Navigating the complexities of stuttering can bring confusion and anxiety for both children and their families. That’s why I wrote “It’s Just the Way I Talk: Facts About Stuttering for Ages 5-8.” It is a compassionate guide designed to transform uncertainty into understanding and empower young voices.

I’m incredibly proud to share that this book has not only become a steady seller, but it’s also reached #40 in Children’s Books on Physical Disabilities on Amazon. Furthermore, it has been read cover-to-cover numerous times on Kindle Unlimited! This continued success is a testament to the critical need it fills. It provides clear, accessible resources for young children who stutter.

From an SLP’s Heart: Why I Wrote “It’s Just the Way I Talk”

As a speech-language pathologist with over 24 years of experience, I’ve seen firsthand the profound impact stuttering can have on a child’s self-esteem. I vividly recall working with a young boy, Alex, who felt isolated and ashamed, his confidence faltering. During our sessions, a profound realization struck me: Alex, and indeed many other children who stutter, didn’t truly understand what stuttering was.

More importantly, they didn’t realize they weren’t alone in their experiences. This critical gap in understanding became the seed that blossomed into “It’s Just the Way I Talk.” My dream was to create a resource that not only provides factual clarity but also helps children realize they are not alone. Ultimately, the book aims to build their confidence to communicate freely.

Why “It’s Just the Way I Talk” Matters: More Than Just Facts

“It’s Just the Way I Talk” goes beyond simply explaining stuttering. It’s a heartfelt celebration of unique communication styles and a powerful tool for fostering confidence and acceptance. Geared toward early to mid-elementary ages, it’s also proven valuable for older children and adults seeking foundational knowledge.

Here’s what makes it an essential resource:

• Child-Friendly Truths: The book demystifies stuttering (also known as stammering). It provides clear, age-appropriate facts about what it is, why it happens, and why it’s a perfectly normal brain difference – not a fault.
• Fostering Acceptance & Confidence: It gently tackles common questions and anxieties. Children learn they are not alone and that stuttering doesn’t reflect intelligence or ability. This fosters self-acceptance and empowers young readers to embrace their voice.
• Beyond “Fixing”: Focusing on Strengths & Self-Advocacy: The book encourages children to identify their strengths rather than solely focusing on “curing” stuttering. It helps them develop self-advocacy skills and explore the stuttering community, promoting a positive self-image.

• Navigating Reactions from Others: The book offers practical guidance on understanding why others might react in certain ways. It empowers children to communicate their needs, highlighting that well-meaning suggestions like “slow down” or “just relax” might not always be helpful.
• Support for the Whole Family & Beyond: It provides updated information and valuable guidance for parents, teachers, and speech-language pathologists (SLPs). This fosters a supportive communication environment. Additionally, it helps cultivate empathy and inclusivity in non-stuttering children by promoting understanding of communication differences.

Aligning with Evidence-Based Practices

As a practicing SLP for many years, I’ve consistently observed the challenges faced by children who stutter and the need for resources that align with established evidence-based practices (EBPs). “It’s Just the Way I Talk” was carefully crafted to meet these standards. It is recommended by organizations like the American Speech-Language-Hearing Association (ASHA) and the National Institute on Deafness and Other Communication Disorders (NIDCD):

• Psychoeducation: The book empowers children with essential, factual information about stuttering, including its normalcy and lack of control. This directly aligns with EBP recommendations, which helps reduce anxiety in children who stutter. (Ref: National Institute on Deafness and Other Communication Disorders)
• Parent Training: By understanding stuttering and its causes through the book, parents can provide a more informed and supportive environment at home. This is a key aspect of successful stuttering therapy. (Ref: Journal of Fluency Disorders)
• Communication Strategies: The book indirectly introduces communication strategies by encouraging children to communicate what helps them stutter less. This aligns with EBPs that teach children self-advocacy skills and strategies for managing their communication. (Ref: Language, Speech, and Hearing Services in Schools)

“It’s Just the Way I Talk”: What Readers Are Saying

"This book is invaluable for parents, teachers, and therapists, as it promotes empathy and confidence in kids who stutter. It's a must-read that makes a significant difference in understanding and accepting speech differences. Highly recommend ?"

"This empowering book is a wonderful tool for young children navigating the challenges of stuttering. It presents important facts and strategies in a way that is both accessible and encouraging, helping kids feel more confident about their speech. The heartwarming narrative normalizes stuttering, fostering a sense of acceptance and support. Ideal for families and educators, this resource promotes empathy and understanding in a fun and relatable manner."

