, although unseen, these anatomical ties have potentially pervasive effects when not addressed properly. 

  

Now, have you ever wondered how untreated ties could stealthily march into adulthood bearing challenges? Picture this: untreated tongue ties affecting not just early childhood but casting shadows over adult lives, leading to conditions like a persistent lisp or other speech impediments. It doesn't end there. 

  

You see, the mid and posterior parts of the tongue, if not enabled to elevate properly due to incomplete releases or unaddressed posterior ties, may hinder breath control, efficient swallowing, and crystal-clear speaking abilities. Intriguingly clustered under the umbrella term Orofacial Myofunctional Disorders (OMDs), these conditions emphasize the interconnected nature of oral anatomy and everyday functioning. 

  

How Tongue Ties Affect Speech Development 

Speech development relies heavily on the tongue's ability to move freely and precisely. When restricted by a tongue tie, children may face challenges articulating sounds, developing oral-motor skills, and building confidence in communication. Being aware of these impacts can help parents identify the need for intervention, enabling their children to overcome barriers and express themselves clearly. 

  

Issues Articulating Sounds Requiring Accurate Tongue Placement 

Tongue ties restrict the movement needed to articulate certain sounds, such as /l/, /r/, /s/, /t/, and /d/ to name a few. These sounds demand exact tongue positioning behind the teeth (aka "the spot"), which can be difficult for a child with a restricted tongue. As a result, speech can become unclear, with sounds substituted, distorted, or omitted entirely. For example, a child may produce a slushy /s/ or they might produce a sound that is distorted and more vowel-like such as the ending in "cah" instead of a strong, precise /r/ in "car." This limitation can make communication frustrating for both the child and the listener, highlighting the importance of early intervention to address these challenges. 

  

Speech Delays and Distorted Speech Sounds 

Tongue ties can lead to speech delays as children struggle to produce sounds that are necessary for early language development. This delay often extends to the clarity of speech, as the restricted tongue movement distorts sounds, making them difficult to understand. Over time, these distortions can become ingrained, requiring speech therapy to correct. Children may avoid speaking altogether in certain situations due to the effort required, impacting their confidence and willingness to communicate. 

  

Difficulty with Oral-Motor Skills 

The restricted range of motion affects oral-motor skills, fundamental for clear speech. Limited tongue mobility can hinder the coordination required for smooth transitions between sounds and syllables. This can result in a choppy or laborious speech pattern. Poor oral-motor control may also affect other functions, such as chewing and swallowing, further complicating overall oral health. 

  

Frustration and Communication Challenges 

When children cannot express themselves clearly, frustration is a common outcome. They may feel misunderstood, leading to emotional outbursts or withdrawal from social interactions. Parents and caregivers often find themselves acting as interpreters, which can strain family dynamics and hinder the child’s social development. 

  

Impact on Phonological Awareness 

Tongue ties can impair a child’s ability to recognize and manipulate sounds, a critical component of phonological awareness. This skill is a pillar of early literacy, including learning to read and spell. Without clear articulation, children may struggle to connect sounds to letters, potentially delaying their academic progress. 

  

Compensatory Strategies 

To cope with their limitations, children with tongue ties often develop compensatory strategies, such as using alternative sounds or exaggerated mouth movements. While these strategies may help in the short term, they can lead to inefficient speech patterns that persist into later years. Professional intervention is often required to address these adaptations and foster correct speech habits. 

  

The Impact of Tongue Ties on Eating 

Eating is one of the earliest skills infants develop, but a tongue tie can significantly disrupt this process. From difficulties breastfeeding to challenges with solid foods and long-term effects on oral health, the impact of tongue ties on eating is multi-dimensional. Early recognition and support can promote smoother, more enjoyable mealtimes for both children and caregivers. 

  

Difficulty Latching During Breastfeeding 

Tongue ties are often first noticed during breastfeeding. A restricted tongue can prevent a proper latch, making it difficult for infants to create the suction needed for effective feeding. Mothers may experience pain or frustration during nursing, and infants may become fussy or irritable. These feeding challenges can lead to inadequate milk transfer, resulting in prolonged feeding sessions that leave both mother and baby exhausted. 

  

Poor Weight Gain in Infants 

Infants with tongue ties may struggle to extract sufficient milk, even with frequent feedings. This inefficiency can result in poor weight gain, raising concerns about the baby’s overall health and development. Pediatricians often recommend assessing for tongue ties when weight gain does not meet expected milestones, particularly when other feeding issues are present. 

