Tongue tie in toddler - HV won't refer

[ElPolloDiabolo]

2.4yo DS2 has a tongue tie and is having trouble forming quite a few sounds. "s" and "r" in particular.

The amount of words he knows and his understanding is pretty good, but I was worried that the sound of his speech would suffer if there was no intervention.

We asked for the tie (which was missed in the hospital despite my problems BFing) to be cut when he was 2 weeks old, but by the time someone could see us to do it my nipples were in shreds and I'd moved on to formula. The HV told me that the tie would naturally break before he started to talk.

Well it hasn't and my HV has advised that they don't refer for a tie snip after 6 weeks and also she won't refer him for any kind of speech therapy at this stage.

Does that sound right to you or should I be pushing for more to be done?

He can't stick his tongue out at all and it still has the pronounced bow shape.

Hi OP, I'm an SLT. Not saying 's' and 'r' is normal at that age. 'S' usually comes in around 3 years old, 'r' more like 6 or 7. Tongue tie doesn't always cause problems with talking.

Don't correct your DS but say the word back to him with all of the sounds in the right place.

Does he have any problems with chewing or swallowing? Can he lick an ice cream?

Hi my ds (2 1/2) just had his tongue tie snapped and it has made a huge difference to his speech, so if you think it is causing him issues you should definitely insist for it yo be looked at. He had to be under general anaesthetic but he was only in surgery for 20 min and we were out of hospital at lunch time. Could you speak to your gp about it and ask them for referral?

Is going private an option?

Tongue tie can cause all sorts of problems that you would never realise were related. Speech and feeding are only the tip of the iceberg.

Restricted tongue movement can affect the whole orofacial structure in some cases (note I say "some" not "all") which can cause problems with overall health.

DS1 went undiagnosed until he was 6yo and had no end of problems. Funnily enough, neither speech or licking an ice cream were any problem to him at all. And why are HCPs obsessed with licking fucking ice creams when there are some really serious health problems which stem from ties which they seem oblivious to.

If I could turn the clock back with ds1, I would have taken him pronto to a dentist who has specialised in ties and can assess the orofacial structure.

GA is not necessary btw.

Mawbroon, its not about the icecream, its about whether a child can extend their tongue out of their mouth and past their lips. So what seems like a silly question to you is actually quite significant in assessing the impact of a tongue tie.

Thanks all.
No budget for a private op sadly, but maybe it's worth going via the GP route instead.

Lotta I can see the case for a 'watch and wait' approach, but to me, the sounds he's making sound impeded rather than underdeveloped, IYSWIM.

I just don't want to wait until he's really affected by it if there's something I could do now.

There seems to be much conflicting opinion about tongue tie!

He can extend his tongue a couple of cm beyond his lower lip but that's all.

Well you're right to follow your instinct OP. You don't have to go through the HV - SLT departments will take referrals from parents too although a referral for those sounds at his age is unlikely to be accepted. Do you have a Children's Centre bear you? You may be able to book an appointment to have a chat with an SLT and get further advice

I fully understand the question about ice creams what I am getting at is that there are much more serious consequences to untreated ties than being unable to lick an ice cream.

Y'know things like affecting breathing, eating and sleeping - somewhat more important than being able to lick an ice cream.

Sorry, i just get so frustrated at the lack of knowledge by HCPs in general. The information is all out there if only they would look at it and stop dismissing parents who are more knowledgable about it than they are.

I have similar concerns with my 2 yr old. Again, suspected TT but left too late to diagnose/get treated in 'the broken system'. Has the HV assessed your DS's speech? My HV and I were concerned that if problems didn't resolve, the waiting lists for speech therapy are long and it would take for ever to get an appointment, if needed. So she gave us a quick assessment a couple of months back (as a benchmark) and we've just had an additional assessment to check progress. DD's speech has only just started taking off, so we agreed to wait a couple more months before assessing again and then submitting a referral if DD is still having issues. Has your HV done this?

Question for Lotta - Does sideways tongue movement come into it too? And do lisp's resolve themselves? (Sorry to hijack OP)

Somebody who can lick an ice cream may still have a significant posterior tongue tie which often goes unnoticed because it appears normal to the untrained eye.

lisp's?! lisps.

What mawbroon says.

PickledLily, yes sideways movement is part of the assessment. By a 'lisp', do you mean saying 's' as 'th'? It usually resolves itself by age 7, if its still persisting after that, you may need a SLT referral.

Thanks Lotta :)

Fyi London price private cost (2013) was £80. we were seen within 2 days in early evening appt so no time off needed
and in same place as nhs. btw it's a dental surgeon that does this for our local nhs (it's a lot of money but it's a one off and it's done forever - I would have sold anything to raise the cash as I got shredded too ... Very painful and ds took inboard a lot of air!). All done in under ten mins. Doesn't sound too tied if can poke out of mouth perhaps it's borderline??

Just to add to above posts my ds tie at middle/back of tongue and so not the classic front tie shown in pictures. It was a "tight tie" so just as significant as front obvious one (it also affected breathing, swallowing, eating, sleep and I am certain it would have affected speech). My bro recently adopted a boy (4) social services missed his tie and did nothing even though he had all manner of verbal work arounds in his speech - speech and language therapy helping but it's ridiculous such a basic and common thing is not captured when it's needed.