Integrating “It’s Just the Way I Talk” (For SLPs & Educators)

“It’s Just the Way I Talk” can be a valuable tool in various settings. Here are some ideas for how you can integrate it into therapy sessions, classrooms, or home environments:

• Read the book together: This can spark natural discussions about stuttering. It opens the door for children to share their experiences and feelings.
• Role-playing scenarios: Use the book’s content to role-play how children can respond to well-meaning but unhelpful comments from others. This builds their self-advocacy skills.
• Creative activities: Encourage children to create artwork, write stories, or engage in other creative activities inspired by the book’s themes of acceptance and unique communication.

I’d love to hear from fellow SLPs about how you’re using “It’s Just the Way I Talk” in your therapy sessions! Feel free to share your experiences and creative activities in the comments below.

Join the Movement: Get Your Copy & Spread the Word

Ready to empower a child’s voice and foster greater understanding of stuttering?

Get Your Copy Today!

I’ve priced “It’s Just the Way I Talk” just slightly above cost to ensure it’s accessible to as many families as possible. You can find it on Amazon, or get a 10% discount in my webstore (click here to see all available locations)! Consider purchasing and donating to your local school.

Spread the Awareness!

Every child deserves to feel confident about their voice. You can help us reach more families, educators, and therapists by sharing this post with your network. Please use the hashtag #ItsJustTheWayITalk when you share!

Boost Visibility!

Searching for “It’s Just the Way I Talk” on Amazon and search engines (by both title and relevant keywords like “children’s book stuttering,” “stuttering facts,” “speech therapy resources”) and clicking on it significantly helps. This action allows the platform to recommend it to others interested in communication differences. Your simple search makes a huge difference!

Request at Your Library

Consider requesting the book at your local public and school libraries, and favorite bookstores. Every new placement helps reach more children who need this message!

Your Voice Matters: Leave a Review!

Reviews are the heartbeat of a book’s success, especially for a mission-driven title like ‘It’s Just the Way I Talk.’ Each review, particularly those with comments, significantly boosts our visibility on platforms like Amazon and Goodreads. This helps us reach more children who need to feel confident about their voice. Whether you borrowed or bought a copy, please take a moment to share your thoughts on Amazon, Goodreads, or your library app. Your feedback truly helps us spread this vital message!

Want more empowering resources for stuttering? Check out Empowering Kids Who Stutter: Practical Tips & Resources.

Looking for additional resources to help children develop self-advocacy skills? I also recommend checking out my article Sail Away from “I Don’t Know”: A Treasure Map to Classroom Communication!

Looking Ahead

I’m passionate about continuing to bridge informational gaps. Looking ahead, I’m eager to create similar resources tailored for older children who stutter. These will address their evolving needs as they mature.

Together, let’s celebrate communication in all its forms!

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The post Lifting Up Young Voices: Why “It’s Just the Way I Talk” Continues to Be an Essential Resource for Children Who Stutter appeared first on Mrs. Speech Online.

Teaching children how speech sounds are made is a great instructional activity for both the therapy room and the classroom!  Phoneme categorization is a highly effective activity for developing strong phonological awareness skills in young learners.

By sorting phonemes based on their place of articulation (where the sound is made), manner of articulation (how the sound is made), and voicing (whether the vocal cords vibrate), children gain a deeper understanding of how sounds are produced.  This can aid early learning as it allows children to make connections and organization of the phonemes.

This knowledge is crucial!

Improved Reading and Spelling

Strong phonological awareness is a foundational skill for reading and spelling. By understanding how sounds are created and how they relate to each other, children can more easily decode words, sound out unfamiliar words, and spell accurately.

For Example:

Why do some “long u” words also have a “y” sound in front?  The process of “yod-dropping”, or losing the “y” sound, in American English, generally occurs when the “ū” following an alveolar sound “t,d,n,l,s,z”.  Labials or velars have retained the original “yū” pronunciation, as well as words beginning with a “ū”.  There are exceptions; however, many of those can be traced back to the origin language, such as “puma”, or dialectal differences.

Enhanced Speech Clarity & Pronunciation

Sorting phonemes helps children become more aware of the subtle differences between sounds, which can improve their speech clarity and articulation.