  

Early Feeding Aversion 

Feeding aversion can develop as a result of frustration or discomfort during breastfeeding or bottle feeding. Infants may begin to associate feeding with negative experiences, becoming reluctant to nurse or drink from a bottle. This aversion can make meal times stressful for parents and lead to further nutritional challenges. 

  

Challenges with Bottle Feeding 

Bottle-fed infants with tongue ties may struggle to maintain a proper seal on the bottle nipple, leading to excessive air intake and resulting in gas or reflux. These issues can disrupt feeding sessions and contribute to irritability, making it challenging for parents to provide their babies with adequate nutrients. 

  

Gagging and Choking 

As children transition to solid foods, a tongue tie can make it difficult to manipulate food effectively in the mouth. The restricted tongue movement increases the risk of gagging and choking, particularly with textured or solid foods. This can make introducing new foods a stressful experience for both child and caregiver. 

  

Difficulty Swallowing 

Swallowing requires coordinated tongue movement to form a proper bolus and direct it to the back of the throat. A tongue tie can disrupt this process, making swallowing inefficient and uncomfortable. Children may struggle with excessive drooling or food residue in the mouth, further complicating their eating habits. 

  

Impact on Dental Health 

Tongue ties can have long-term effects on dental health by influencing the development of the oral structure. Restricted tongue movement may exert pressure on the dental arch, contributing to issues like crowding, misalignment, or bite problems. Plus, difficulty clearing food particles from the teeth can increase the risk of cavities and gum disease. Early intervention can help mitigate these impacts and support healthier oral development. 

  

Identifying Symptoms of Tongue Ties 

Recognizing the symptoms of tongue ties in your child is a key step toward addressing challenges that could impact their daily life. Tongue ties, or ankyloglossia, can manifest in a variety of ways, affecting feeding, speech, and overall oral function. While some symptoms are immediately apparent, others may be subtle, requiring keen observation. 

  

Feeding-Related Symptoms 

From birth, feeding difficulties often provide the first signs of a tongue tie. Infants may struggle to latch effectively during breastfeeding, leading to prolonged feeding sessions, frequent detachment, and maternal discomfort. This inefficiency can result in poor weight gain despite frequent nursing. Bottle-fed infants may also exhibit challenges, such as excessive air intake, leading to fussiness and gas. As children transition to solid foods, signs like gagging, choking, or a preference for soft textures may emerge. Extended mealtimes and difficulty clearing food from the mouth are additional indicators. 

  

Speech and Oral Development Symptoms 

Speech challenges related to tongue ties typically become evident as children begin to articulate sounds. Limited tongue mobility can hinder the production of certain sounds, leading to unclear speech or difficulty with phonics. Children may develop compensatory strategies, using simpler words or altering their speech patterns. Frustration from being misunderstood can impact their confidence and willingness to engage socially, further complicating their development. 

  

Additional Symptoms 

Beyond feeding and speech, other signs of tongue ties may include mouth breathing, difficulty sticking out the tongue, or an inability to lick the lips. Dental issues such as food remnants stuck between teeth or poor oral hygiene may also point to restricted tongue movement. 

  

If you observe these symptoms in your child, consulting a healthcare professional can open the door to solutions tailored to their needs, helping them thrive in all aspects of their development. 

  

Final Words 

A restricted tongue can affect your child's speech, eating, and emotional well-being, revealing the necessity of a well-rounded approach to therapy. 

  

Addressing a tongue tie early not only supports speech clarity and eating proficiency but also contributes to your child’s emotional and social confidence. When your child can eat and speak freely, they’re equipped to embrace every opportunity—whether it’s joining in play with their peers, expressing themselves in the family circle, or trying new foods at mealtimes. 

  

With the right support and guidance from experienced professionals at Tryumph Speech Therapy, it becomes possible to tackle these challenges head-on, ensuring your child has the tools and confidence needed for a bright, communicative future. 

  

Our speech therapy for children provides a compassionate, individualized approach that accounts for the cultural and personal sensitivities each child brings to the table. Whether your child needs help with speech articulation due to a tongue tie or aid in developing better eating habits, they will receive the personalized support they deserve. Schedule in-person sessions in Austin and online sessions in all of Kansas and Texas. 

  

Connect with experts who stand ready to work closely with your family, turning potential obstacles into opportunities for growth and self-assurance in your child’s formative years. Schedule a Free discovery call! 

  

Have questions? Reach out via phone at (512) 898-9858 for a personal conversation, or simply shoot a message to [email protected].