Typically, a speech disorder co-exists with lip and/or tongue-tie. Despite years of research that have shown inconclusive results or no effects on speech production via tongue-tie release and/or lip tie release, people are still having surgery to “fix” speech impairments in children. However, research has proven that tongue-tie or ankyloglossia does adversely affect breastfeeding in newborns. Therefore, tongue and lip ties are typically found during infancy and parents are given the option to surgically remediate or use alternate means to assist with breastfeeding.
Dr. Messner, Chief of Otolaryngology of Texas Children’s Hospital, and several of her colleagues developed the “Clinical Consensus Statement: Ankyloglossia in Children. Dr. Messner and her colleagues developed their statement after review of multiple medical research studies to identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using methodology established for the American Academy of Otolaryngology-Head and Neck Surgery Clinic” (Messner et al, 2020). Per their findings, “ankyloglossia does not typically affect speech” (Messner et al, 2020). The physicians, Dr. Messner and her associates further state in the consensus, “A consultation with a speech pathologist is encouraged before frenotomy/frenuloplasty in an older child who is undergoing the procedure for speech concerns. The purpose of the consultation with the speech pathologist is to confirm that there is a significant tongue-tie affecting the speech before any surgery is performed” (2020).
Truth behind Tongue Tissue and Lip Tissue:
- Despite the research, several ENTs, some SLPs and pediatricians believe tongue-ties cause speech impairments (Kummer, 2005).
- There are parents that are convinced that the tongue is the primary cause of their child’s speech disorder, regardless of a tongue-tie or not. These parents advocate and seek surgery for their child.
- During the first 4-5 years of life, the oral cavity develops and changes significantly in shape and size (Kummer, 2005).
- Lip and tongue-ties may stretch and rupture ultimately remediating themselves via natural development during those first 4-5 years of life (Kummer, 2005).
- Lip ties rupture sometimes during childhood secondary to falls.
A speech impairment can exist simultaneously as the tongue tie. However, there is no evidence that the tethered tissue caused the speech impairment. They just happen to exist together.
- For the purposes of speech production, the tongue and lips require a small range of motion (ROM) compared to the full ROM that each muscle group (lips and tongue) can move naturally.
- Tongue and lip ties are highly controversial.
- Tongue and lip ties are medical diagnoses and are diagnosed by an MD, not SLPs.
- Teenagers tend to independently seek tongue-tie release for purposes outside of speech (e.g., kissing).
Conclusion and Recommendation:
Consult an SLP prior to surgery, as the clinical consensus statement suggests, to ensure that the tongue has full range of motion (ROM) for the purposes of speech production.Be a critical thinker and ask questions. Verify the information you are given. If your provider becomes uncomfortable or defensive, consider finding a new provider.