Early Identification of Speech-Sound Disorders

The phoneme sorting activity can help teachers and SLPs identify children who may be experiencing difficulties with speech sound production.

I’ve created a new TPT Easel Activity to help you!  This resource includes 3 phoneme sorting pages, and a full color oral anatomy image, with labels!

Teaching Tips for Phoneme Categorization

• Prior Knowledge: Before introducing phoneme sorting, review letters and their corresponding sounds. Emphasize saying each phoneme in isolation (e.g., /p/ for “p,” not “puh”).
• Watch videos of speech sounds, such as G – How to Make G Sound
• Multi-sensory Learning:
  • Visual: Use mirrors or self-view cameras to allow children to observe their own mouth movements.
  • Kinesthetic: Encourage children to touch their lips, teeth, and tongue as they learn about the different places of articulation.
  • Auditory: repeat the sound multiple times.
  • Tactile: Have children feel the air movement with their hands or light objects (tissues, feathers) when exploring manner of articulation (e.g., stops, fricatives).
• Modeling: Demonstrate the sorting process yourself, thinking aloud as you categorize sounds.
• Guided Practice: Go through each sort together as a class, discussing the characteristics of each phoneme.
• Differentiation: Start with a small set of sounds for younger children or those who are struggling. Gradually increase the complexity.
• Early Intervention: In early learning classrooms, integrate phoneme sorting with letter and sound instruction, emphasizing how sounds are produced.

Extension Activity Ideas:

• Watch how the mouth works in real-time while someone is speaking! It is constantly making fine-tuned movements to produce recognizable speech.
  • This is a great video that shows an MRI of a person speaking and explains some of the sounds: An Introduction to the Vocal Organs – with MRI video
• Explore vowel production: Discuss the places of vowel production (front, middle, back) within the oral cavity. While these sounds involve less physical contact with the mouth, understanding their placement is crucial for comprehensive phoneme awareness.
  • Interact with the Chart | Color Vowel

• Anatomy of the speech system: In addition to teaching oral anatomy, teach students about the anatomy of the entire speech system, from lungs to the nose. This can be effectively integrated into a unit on the respiratory system.
• Expand Phonemic Awareness: Integrate place, manner, and voicing instruction with other essential phonemic awareness skills such as:
  • Blending: Combining phonemes to form words.
  • Segmenting: Breaking words down into individual phonemes.
  • Rhyming: Identifying and generating rhyming words.
  • Alliteration: Recognizing and producing words that begin with the same sound (not letter)

Connect Phoneme Categorization to Reading & Writing:

Analyze Pronunciation

Introduce the IPA

Introduce the International Phonetic Alphabet (IPA) or dictionary-style phonetic symbols alongside graphemes (letters) and phonemes. This helps students understand the relationship between sounds and their written representations. (The image to the right states “You wish you could read this message!”)

Talk About Production

When breaking down phonemes, discuss the oral movements involved in their production. Explore words with unexpected pronunciations, such as “truck” (often pronounced with a /chr/ sound), “Wednesday,” “library” (/laɪbɝi/), “doubt,” or “knight”.

Explain how sounds influence each other within words

For instance, in “butter,” the /t/ sound is often influenced by the surrounding vowels, resulting in a reduced pronunciation (/bʌdɚ/ or /buhder/). Discuss how the voicing of the plural “-s” changes depending on the preceding consonant.

• See my article: Everyday Phonological Processes & Their Impact in the Classroom
• 3.2: Assimilation and Dissimilation – Social Sci LibreTexts

Integrate with Other Language Concepts:

Spelling

Connect phoneme sorting to spelling instruction by exploring spelling rules, guidelines, and the impact of etymology on spelling.

• Spelling Rules & Guidelines
• Spelling: Instructional Guidelines
• Basics: Spelling | Reading Rockets

Etymology

Utilize resources like Etymonline to investigate word origins and their influence on spelling.

• See my article: The Importance of Etymology in the Classroom
  • Etymology
  • The Impact of English Word Origins on Modern Spelling – Lucky Little Learners
  • Etymonline – online etymology dictionary (shows ads)

Morphology

Explore how morphemes (meaningful units within words like affixes) affect pronunciation and spelling.

• Morpheme Mapper – Phonics & Stuff

Collaboration

Teachers and SLPs can collaborate on this! Consider guest teaching or co-facilitate the activity. Both SLPs and teachers provide valuable insights into student needs and offer specific strategies for addressing individual challenges.

