One of the prime articulators is the tongue. The tongue has a tip, middle, and back part (i.e., root). It is a muscular bag with layers of muscles enabling many shapes and forms to create speech sounds as well as to manipulate food into boluses. The tip can normally be extended or pointed outward. It can move upward to touch the back of the anterior teeth or the gum ridge to make lingua-alveolar or lingua-dental sounds. But some children cannot raise the tip of their tongues very far, and when they try, the tongue forms a heart shape. What is happening? It may affect their speech and eating.
Apply your understanding of articulation and resonation to clients who are tongue-tied. This discussion is intended to allow you to show evidence that you have achieved the following Learning Outcomes:
Analyze physiology of communication (ILO3, PLO3) CLO3: Apply knowledge of anatomy and physiology of communication to diagnose and treat patients with communication disorders (ILO3, PLO3)
Explain tongue-tied conditions and describe a simple surgical repair for the condition. Explain how tongue-tied conditions can affect articulation and resonation.
Full Answer Section
- Frenuloplasty:
- A more complex surgical procedure that may be required for older children or adults with thicker frenula.
- Involves surgically altering the frenulum and may require sutures.
- Local or general anesthesia may be used.
Effects on Articulation and Resonation
- Articulation:
- Ankyloglossia can lead to articulation errors, particularly with sounds that require tongue tip elevation.
- Children may substitute sounds or produce distorted versions of target sounds.
- For example, they may have difficulty producing the "th" sound in "think" or the "l" sound in "light."
- This condition can cause lisping.
- Resonation:
- While less direct, ankyloglossia can indirectly affect resonation.
- The tongue's position and movement influence oral resonance.
- If the tongue is restricted, it may alter the size and shape of the oral cavity, potentially affecting resonance.
- Also, if the tongue is unable to move correctly, it can cause the individual to compensate by using other muscles in the vocal tract. These compensations can have an adverse affect on resonation.
- Ankyloglossia can also cause an open mouth posture, which can effect resonation.
- Feeding and Swallowing:
- Ankyloglossia can cause difficulties with latching during breastfeeding, and with chewing and swallowing solid foods later in life.
- These difficulties can have an adverse affect on the overall health of the individual.
Clinical Implications
- Assessment:
- A thorough oral motor examination is essential to assess tongue mobility and identify ankyloglossia.
- Speech-language pathologists play a crucial role in evaluating articulation and identifying any related speech errors.
- Intervention:
- Surgical repair may be recommended to release the restricted frenulum.
- Post-surgical speech therapy may be necessary to address any residual articulation errors and improve tongue function.
- Oral motor exercises can be used to improve the strength and range of motion of the tongue.
- Feeding therapy may also be needed.
By understanding the physiological impact of ankyloglossia, speech-language pathologists can provide appropriate assessment and intervention to improve communication and oral motor function.
Sample Answer
Tongue-Tie (Ankyloglossia)
The condition described, where a child cannot raise the tip of their tongue very far and it forms a heart shape when they try, strongly indicates ankyloglossia, commonly known as tongue-tie. This occurs when the lingual frenulum, the thin tissue connecting the underside of the tongue to the floor of the mouth, is abnormally short, thick, or tight.
Physiology and Impact
- Normal Tongue Function:
- The tongue's flexibility and range of motion are crucial for speech articulation, swallowing, and oral hygiene.
- It allows for precise movements needed to produce various speech sounds.
- It is needed for the manipulation of food in the oral cavity.
- Ankyloglossia's Restriction:
- A restricted frenulum limits the tongue's ability to elevate, protrude, and move laterally.
- This restriction can affect the production of sounds that require tongue elevation, such as /t/, /d/, /n/, /l/, /r/, and /θ/ (th).
- It can also impact the ability to create proper suction needed for effective swallowing.
Surgical Repair (Frenotomy/Frenuloplasty)
- Frenotomy:
- A simple surgical procedure where the lingual frenulum is clipped or cut.
- Often performed on infants with minimal discomfort and bleeding.
- In many cases, it can be done without anesthesia.