Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Tongue-Tied Toddler | | | QUESTION | | | Dear Dr. Needlman,
I have a 19-month-old son who only says two words ("no" and "Daddy"). He does babble, but I'm very worried about his speech since I know it is important to get an early diagnosis. I don't think it's his hearing because he can understand a few commands like "come here," "sit down," and "clap your hands." I notice he is not at the same level in regards to speech as other boys his age. He is tongue tied. Does that affect speech?
— Worried Mom in Hayward, California | | | ANSWER |
October 16, 2000 | | | Dear Worried Mom,
There is a little band of tissue that runs between the bottom of the tongue and the floor of the mouth. In some children, this band of tissue is too short, so the tongue can't stick out very far. This is often called "tongue tie."
Usually, tongue tie has no effect on speech, but when it's very severe, it can interfere with a child's ability to make certain sounds. The child may be difficult to understand, but will still have the same number of words in his vocabulary. So, I don't think tongue tie is a likely explanation for your son's lack of speech.
The most likely explanation is simply a mild speech delay. You are right that most toddlers your son's age have larger vocabularies, but there are many, many children who are slower to develop speech. Boys are more likely to be slow in this regard than are girls. Most of the time, the boys catch up by age two or three and do just fine in the long run.
You also are right that early diagnosis is important if a child does have a speech problem.
If you haven't already discussed your child's situation with his doctor, I would encourage you to do so. She may be aware of recurrent ear infections or other health problems that could affect his hearing and would benefit from treatment, or she may want to call in a specialist.
In general, however, if a toddler is developing normally in other areas, has an age-appropriate ability to understand language, and can communicate his needs and thoughts non-verbally, I usually feel comfortable waiting a while before recommending a specialist. By age two, if speech is not clearly perking along, I will often recommend formal hearing, speech, and language evaluations. Your child's healthcare provider can help set these up. You also might be interested in the articles on language acquisition posted in the Behavior and Development section of our website.
— by Robert Needlman, M.D., F.A.A.P. |
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