Other resources on Phoneme Categorization:

• Place Manner Voice Chart | The Speech Guide
• Understanding Consonant and Vowel Phonemes in English
• Rethinking Spelling Instruction — Reading Rev
• Word Mapper – Phonics & Stuff – phoneme to grapheme tool
• Teaching Tools – Phonics & Stuff – includes word chain builders, phonemic manipulation tool, and sentence generator. There are games and a worksheet creator on other tabs. Some features require a free account, and others require a subscription.

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Have you ever wondered why we often say “comfortable” instead of “comfterble”? Or why “strength” can sometimes sound like “strenkth”? These seemingly random variations in pronunciation are actually fascinating examples of everyday phonological processes. Every time we talk, sounds influence each other.  You might think of these processes as the “peer pressure” nearby sounds exert on each other.

Why do we use processes?

Imagine typing an essay. What if you are only allowed to strike the keys precisely on the center, with good finger & wrist posture.  Would it take you longer to type?  Would it seem awkward and more fatiguing?

Phonological processes, particularly coarticulation, are not random, or even necessarily erroneous, occurrences. They reflect the efficient and dynamic nature of human speech production. 

Our speech system is incredibly complex. Coarticulation allows us to produce speech smoothly and quickly by anticipating and adjusting to upcoming sounds. By anticipating the next sound, we can position our articulators (tongue, lips, jaw) in advance. This makes speech production more efficient and fluid without (usually) impairing the listener’s understanding.

They Happen All the Time

SLPs often focus on phonological processes as patterns of errors in articulation therapy. However, it’s crucial to remember that these processes are also a natural part of everyday speech for all of us.

It’s important to remember that when children are sounding out words, they are often applying these natural and normal “shortcuts” of speech. This means their pronunciations (and spellings) may not always perfectly match the standard pronunciation. Instead, they reflect the natural and dynamic nature of spoken language.

This blog post will explore key phonological processes that we all use everyday, like coarticulation, assimilation, epenthesis, and elision. We’ll discuss how understanding these processes can benefit both teachers and Speech-Language Pathologists (SLPs) in the classroom.

The “Peer Pressure” of Speech Sounds

Assimilation: Similar Sounds Mesh

Assimilation is a specific type of coarticulation where two similarly produced sounds are combined. See the above image where the octagon and circle (similar shapes) combine.  They are both visible, the color of the circle impacted by the color of the octagon. We might compare it to friends who spend a lot of time together, who often start to share similar mannerisms.

Example: “Ten plus two” often becomes “tem plus two.” The /n/ becomes more like the following /p/ sound.  In “I miss you”, the /s/ responds to the “peer pressure” of the /y/, becoming more like the /sh.

Coproduction: Sounds Overlap

In coproduction, another type of coarticulation, sounds that use different articulators are overlapped. In the illustration above, the two circles overlap, but both circles are still visible.  Using our analogy of typing, we anticipate the next key and position our finger accordingly before the current keystroke is fully completed.

Example:   Lips begin to round for the /u/ in “suit” while still producing the /s/.  Words ending with a vowel + nasal, such as “can”, often have some nasality in the vowel.

Epenthesis: Adding Sounds

Epenthesis involves the insertion of a sound that doesn’t exist in the underlying form of a word. Look at the image above, where two shapes become three.  Imagine trying to keep your pants up. You could use a belt or suspenders, or you could even add a small clip to help keep them in place. Epenthesis is similar. It’s like adding a small “clip” (an extra sound) to a word to make it easier to pronounce.

Example: We often pronounce “Athlete” as “ath-uh-lete.”  “Tenth” often has a slight /t/ sound between the /n/ and /θ/.

Elision: Deleting Sounds

Elision is the omission of a sound within a word. See how one of the shapes above is omitted.  Imagine you have a pair of pants that are slightly too long. To make them fit better, you might hem them, essentially “deleting” a portion of the fabric. Elision is similar – we “delete” or omit sounds from words during speech to make them easier and quicker to pronounce.

Example: Frequently, we omit one of two /r/ sounds in a word, such as “caterpillar” or “governor.” We also typically remove the middle “e” in “camera.” We use “shortcuts” like “gonna” instead of “going to”, or “dunno” for “don’t know”.  In fact, contractions are really a form of elision themselves!

Why Do These Everyday Phonological Processes Matter in the Classroom?

