Updated: Aug 2, 2022
For my first blog post, I would like to share what I have recently learned about anyloglossia (i.e. tongue tie) and how research is changing in this area.
Sitting in my anatomy class, I learned about the frenulum and its function-- anchoring the tongue and limiting its movement in different directions. We were told that a shortened frenulum (i.e. tongue tie) does not impact speech development, and that it can only impact infant feeding. Fast forward 5 years later, and more research has been conducted in this area.
"Ankyloglossia, or tongue-tie, is a congenital anomaly characterized by a shortened lingual frenulum that may cause restricted tongue mobility resulting in several functional limitations" (Khan et al., 2017).
Research by Duggamati et al. (2019) studied 48 patients (mean age 2.86 years) who underwent lingual frenulectomy for speech and language impairment. Their research found that children with pre-ope moderate and moderate to severe speech impairment attained statistically significant speech improvements compared to children with preoperative mild and mild-to-moderate speech impairment.
Research by Baxter et al. (2020) looked at 37 patients (mean age 4.2 years) pre and post frenulectomy and found that overall, speech improved in 89% or participants. Additionally, solid feeding improved in 83%, and sleep improved in 83% of patients as reported by parents. A significant amount of slow eaters ate more rapidly and 72% of restless sleepers slept less restlessly. Parents reported improved speech production in 76% of children after just one week! After tongue-tie releases paired with myofunctional exercises, most children experience functional improvements in speech, feeding, and sleep.
Through taking courses at the Breath Institute, I learned that tongue ties often cause the tongue to rest on the bottom of the mouth. Low tongue posture often results in mouth breathing. Mouth breathing leads to an amalgamation of issues: a narrowed hard palate, low tongue tone (i.e. weak tongue), food aversions, symptoms of ADHD and anxiety, and many other issues that impact quality of life.
I work with a handful of students who have limited tongue mobility and I am continuing to work on /s, l, r/ with them. Using speech therapy techniques when there is a structural issue is putting a band-aid on a broken leg. How can we help our clients without treating the root cause?
Find an experienced speech-language pathologist, pediatrician, dentist, or orthodontist to assess for an orofacial myofunctional disorder (OMD). Orofacial myofunctional disorders (OMDs) are abnormal movement patterns of the face and mouth.
Some signs and symptoms to look out for:
Difficulty saying speech sounds (e.g. /r, t, d, l s, z, ch, j/)
Messy eaters/inability to form a bolus
Tongue thrust (tongue pushes against front teeth when speaking or swallowing).
Difficulty closing the lips
Low tongue posture in mouth
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. https://doi.org/10.1177/0009922820928055
Daggumati S, Cohn JE, Brennan MJ, Evarts M, McKinnon BJ, Terk AR. Speech and Language Outcomes in Patients with Ankyloglossia Undergoing Frenulectomy: A Retrospective Pilot Study. OTO Open. January 2019. doi:10.1177/2473974X19826943
Khan S, Sharma S, Sharma VK. Ankyloglossia: Surgical management and functional rehabilitation of tongue. Indian J Dent Res. 2017 Sep-Oct;28(5):585-587. doi: 10.4103/ijdr.IJDR_739_16. PMID: 29072224.