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When a child has difficulty with speech, parents often wonder what might be causing it. One topic that comes up frequently in pediatric speech therapy is tongue tie, also known as ankyloglossia. While tongue tie does not affect every child’s speech, it can play a role in how clearly some children produce sounds. Understanding the connection can help families make informed decisions and seek the right support. What Is Tongue Tie? Tongue tie is a condition present at birth in which the thin piece of tissue under the tongue (the lingual frenulum) is shorter, thicker, or tighter than usual. This can limit how far the tongue can move up, out, or side to side. Tongue tie varies in severity. Some children have very mild restriction with no noticeable impact, while others have more significant limitations that affect feeding, oral movement, or speech. How the Tongue Affects Speech The tongue plays a major role in speech production. It needs to move quickly and precisely to touch different parts of the mouth, such as the roof of the mouth, the teeth, and the lips. Many speech sounds depend on this movement, including: Lingual sounds like /t/, /d/, /n/, and /l/ Back sounds like /k/ and /g/ Blends and later-developing sounds such as /r/ and /s/ If the tongue cannot lift or move freely, a child may compensate by using other parts of the mouth, which can affect clarity. Does Tongue Tie Always Cause Speech Problems? No. This is an important point. Not every child with a tongue tie will have a speech disorder, and not every speech disorder is caused by tongue tie. Some children adapt well and develop clear speech despite limited tongue mobility. Others may show signs such as: Distorted or unclear speech sounds Difficulty with certain sounds despite practice Reduced tongue elevation or range of motion Fatigue or frustration during speaking tasks A comprehensive evaluation is needed to determine whether tongue tie is contributing to a child’s speech difficulties. The Role of a Pediatric Speech-Language Pathologist A pediatric speech-language pathologist (SLP) plays a key role in assessing and supporting children with suspected tongue tie. An SLP can: Evaluate speech sound production and intelligibility Observe tongue movement and oral motor patterns Determine whether speech errors are developmentally appropriate Identify compensatory strategies the child may be using If tongue tie appears to be impacting speech, the SLP may collaborate with other professionals, such as pediatricians, dentists, or ENT specialists. Treatment Options and Therapy Support Treatment depends on the child’s individual needs. In some cases, speech therapy alone is sufficient to improve clarity and articulation. Therapy may focus on: Strengthening tongue movement and coordination Teaching correct placement for speech sounds Increasing awareness of tongue positioning In other cases, families may explore medical or dental consultation to discuss whether releasing the tongue tie is appropriate. If a release is performed, speech therapy before and after the procedure is often recommended to help the child learn new movement patterns and use the tongue effectively for speech. What Parents Can Do If you’re concerned about your child’s speech: Listen for clarity: Are unfamiliar listeners able to understand your child? Watch tongue movement: Does the tongue lift easily or appear restricted? Seek a professional evaluation: An SLP can determine whether speech therapy is needed. Early support can make a big difference in building confidence and communication skills. Final Thoughts Tongue tie is just one of many factors that can influence speech development. With the right assessment and support, children can make meaningful progress and develop clear, confident communication skills. Pediatric speech therapy focuses on the whole child—helping them be understood, feel successful, and express themselves fully. If you have concerns about your child’s speech or oral movement, a pediatric speech-language pathologist is a great place to start.

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Speech Therapy and Tongue Tie: What Parents Need to Know