Understanding these common speech patterns is crucial for both teachers and SLPs. It provides valuable insights into the complexities of speech, language, and literacy development. Here are some key benefits:

Improved Reading:

• Understanding how sounds change in speech is crucial for developing strong reading skills. Recognizing that sounds can influence each other helps students bridge the gap between spoken and written language.
• Coarticulation plays a key role in fluent reading. When students understand how sounds are produced and how they influence each other, they anticipate how words will sound. This makes reading more fluent and accurate.
• For example, we typically pronounce the /t/ in “butter” as a flap (soft, rapid /d/). Knowing this helps students anticipate and decode the word more easily. It allows students to become more flexible and adaptable readers, able to recognize words in a variety of spoken contexts.
• Furthermore, understanding phonological processes can help students navigate the complexities of dialect in literature. It aids underastanding the regional or cultural “peer pressure” of sounds. This empowers students to better understand and appreciate the diversity of spoken language, and its written representation.

Enhanced Phonics Instruction: 

• Phonological processes help explain the “why” behind seemingly inconsistent spelling rules. For example, to help students understand why “camera” is spelled differently than it sounds, we might teach the concept of elision.
• This knowledge empowers teachers to go beyond rote memorization of phonics rules. By understanding the underlying reasons for these rules, teachers can provide more meaningful and insightful phonics instruction.
• Teachers can use this knowledge to address common student misconceptions about spelling. For example, students may consistently misspell words with frequent elisions. Teachers can explicitly address these patterns and help students understand the connection between pronunciation and spelling.

Spelling:

• Understanding phonological processes can help students become more aware of the discrepancies between how words are spoken and how they are written. Students who know that they pronounce the /t/ in “butter” with a flap understand that it’s still spelled with a “t.”
• Phonological processes can explain why some words are spelled differently than they sound. For instance, knowing about elision can help students understand why “camera” can be pronounced “cam-ra” and why the spelling reflects the full pronunciation.
• This knowledge can help teachers identify patterns in students’ spelling errors and provide targeted interventions. If a student consistently omits sounds that are often elided in speech, teachers can provide specific instruction and practice to address this pattern.

Phonemic Awareness:

• Understanding typical phonological processes helps students develop a deeper awareness of the sounds that make up words. By recognizing how sounds can change and interact within words, students become more attuned to the subtle nuances of speech.
• This enhanced awareness of individual sounds is crucial for developing strong phonemic awareness skills. Phonemic awareness, the ability to identify and manipulate individual sounds in words, is a foundational skill for reading and writing development.

Essential for the Understanding of Everyday Processes:

Before students can truly grasp the intricacies of these everyday phonological processes, they must have a solid foundation in the basics of speech sound production. Understanding place, manner, and voice is paramount. 

Place refers to where in the mouth the sound is produced (e.g., alveolar ridge, lips). Manner refers to how the sound is produced (e.g., stop, fricative, nasal). Voice refers to whether the vocal cords vibrate during sound production. 

This knowledge is essential for recognizing how sounds influence each other and understanding why certain changes occur. For example, to understand why the /n/ in “ten plus two” assimilates to an /m/, students need to know that both /m/ and /p/ sounds are produced with the lips.

See my recent blog post, Developing Phonological Awareness: Phoneme Categorization by Place, Manner, and Voice, for more information on speech sound production!

“Peer Pressure” of Speech Sounds – Activities for the Classroom:

• Minimal Pair Activities: Use minimal pairs (words that differ by only one phoneme) to explore how sound changes affect meaning.
• Sound Sorting: Have students sort words based on how sounds change within them, or where a sound is made.
• Read Aloud: Encourage students to pay attention to how sounds change during reading.
• Discussion: Discuss with students how sounds change when speaking carefully or when in a hurry.  Discuss different dialects and accents.
• Identify Examples:  Find more examples of the above processes, and have students read them carefully with good enunciation. Then have them say them quickly, as if talking to a friend.  Have students identify what sounds changed.
• Tongue Twisters: Use tongue twisters to explore how sounds interact.  Have students identify WHY the tongue twister was difficult!

Conclusion

By explicitly teaching students about the “peer pressure” among sounds – how they influence and shape each other – we can help them become more aware of the subtle nuances of speech. This awareness can significantly enhance their understanding and use of speech, language, and literacy, ultimately leading to more confident readers and writers.

Happy Processing!

