Tongue Ties and Talking: Are They Really to Blame for Speech Trouble?

Elizabeth Lian CCC-SLP
May 23
3 min read

As a speech-language pathologists (or “speech therapists” or "speech teachers"), I often get questions about tongue ties. One of the big ones is:

“Could my child’s tongue tie be the reason they’re having trouble saying certain sounds?”

It’s a fair question—and one that’s sparked a lot of debate! The idea that a restrictive lingual frenulum is always responsible for articulation errors is a common misconception, both among caregivers and some professionals. But what does the research actually say?

What Is a Tongue Tie Anyway?

A tongue tie, or ankyloglossia, happens when the little string of tissue under the tongue (called the lingual frenulum) is shorter or tighter than usual. In some cases, it limits how far the tongue can move—especially upward or outward.

But here’s the twist: just because a tongue can’t stick out very far doesn’t mean it can’t do its job for speech!

Does a Tongue Tie Cause Speech Problems?

Not usually. A visible tongue tie doesn’t automatically equal an articulation issue.

Research tells us that:

Kids with tongue ties often develop typical speech (Messner & Lalakea, 2002).
The tongue's range of movement required for speech sounds (especially those made at the alveolar ridge like /t/, /d/, /n/, /l/, and /s/) is often preserved even in the presence of a visible tongue tie.
Children are pretty clever. They often find compensatory strategies to make sounds just fine (Mills et al., 2019).
Studies haven’t found a strong connection between tongue tie severity and articulation difficulties (Wallace & Clarke, 2006).

In short, a tongue tie might look dramatic, but in many cases, it’s just along for the ride—not driving the speech bus.

So When Should We Worry?

There are situations where a tongue tie might interfere with speech, but they’re more the exception than the rule. Here’s when it might deserve a closer look:

If a child can’t lift or move their tongue enough to make sounds like /l/, /r/, /t/, or /d/, even with support in therapy.
If progress in articulation therapy is really slow or stuck, and movement limitations are clearly getting in the way.
If the tongue tie is also causing feeding problems, especially in babies.

In those cases, a referral to an ENT or a pediatric dentist might be helpful.

What Should Parents Do?

Focus on function, not just appearance. A tongue that looks tight might still move well enough for speech.
Don’t rush to surgery. Try therapy first—especially for kids with mild-to-moderate ties.
Your SLP can work on target sounds using fun, evidence-based strategies. (We’re pretty good at turning “tricky tongue sounds” into games!)

Tongue ties are like the plot twists of the speech world: surprising, sometimes dramatic, but not always meaningful to the outcome. If your child has one, don’t panic. Plenty of people with tongue ties speak beautifully, eat normally, and go through life without ever needing a release.

When in doubt, consult your friendly neighborhood SLP. We’re happy to help you sort out what matters, what doesn’t, and what next steps—if any—make sense.

Sources:

Messner, A. H., & Lalakea, M. L. (2002). Ankyloglossia: controversies in management. International Journal of Pediatric Otorhinolaryngology, 54(2–3), 123–131.

Mills, N., Keough, N., Geddes, D., & Pransky, S. M. (2019). Tongue-tie and beyond: Recommendations for assessment and treatment. Journal of Clinical Lactation, 10(2), 56–62.
Wallace, H., & Clarke, S. (2006). Tongue tie division in infants with breastfeeding difficulties. Archives of Disease in Childhood, 91(12), F545–F547.