Tongue-tie in Children: What It Is, Its Consequences, and the Role of the Speech therapist
As a specialized speech therapist, I evaluate tongue mobility and work with otolaryngologists to address tongue-tie in children, both in Malaga and online.
A tongue-tie (ankyloglossia) is a condition in which the frenulum (the tissue connecting the underside of the tongue to the floor of the mouth) is shorter, thicker, or stiffer than usual, limiting the tongue’s mobility.
What is a tongue-tie in children?
It is one of the most commonly diagnosed congenital oral conditions in recent years. The number of scientific publications on the subject has increased exponentially, although this has not always translated into higher-quality evidence: a recent analysis of 462 articles published between 2017 and 2024 found that only 2.8% were randomized clinical trials, the highest standard of quality in research.
Causes and Diagnosis of a tongue-tie in children
A tongue-tie is congenital. It must be diagnosed by a medical professional (pediatrician or otolaryngologist), who evaluates the length, thickness, and mobility of the frenulum, as well as its actual functional impact on each child.
What are the real consequences? What the evidence shows
It’s important to be precise here, because there’s a lot of inaccurate information circulating on this topic.
Regarding breastfeeding: the evidence is more consistent. The American Academy of Pediatrics recognizes the impact of a tongue-tie on breastfeeding in newborns.
Regarding speech: the relationship between a tongue-tie and speech difficulties remains controversial. A systematic review with a meta-analysis concluded that the evidence regarding the benefits of frenectomy (frenulum surgery) for speech is inconclusive, due to studies of low methodological quality.
A prospective study of children aged 2 years or older referred for speech problems found frequent articulation errors (phonological substitutions and slips), but the authors themselves note that the relationship between ankyloglossia and speech remains controversial.
The Role of the Speech therapist
Although the evidence regarding speech is not conclusive in general, this does not mean that a tongue-tie is irrelevant for each individual child. My work as a speech therapist consists of:
- Assess tongue mobility and its specific functional impact in each case (speech, swallowing, breathing).
- Consult with an otolaryngologist when significant ankyloglossia is suspected.
- Work on oral motor function before and after a possible frenectomy, if one is decided upon.
- Do not recommend surgery as an automatic solution to a speech disorder without a comprehensive functional evaluation.
Tongue-tie: Speech therapist in Malaga and Online
If you suspect that your child may have a tongue-tie, it is recommended that you first seek a medical evaluation and, at the same time, a speech therapist’s evaluation of oral function and speech.
I offer speech therapy sessions in Spanish, French and English, both in person at my office in Mijas (Malaga) and online for patients from all over Spain and abroad.
Would you like to learn more about related disorders? Be sure to read my article on atypical swallowing in children as well.
- Thornton, et al. (2025). Systematic review of tongue tie publications: Exponential rise in publications without exponential increase in evidence. Otolaryngology–Head and Neck Surgery. https://doi.org/10.1002/ohn.1264
- American Academy of Pediatrics. (2024). Identification and management of ankyloglossia and its effect on breastfeeding in infants. Pediatrics, 154(2).
- Speech Outcomes of Frenectomy for Tongue-Tie Release: A Systematic Review and Meta-Analysis. (2024). https://speechbite.com/article/73222/
- Melong, J., Bezuhly, M., & Hong, P. (2024). The effect of tongue-tie release on speech articulation and intelligibility. Ear, Nose & Throat Journal. https://doi.org/10.1177/01455613211064045
