Tongue-tie (or ankyloglossia) is known as a structural impairment limiting tongue mobility. Tongue-ties are often associated with children who have difficulties with feeding and/or speech production.

Tongue-ties impact about 3-16% of infants worldwide (Ingram et al., 2015). The wide variation in incidence is attributed to no universally accepted diagnostic criteria across professions exposed to this population. Incidence is highly dependent on the profession reporting.


Common physical characteristics include short, thick frenulum (what attaches the tongue to the floor of the mouth), and “heart shaped” tongue when stuck out. Difficulty with producing sounds such as /t,d/, /z,s/, /th/, /n/, /l/, /r/ (Messner & Lalakea, 2006).

The Effect of Ankyloglossia on Speech in Children

There is limited research which suggests that there is a known difference in tongue mobility and accuracy in speech among children with tongue ties (Messner & Lalakea, 2006). In previous studies, when the children had their tongue-ties released, some had their speech improve if the procedure was done early enough. However, if too old, may already developed compensatory strategies because of the structural limitation which would be remediated through intervention.


Most known treatment is associated with breastfeeding. Currently, there is limited research related to speech production influence. If the tongue-tie is influencing accuracy in speech production, then it is unlikely that speech therapy alone will remediate the issue.

Surgical Intervention

Usually intervention/remediation of the tongue-tie may be completed by a pediatrician, dentist, or otolaryngologist (Ear, Nose, Throat doctor). The most common procedures for tongue-tire remediation are known as frenectomy or frenotomy. A frenectomy is the complete removal of the frenulum by either a laser, scalpel or scissors. This procedure often requires general anesthesia. A frenotomy is a snip or clip of the frenulum. Usually after this procedure, there is remnant of the frenulum and is often not a complete release. The release sometimes improves length or mobility in the tongue, but will often need to follow-up with intervention (Baxter & Hughes, 2018).


Baxter, R., & Hughes, L. (2018). Speech and feeding improvements in children after posterior tongue-tie release: A case series. International Journal Of ClinicalPediatrics, 7(3), 29-35.

Dollberg, S., Manor, Y., Makai, E., & Botzer, E. (2011). Evaluation of speech intelligibility in children with tongue-     tie. Acta Paediatrica, 100(9), e125-e127.

Ferrés Amat, Elvira, et al. “Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol.” Medicina Oral, Patología Oral y Cirugía Bucal 21.1 (2016):e39-e47. Web.

Ingram, J., Johnson, D., Copeland, M., Churchill, C., Taylor, H., & Emond, A. (2015). The development of a tongue             assessment tool to assist with tongue-tie identification. Archives of disease in childhood. Fetal and neonatal edition, 100(4), F344-F348.

Ito, Y., Shimizu, T., Nakamura, T., & Takatama, C. (2015). Effectiveness of tongue-tie division for speech disorder in children. Pediatrics International 57(2), 222-226. Web.

Messner, A. H., Lalakea, M. L. (2002). The effect of ankyloglossia on speech in children. Otolaryngology Head and Neck Surgery 127(6), 539-545.

Suter, V. G., & Bornstein, M.M. (2009). Ankyloglossia: Facts and myths in diagnosis and treatment. Journal of Periodontology 80(8), 1204-1219. Web.

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Blue Bird Day fosters socialization, sensory regulation, and pre-academic learning in children ages 2-7 years in therapeutic rotations that simulate  preschool and kindergarten settings. Our compassionate therapists practice a relationship-based and family-centered approach, provide parent training, and collaborate on goals and individualized intensive treatment plans for your child.

We believe in a collaborative and multi-disciplinary team approach to therapy. A team of occupational therapists, speech-language pathologists, dietitians, developmental therapists, behavioral therapists, physical therapists, and therapeutic assistants are created for each child to ensure child and family are fully supported and the best possible results are achieved.  

Options for individualized, group and virtual therapy sessions are available as well. 

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