Tongue tie or short tongue is often associated with misarticulation or speech delay. Tongue tie occurs when the thin muscle under the tongue or frenulum is too short. This will limit tongue movement and will interfere with the function of the tongue.
Four main functions of the tongue are speech, breastfeeding, digestion and social activities.
“If your child’s tongue is not able to function normally, please bring him/ her to see a specialist for early intervention.”
These are the physical characteristics of tongue tie:
- Unable or have difficulty to protrude the tongue
- Tip of the tongue is flat, heart-shaped or split
- Unable or have difficulty to move tongue to the left and right
- Tip of the tongue is unable to reach the hard palate/ roof of the mouth
- Tip of the tongue is unable to lick upper lips
- Unable to roll tongue backwards
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Tongue Function
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Normal Tongue
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Tongue Tie/ Short Tongue
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| Speech |
Tongue muscles are capable of different movements such as expanding, shrinking, rolling and changing its shape to produce different speech sounds. For example: “High Vowel” refers to the sound produced when the tongue is curved towards the roof of the mouth and “Low Vowel” is produced when the tongue is situated low and flat in the mouth. |
A short frenulum will affect the quality of a child’s speech sound production. The limited movement of the tongue will cause:
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| Chewing and swallowing |
The tongue is also important during digestion of food in the mouth:
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| Breastfeeding | Comfortable feeding |
Your baby may have a tongue tie if:
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| Social activities | The tongue is used in social activities such as signaling, blowing, licking and others. |
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Role of Speech-Language Therapist
Step 1: The Speech-Language Therapist will assess and record new patient information as below:
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Patient demographic/ information (name, age, family background, etc.)
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Family history
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History of eating and early feeding skills
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Current feeding skills
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Tongue movement
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Oral hygiene
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Saliva control
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Speech assessment
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Language development
Step 2: The therapist will determine the need for surgical intervention
- If surgical intervention is needed, the patient will be referred back to your medical practitioner
Step 3: The therapist will plan for therapy objectives after surgery.
Facts on Surgical Intervention
- Not all patients with tongue tie will need to undergo surgical intervention.
- Surgical intervention will be performed only if necessary.
- In addition to patient/ caregiver complaints, evaluation from medical practitioner and therapist will further determine if the patient will need to undergo surgery to release his/ her frenulum. Surgery will be performed only with patient/ caregiver consent.
- Surgical intervention involves cutting away tissue and anesthesia by a specialist.
Goal of Tongue exercises after Surgical Intervention:
Purpose of exercises:
- Shaping the tip, height and protrusion of the tongue in and outside the mouth.
- Increase kinesthetic awareness to know other parts of the mouth and what can be done in terms of structure and texture.
- Trains the tongue for movements related to cleaning the oral cavity
The following are suggested tongue exercises:
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Move the tongue in and out of the mouth. Repeat 10x.
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Stretch the tongue towards the nose, and then bring it down towards the chin. Repeat.
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Lick lower lip and upper lip with the tip of the tongue in an open-mouth position. Repeat 10x. This can be done separately. You can also try to put jam or flavoring on the lip to increase your child’s interest in the activity.
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Push inner cheeks with tongue.
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Move tongue to the right and left corner of the lips.
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Move tongue to touch the roof of the mouth (hard palate)
Tips for Tongue Exercises
Tip 1 : Discuss with a Speech-Language Therapist before proceeding with any exercises. Recommendation from a therapist is utmost important so that the exercise fits the needs of your child.
Tip 2 : Do the exercises with your child in a fun and enjoyable way.
Tip 3 : Do the exercises as long as 5 to 10 mins for two to three times each day.
Tip 4 : Use pictures, videos and be a good model by showing how to perform the exercises correctly and precisely.
Tip 5 : Encourage and praise your child for his/ her efforts
Tip 6 : Include other family members in the activity to increase participation
“Will my child’s speech be normal if he/ she does tongue exercise without surgical intervention?”
Tongue exercises alone may not guarantee that speech quality will get better as there are other factors that may affect one’s articulation.
Seek help from a Speech-Language Therapist in the nearest hospital for an assessment.
References:
- Carmen.F (1998). Tongue Tie- From Confusion to Clarity: A Guide to the diagnosis and Treatment of Ankyloglossia. Publisher: Tandem Publications
- Dental Health (2011). Tongue-tie. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Tongue-tie
| Last Reviewed | : | 28 August 2020 |
| Writer | : | Norhafillah bt Abdul Rahman |
| Translator | : | Angela Yew Wei Ching |
| Accreditor | : | Fairus bt. Mukhtar |
| Reviewer | : | Nadwah bt. Onwi |