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I’ve dealt with chronic teeth grinding (bruxism) and jaw pain (temporomandibular joint disorder, or TMJD) for most of my life. (Read here about how it increased my empathy!) It wasn’t until I was 48 that I learned a surprising possible contributor: a mild, previously undiagnosed, posterior tongue tie.

What is posterior tongue tie?

A posterior tongue tie is further back under the tongue than we traditionally think of a tongue tie.  It is not as easily seen and was previously thought to not have much of an impact on an individual’s health or well-being. I know I’d never heard of it, even as an SLP.

Apparently, I had been compensating for the difficulty in raising my tongue. I was using other parts of my mouth in ways they weren’t meant to be used. For example, while I could move my tongue tip to the spot just behind my teeth, even with my mouth open. However, when I did so, my tongue pulled all the fascia in the floor of my mouth, like the salivary glands, with it. This made the movement much more effortful. 

I could definitely feel the pull when I tried to open wide and touch my tongue tip to the top. To stick my tongue outside of my mouth, especially to the side, I had to compensate. I was using my jaw and lips to increase the range of motion. To swallow, my tongue thrust forward, compensating for the decreased mobility of the back of my tongue.

I share my experience to raise awareness about the complexities of tongue tie. My hope is to encourage others to explore potential connections between speech, swallowing, and other oral health issues with this often-overlooked condition. This information can empower individuals to seek appropriate evaluation and treatment.

What exactly is Tongue Tie?

Traditionally, we think of tongue tie (ankyloglossia) as a simple condition. It involves a short, tight band of vertical tissue running from the bottom of the tongue to the floor of the mouth (the lingual frenulum), which restricts tongue movement. You can see an example of the traditional concept in the picture on the left.  

But the reality is much more nuanced. Current research is beginning to recognize that tongue tie can present in various forms. This includes subtle limitations and attachments further back in the tongue (posterior tongue tie), which may not be immediately apparent.

For years, the focus was on severe limitations, primarily impacting breastfeeding. When I was in graduate school (a quarter of a century ago!), tongue tie was briefly mentioned. At that time, it was considered to impact an individual only if the tip of the tongue could not reach the alveolar ridge. Basically, if the child could breastfeed and say /t/ or /th/, it was considered sufficient.  Which explains why I was first identified as having a tongue tie at 48!

The recognition and understanding of tongue tie are continuously expanding. As we delve deeper, its potential impact on overall health is also becoming clearer. This is an evolving field, with ongoing research to refine assessment and classification methods. Currently, there is no single, universally accepted evaluation protocol. This can sometimes lead to varying interpretations and approaches among healthcare professionals.

However, emerging evidence suggests that even subtle restrictions can have significant, often overlooked, consequences.

New tongue tie assessment protocol 

• Length between tongue tip and the attachment of the frenum to the tongue (Kotlow Free Tongue Measurement)
• Difference between maximum opening of mouth and maximum opening with tongue tip to just behind top teeth
• Difference between maximum opening of mouth and maximum opening with tongue suctioned to roof of mouth
• Compensations – floor of mouth, jaw, lips, neck
• Tension – present or absent in mouth, jaw, neck, etc.

It is the presence of the compensations and tension more than the measurements that are more indicative of a problem with the tongue tie, especially in adults.  And yet, those are the most difficult to consistently “measure,” especially between professionals.

How does posterior tongue tie affect feeding and swallowing?

A posterior tongue tie affects the mid and back of the tongue. It can interfere with the proper movement of the tongue and cause issues with proper feeding and swallowing.  Some experts even argue that a posterior tongue tie is more detrimental than an anterior!

Babies:

• creating the seal needed for breastfeeding
• fussy feeding
• choking, coughing, gurgle sound
• inefficient sucking, can lead to increased air intake during feeding causing excessive spitting up
• Feeding fatigue
• Cracked, bleeding, or severely bruised nipples

Children (and adults):

• poor chewing movement and control of food bolus (clump), which can cause food spillage and/or food left in pockets of mouth
• Poor movement of food bolus to the back of the mouth for swallowing
• Increased risk of choking or gagging
• may result in reluctance to try new textures

The Lesser-Known Impacts of Tongue-Tie

Feeding and swallowing difficulties are well-known to be symptoms of tongue tie in babies. However, the impact of tongue tie can extend far beyond infancy and feeding. It can affect various aspects of oral health and well-being.

