Assessing Tongue Mobility Issues in Preschool Children: When to Seek Help

Tongue mobility

Hello Doctor, my son is 4 and a half years old.
I have noticed that he can only stick his tongue out but cannot curl it upwards, and his lateral movement is also not very flexible.
However, he does not have a W tongue.
He can generally be understood when he speaks, but there are still some issues with pronunciation.
I have read online about tight tongue ties causing poor tongue mobility and speech problems.
Doctor, does my son's condition require an examination by a pediatric surgeon, or are there any methods that can help him? Thank you, Doctor.

Amy, 30~39 year old female. Ask Date: 2020/07/24

Dr. Xiao Kaiwen reply Pediatrics

As long as the tongue can extend forward to cover the lower lip, there is no issue with a tight frenulum or tongue mobility (the tongue only needs to extend forward, without the necessity for upward curling or lateral movement).
In fact, our speech production involves not only the tongue; the majority relies on the coordination of small muscles near the vocal cords, which is often a developmental coordination issue in young children.
If there are articulation problems, it is generally recommended to first provide patient guidance at home.
If there is still no improvement, a visit to a hospital for speech therapy may be necessary.

Reply Date: 2020/07/24

More Info

Assessing tongue mobility issues in preschool children is an important aspect of their overall development, particularly when it comes to speech and language skills. Your concerns about your son's ability to move his tongue freely and articulate certain sounds are valid and warrant careful consideration.

First, it's essential to understand that tongue mobility is crucial for various functions, including eating, speaking, and even swallowing. The tongue's ability to move in different directions—up, down, left, and right—plays a significant role in how well a child can articulate sounds and words. In your case, your son can extend his tongue forward but struggles with upward curling and lateral movement. This limitation could potentially impact his speech clarity and articulation.

The condition you mentioned, known as "ankyloglossia" or tongue-tie, occurs when the frenulum (the band of tissue connecting the underside of the tongue to the floor of the mouth) is too short or tight, restricting tongue movement. While some children with tongue-tie may not experience significant issues, others may face challenges with speech, eating, or oral hygiene. The fact that your son has some articulation difficulties could suggest that his tongue mobility is affecting his speech development.

In terms of seeking help, it is advisable to consult with a pediatrician or a speech-language pathologist (SLP) first. They can conduct a thorough assessment of your son's oral motor skills and speech clarity. The SLP will evaluate his ability to produce sounds and words, as well as his overall communication skills. If they determine that his tongue mobility is indeed impacting his speech, they may recommend further evaluation by a pediatric dentist or an oral surgeon specializing in tongue-tie releases.

If the assessment indicates that your son has a significant restriction due to a tight frenulum, a procedure called a frenotomy or frenuloplasty may be suggested. This minor surgical procedure involves snipping or removing the frenulum to allow for greater tongue mobility. Many children experience immediate improvement in their ability to move their tongues and articulate sounds after this procedure.

In the meantime, there are several strategies you can implement to help your son improve his tongue mobility and speech clarity:
1. Oral Motor Exercises: Engage your son in fun oral motor exercises that encourage tongue movement. For example, you can have him practice sticking out his tongue, moving it side to side, and curling it up. Make it a game to keep him engaged.

2. Speech Therapy: If recommended, enrolling your son in speech therapy can provide him with targeted exercises and strategies to improve his articulation and overall speech clarity.

3. Encourage Play: Activities that involve blowing bubbles, using straws, or playing with chewy toys can help strengthen the muscles in the mouth and improve tongue mobility.

4. Modeling Speech: Regularly model clear speech for your son. Encourage him to repeat words and sounds after you, focusing on proper articulation.

5. Positive Reinforcement: Celebrate his efforts and progress in speech. Positive reinforcement can motivate him to practice and improve.

In conclusion, while your son's current tongue mobility may not be severely limiting, it is essential to monitor his speech development closely. Consulting with a pediatrician or speech-language pathologist will provide you with a clearer understanding of whether further intervention is necessary. Early intervention can significantly impact a child's speech and language development, so seeking help sooner rather than later is always a wise choice.

Similar Q&A

Addressing Speech Concerns in Toddlers: When to Seek Help

Hello Dr. Chang, my daughter is now 3 years old, going on 4 in traditional age, and she is in preschool. However, since she started speaking, she has been rolling her tongue, and people say that she speaks with a "twisted tongue" in Taiwanese. What should I do? Should I...

Dr. Zhang Guozhen reply Pediatrics
Dear Dr. Zhang Guozhen of Pediatrics, Regarding the case of a three-year-old child who is not speaking clearly and shows signs of delay, there may indeed be an issue. It is possible that the pronunciation will improve over time; however, if there is no improvement by the age of ...

Addressing Speech Delays in Toddlers: When to Consult Rehabilitation Specialists

Hello Doctor: My precious son is almost 2 years old and his speech development is not on par with his peers. Due to his language expression difficulties, he often screams loudly, to the point of losing his voice and becoming hoarse yet still continues to shout! An ENT specialist ...

Dr. Chen Xianchang reply Rehabilitation
Hello, Miss: Thank you for your inquiry. Here are my responses to your questions and some suggestions: 1. Your child may be experiencing language barriers due to the following factors: a. Insufficient expression, leading to difficulty in communication, which may result in y...

Understanding Speech Delays in Children: Seeking Help in Kaohsiung

Hello Dr. Zhou, I have a question to ask. My child is over 2 years old now, but their speech is still not very clear. I initially thought that a frenotomy (tongue tie release) would help, but after visiting another pediatrician, I was told that it is unnecessary because the tip...

Dr. Zhou Zuyou reply Pediatrics
Language disorders can be evaluated by an otolaryngologist (ENT) who specializes in speech therapy. In the Kaohsiung area, you can visit Kaohsiung Medical University Hospital, Kaohsiung Veterans General Hospital, or Chang Gung Memorial Hospital. In the Tainan area, you can go to ...

Addressing Speech Delays in Toddlers: When to Seek Help

Our child is already 2 years old this year, but he has noticeable pronunciation issues. We had a brain ultrasound done in October, and the doctor said there were no problems and that he would improve as he gets older, but we are still very worried. He only pronounces a few words ...

Dr. Xiao Kaiwen reply Pediatrics
Before the age of 3 to 4 years, the development of the articulatory organs in young children is not fully matured, and their language proficiency is insufficient, often resulting in inaccurate pronunciation. However, as they grow older, their language development becomes more ref...