Tongue Tie 101 for SLPs: What Is Our Role?



Ankyloglossia, or tongue tie, has recently become an area of discussion and sometimes controversy for SLPs. To ignore it, or not to ignore it? To refer for surgical procedure, or not to refer? To accept speech that “sounds okay” in the presence of tongue tie, or to emphasize precise speech production? To delve deep enough to see if there is far more than meets the eye, or to leave it to other professionals to make the decisions?

by Sandra Holtzman, M.S., CCC-SLP, C.O.M.

Course Overview

This course will shed light on these dilemmas. Participants will get an overview of the consequences of tongue tie as related to infant feeding issues, dental concerns, emotional and social aspects, phase one swallow considerations, and most importantly the speech connection! Participants will be introduced to assessments and various techniques used to release the lingual frenum. Offered for 0.25 ASHA CEUs – 2.5 contact hours (Run Time: 2:28:13).

Course Format

Video PowerPoint presentation with author narration and downloadable handout.

Course Objectives

At Course conclusion, participants will be able to:

  1. Understand the link between ankyloglossia and certain types of speech disorders.
  2. Define and describe ankyloglossia in its many forms.
  3. Describe the deleterious effects of tongue tie on normal oral motor functions including the preparatory stage of the swallow process.
  4. Utilize the QTT “quick tongue tie assessment” for tongue tie.
  5. Become familiar with two types of formal assessments.

Course Completion Timeframe: You have unlimited time to complete this online course. You may log off and log on as you wish in order to complete all sections of this course. Content Access: Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the E-Courses tab, and then viewing your desired course. Certificate of Completion: On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on the Eastern Standard Time Zone), and number of contact hours (CEUs / CEEs). Reviews
“I appreciated the information on infants as well as the great pictures and video examples.” – M.F. (Feb. 2017) “I love the diagnostic information that was given. This topic was not covered enough in coursework in college. I basically knew what a tongue tie was, but had not idea what to look for in diagnosis. I liked the pictures of different types of tongue tie and the confirmation of thoughts about the difficulties. I would have liked more in the form of therapy to do after surgery.” – H.H. (Feb. 2017) “I enjoyed the review of the recommended assessment tools and current, research-based guidelines for diagnosis and recommendation for surgery.” – M.B. (Jan. 2017) “I found the assessment portion of the course to be most beneficial. I appreciated the numerous photos of actual cases of ankyloglossia as they were helpful in learning how to identify the condition.” – E.C. (Dec. 2016) “The portion on what to do when a child with tongue tie is referred to you for speech therapy but is not responsive was really helpful.” – M.C. (Dec. 2016) “Loved the personal testimonies! There is definitely an emotional component. These poor children/adults do have anxiety!” – K.Z. (Dec. 2016) “I liked the pictures of specific cases to help become comfortable with determining need for surgery. However, I expected specific exercises to be done after surgery, especially with infants and toddlers, to be covered.” – A.P. (Dec. 2016) “I appreciated the discussion of submucosul and embedded frenum. The pictures were very informative.” – M.K. (Nov. 2016) “Going over the tests that can be used to determine need for surgery was helpful. The visual aids helped a lot with the course.” – T.P.T. (Nov. 2016) “The discussion regarding breast feeding was beneficial in regards to evaluating smaller babies that may have a tongue tie. The content was very organized and easy to follow.” – E.G. (Oct. 2016) “I really appreciated the visual and functional signs of ankyloglossia beyond limitations in speech sound production. VERY thorough course given the focal topic; very comprehensive course.” – M.R. (Oct. 2016) “I liked the tangible means of quantifying the impact of ankyloglossia on oral motor movements.” – A.D. (Sept. 2016) “This eCourse was extremely comprehensive. The presenter was very knowledgeable about the field and presented the information in an accessible manner.” – S.W. (Aug. 2016) “I found the information to be so much more updated and honestly made more sense than what I learned in school now nearly 20 years ago. I liked that it gave no nonsense advice for practicing SLPs.” – A.W. (Aug. 2016) “I appreciated going over the importance of evaluating the structure as well as functionality of the tongue to help determine the severity of the tongue tie.” – P.V.H. (July 2016) “The entire course was very informative and kept my attention as I learned something new with each section and case study as well as reported studies.” – J.L. (June 2016) “It was an overall great course. Research mixed in with practical experience and implementation. I have a patient who just had a frenectomy, so the explanation on protocol of what to do post surgery was especially helpful.” – C.M. (June 2016) “Covered a very relevant topic and provided a lot of factual information about it with specific examples and visuals and resources.” – R.W. (May 2016) “She presented a lot of visuals and videos that were helpful when using a lot of medical terminology. All was helpful.” – A.E. (April 2016) “The discussion on the various handicaps that tongue tie can place on a person was really beneficial. I liked the visuals and the clear audio explanations.” – E.G. (Mar. 2016) “I liked the many images of a variety of types of tongue ties.” – K.B.V. (Feb. 2016) “I really appreciated the discussion on what else to consider rather than just a heart shape tongue.” – K.D. (Feb. 2016) “I found the variety of case studies vary useful in helping me gain a better understanding in what to look for and how it can negatively impact an individual. I appreciated the useful information about this topic including assessment tools and therapy recommendations.”– L.R. (Feb. 2016) “The discussion on assessment measures for determining when a sx is warranted was helpful.” – K.H. (Feb. 2016) “Learning the many things that are affected by the tongue tie was most beneficial.” – C.J.R. (Feb. 2016) “I found the way to diagnose a client with ankyloglossia very informative. Ms. Holtzman was knowledgeable and easy to listen to. The information was easy to understand.” – N.H. (Feb. 2016) “I appreciated all of the visuals and pictures. I have a better idea of what I am looking for and how to direct my clients now.” – J.G. (Feb. 2016) “Learning the different ways your tongue can be tied was really beneficial.” – K.W. (Feb. 2016) “Tongue tie is often present with children I work with. I liked the data and assessments discussed.” – S.B. (Jan. 2016) “Excellent visuals, video clip examples, and definitions. Easy to follow and navigate.” – J.R. (Jan. 2016)

Additional information


mobile/ ipad/ laptop


Video / PDF

You may also like…