Research on the long-term consequences of tongue tie in adults is still ongoing. Furthermore, there is no standardized assessment and classification system for tongue tie, especially posterior. This presents a challenge in consistently identifying and understanding its impact across different individuals.

Oral Motor and Articulation Challenges

• Oral Motor Challenges: Restricted tongue movement can affect oral motor skills crucial for chewing, swallowing, and even breathing.  This may present as difficulty licking lips, blowing bubbles, or clicking the tongue.
• Speech (Articulation) Difficulties:  Because posterior tongue tie is often overlooked, it may be a hidden contributor for children who have trouble with back sounds, such as /k,g,r,sh/.

Dental and Jaw Health

• Dental Issues: Some studies suggest that tongue tie and the resulting poor oral posture can contribute to dental problems. These include crowding, misalignment, and even underbite or overbite.  Tongue positioning has also been suggested to affect the way the upper and lower jaws grow and develop.  This can occur because the tongue plays a crucial role in proper tooth and jaw development and alignment.
• Jaw Pain and Dysfunction: My experience highlights a potential link between undiagnosed tongue tie and TMJ problems. Symptoms include as jaw pain, ear pain, clicking, locking, and limited jaw movement.
• Bruxism (tooth grinding):  Studies suggest abnormal tongue posture and function may exacerbate, or even cause, bruxism. This could potentially contribute to TMJD. A current theory is that some, if not all, bruxism arises from the jaw’s attempt to find a comfortable resting position. Proper tongue posture can naturally provide this comfortable resting position for the jaw.  The exact relationship between tongue tie, tongue posture and bruxism is still under investigation.
• Breathing, Snoring, and Sleep Apnea: While tongue tie can sometimes contribute to sleep-disordered breathing, such as upper airway resistance syndrome (UARS), it’s not a direct cause of sleep apnea. However, good resting oral posture, often compromised by tongue tie, is crucial for healthy breathing. This can lead to mouth breathing, impacting oxygen intake among other things.

Breathing and Sleep Issues

• Mouth Breathing: Good resting oral posture is important for healthy breathing. However, posterior tongue tie can compromise oral posture and can contribute to mouth breathing. Studies have shown that mouth breathing may impact oxygen intake, among other things.
• Snoring: Many people with tongue tie may also have a longer velum (uvula), or soft palate. This soft tissue is likely stretched to compensate for restricted posterior tongue movement, which can increase the risk of snoring.
  • Regular snoring, in both children and adults, should be evaluated by a medical professional.
  • Snoring can significantly disrupt sleep quality, leading to daytime fatigue, difficulty concentrating, and an increased risk of accidents.
  • Furthermore, chronic snoring can increase the risk of serious health problems, including high blood pressure, heart disease, stroke, and type 2 diabetes.
• Sleep Apnea: While tongue tie can, in some cases, contribute to sleep-disordered breathing, such as upper airway resistance syndrome (UARS), it’s not a direct cause of sleep apnea.

The Importance of Early Recognition

Early identification and intervention are crucial. For infants, addressing tongue tie can improve breastfeeding, speech development, and overall oral health. However, it’s important to remember that tongue tie can still be addressed in adults.

My personal journey has been eye-opening. While I may not be able to completely reverse the effects of years of undiagnosed tongue tie, I’m exploring treatment options. My goal is to improve my oral function and overall well-being.

Treatment team can include:

• Pediatrician or General Practitioner: Often the first point of contact for tongue-tie concerns, they can conduct initial assessments. They also refer to other specialists as needed.
• Orofacial Myofunctional therapist – Most often a specially certified dental tech or SLP, they specialize in correcting improper function of the oral and facial muscles. This includes tongue posture and movement.
• Otolaryngologist (ENT) – Specializes in disorders of the ear, nose, and throat. They can diagnose and treat tongue-tie, including performing surgical procedures.
• Dentist – an assess tongue-tie’s impact on oral health, including dental development and alignment. They may also perform tongue-tie release procedures (frenectomy).
• Physical therapist (PT) –  Tongue-tie can sometimes contribute to postural imbalances. PT can help address these issues, such as forward head posture, which can impact oral function.
• Lactation Consultant – Assists with breastfeeding challenges related to tongue-tie, providing guidance to both mother and infant.
• Speech-Language Pathologist (SLP) – Evaluates and treats speech, language, and feeding/swallowing difficulties related to tongue-tie. They can also provide oral motor exercises and therapy to improve tongue function.

