Additionally, should a speech therapist suspect enlarged tonsils or that there is an anomalous issue contributing to the tongue thrust, a referral may be made to a pediatric otolaryngologist (ENT).
A tongue thrust is when the tongue is placed forward from the position where it should be placed when producing a sound.
You may have noticed your child say “What a thunny day” instead of “What a sunny day”. The tip of the tongue should be placed behind a child’s teeth for the S sound, not between the teeth. When this occurs, it is called a tongue thrust, or a lisp.
There are two types of lisps – a frontal lisp, where the air comes right out the front of the mouth and a lateral lisp, where air escapes from the sides of the mouth.
I often find that children with tongue thrusts swallow by protruding their tongue out of the mouth. A tongue that consistently pushes forward may displace the front teeth, (as can devices such as a pacifier). In an efficient swallow the tongue tip touches the area just behind, but not touching the top front teeth and then the tongue helps propel food and liquid toward the esophagus (food pipe).
Several things may contribute to the severity of a tongue thrust. Thumbsucking, prolonged breastfeeding, use of pacifiers, bottles and sippy cups (past age one) encourage a tongue thrust. A constant open-mouth posture may result in a forward tongue position. Enlarged tonsils and / or adenoids may cause the tongue to thrust forward as there is not enough room in a child’s mouth for the tongue to fully retract.
Eliminating thumbuscking, bottle drinking, etc. can sometimes resolve a tongue thrust. Other times, help from a speech language pathologist is necessary. A speech therapist can assess the muscles of your child’s mouth as well as his or her articulation. An articulation test can determine which sounds your child is having trouble producing. A good speech therapist will listen to your child say all the English sounds in words, sentences and conversation and examine HOW your child says each sound. Does his or her jaw slide around? Do the lips round appropriately? Does the tongue thrust forward? If weakness is determined, specific exercises as well as more traditional speech therapy techniques can usually resolve tongue thrusting.
Stephanie Sigal, M.A. CCC-SLP provides private speech therapy on Manhattan’s Upper East Side. You can contact her at firstname.lastname@example.org / 646-295-4473.