Speech Therapy 101, Inc. - Empowering Parents
"Tongue-Tied" Article written for the "Expert Column" for the Golden Gate Mother's Group

Written by Kim Scott, M.S., CCC-SLP, Speech Pathologist

My son has a short frenulum (tongue-tied). When he was a baby his pediatrician said if it didn’t interfere with his feeding, then it’s not a big deal. At the time my husband wanted it to be clipped, but I didn’t. Now my son is having speech issues, and my husband thinks we should get it clipped sooner rather than later. Has anyone had any experience/have any input on my situation?

: When a child has a restrictive or tight frenulum, it can impair the ability of the tongue to move properly, affecting the child’s speech development. As well as having a speech function, the tongue is needed for sucking, chewing, swallowing, eating, drinking, sweeping the mouth for food debris, etc. Tongue-tie can resolve in early childhood if the frenulum “loosens” by itself, allowing the tongue to move freely for eating and speech. However, in some cases, the child may need to have an operation (frenectomy) to release the tongue. In order to develop speech, the tongue needs to make an amazing range of movements: tip-elevation, grooving and protrusion. The tongue should be able to make a range of movements in all directions for the articulation of a number of sounds, particularly l, r, t, d, s, n, th, sh and z. These sounds are likely to be distorted if a child has limited range of lingual movement. If a surgeon and a speech pathologist agree that surgical intervention is required, the surgical procedure to correct this condition is very simple. If the child is cooperative, it could even be done under local anesthesia. Therefore, mothers need not be overly concerned if this condition is the sole cause for the child’s speech problem. In my experience, I have seen many children who have undergone several years of speech therapy with little or no improvement until the tongue-tie is corrected. I almost always recommend surgery to avoid this situation. Speech therapy can be expensive and frustrating for a child if there is little or no progress. I recommend children get the surgery as early as possible because delaying surgery may result in the child needing more intensive speech therapy after surgery to correct any altered speech patterns. If surgery is done before speech develops, it is more likely that speech therapy will not be necessary.

Q: I have a six-month-old, and I’m thinking of doing baby signing. I am not sure if this is something worth doing. Why did you decide to do it or not do it? Will it delay speech development?

: Baby signing will not delay speech development; in fact, it will do just the opposite. For most children, motor skills develop far faster than verbal skills, and signing helps babies communicate before their verbal skills are fully developed. Babies start communicating the day they are born. They naturally have a strong desire to communicate and get their wants and needs met. They learn to communicate by using facial expressions, body language, pointing and using gestures (like waving bye-bye). By teaching baby signs, you will enable your baby to communicate at a much earlier age. Learning to exchange a gesture or sign instead of crying is the beginning of language. Signing is just another means for them to communicate before they develop their verbal skills. Babies communicate by using whatever means is easiest and quickest. A baby has the motor skills necessary to bring their hands together to create the sign “more” before they have the verbal skills necessary to bring their lips together to articulate the word “more.” Most babies at 12 months of age have an expressive vocabulary of only three to five words, however a baby who knows baby sign can have a vocabulary of approximately more than 100 words!

Advantages of Baby Signing:
■ Promotes development of language skills
■ Significantly reduces crying and frustration
■ Increases early literacy skills
■ Improves expressive language skills
■ Develops larger vocabularies
■ May increase IQ by 12+ points
■ Teaches a second language
■ Signing children typically speak earlier than non-signers

Whether signing, vocalizing, pointing, gesturing, using photos or speaking, any kind of communication is great for babies. Once you teach your baby to sign, you will be able to see into the mind of your baby. Your baby will be better able to share unique thoughts and feelings with you. Also, don’t worry, this won’t delay the child’s speech, because once verbal skills begin to develop, the child will slowly stop using signs and switch to speech.

My favorite source of information when learning sign language is the “ASL Browser.” This browser has hundreds of signs that you can view at anytime http://commtechlab.msu. edu/sites/aslweb/browser.htm).

■ Kim Scott, M.S., CCC-SLP, Speech and Language Pathologist, is the owner of Speech Therapy 101. She can be reached at Kim@ Speechtherapy101.com or 310-922-4227.   

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