A Call to Awareness

This experience has reinforced the importance of:

• Broadening our understanding of tongue tie.
• Early identification and intervention.
• Considering tongue tie as a potential factor in a wider range of oral health and developmental issues.
• More research on classifying tongue tie and how it impacts daily life.

If you have concerns about your child’s speech, feeding, or oral motor skills, consult a qualified healthcare professional. This includes a pediatrician, dentist, or speech-language pathologist. The same applies if you experience any of the issues mentioned above.

Resources:

• Tongue Tie
• Tongue Tie Images, including TRMR-TIP and TRMR-LPS Classifications, and links to information
• How tongue mobility changes face and jaw development
• Correct Tongue Posture: Why correct tongue posture affects your whole face (including your teeth!)
• “Do I Have A Tongue-Tie?” – 5 dimensions of tongue-tie assessment, Dr. Zaghi – The Breathe Course (mostly for professionals, very in-depth)
• Pediatric Sleep-Disordered Breathing and Obstructive Sleep Apnea: The Role of the Speech-Language Pathologist
• Tongue Tie, Airway, & TMJD – Priya Mistry, DDS (the TMJ doc) #tonguetie #airway #tmjd
• What is a Tongue Tie? – Priya Mistry, DDS (the TMJ doc) #tonguetie #nursing #tonguetied

I hope this article provides valuable information and encourages further discussion about this under-taught and often-overlooked condition.

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I’d love to hear from you: What kind of resources do you find would most benefit your students who stutter in developing a better understanding of their speech? Share your thoughts in the comments below!

The Missing Piece: Understanding their own stuttering

Think about it – we spend so much time, and rightfully so, teaching strategies to help ease those bumpy moments in their speech. But how often do we really dig into the “why” behind it all? While doing this, we focus on empowering kids by helping them understand their speech patterns.

I’ve seen so many amazing kids who’ve been in therapy since they were tiny, faithfully practicing their smooth speech techniques with each new SLP who comes along. And yet, when you talk to them, their big questions are often still: “How do I fix this?” and “When can I graduate from speech?” It’s almost like we’re giving them tools without a clear understanding of the landscape they’re navigating.

Beyond “Fixing” the Stutter

Imagine someone with essential tremors just trying to hold still, without knowing it’s a neurological thing. Or someone with nystagmus (involuntary, rhythmic eye movements), where the eyes move in ways they can’t control. It’s kind of the same with stuttering. Knowing this can enable children who stutter by giving them more awareness about their condition.

It’s also important to acknowledge that for young children, early intervention and the teaching of fluency strategies can indeed be highly effective in reducing or even eliminating stuttering. The earlier support is provided, the more neuroplasticity can be leveraged.

However, the longer stuttering persists, the more ingrained it can become, often making complete elimination less likely and the focus of therapy shifting towards management, acceptance, and effective communication. Empowerment lies in knowing how to manage one’s stutter, especially for persistent cases.

Furthermore, the longer a child stutters, the more likely they are to develop negative emotional responses to their disfluency, such as anxiety, frustration, avoidance behaviors, and even shame. These emotional layers can then further complicate their communication experiences, making empowerment a crucial step in therapy.

The Exhaustion of “Smooth Speech” Strategies

For those who haven’t experienced it, try this: for the next half hour, consciously try to use all the fluency strategies we often teach. Go incredibly slowly. Start every consonant with a super soft onset. Pay meticulous attention to every single time your speech isn’t perfectly smooth, every little stumble or word you don’t quite say “right.” Imagine how empowering it can be for kids who stutter to know they’re not alone in this struggle.

It’s exhausting, isn’t it? And for many of our older students who stutter, this isn’t a temporary exercise; it’s their daily reality when they try to mask their natural way of speaking. After years of practicing these strategies, the persistent question echoes: “Why am I still stuttering? Why hasn’t therapy ‘fixed’ it?” Empowering kids who stutter means helping them shift from just managing symptoms to embracing their unique voice.

Empowering Students Who Stutter

That’s why I’m so passionate about education. Kids deserve to know what affects their stuttering – is it stress? excitement? certain words? What’s the deal with incidence rates? (Spoiler alert: it’s more common than many think!). Giving them this knowledge empowers them. It shifts the focus from “fixing” something that isn’t “broken” to understanding and accepting a part of themselves.

This is a big part of why I created “It’s Just the Way I Talk: Facts About Stuttering for Ages 5-8” (reaching #40 in Children’s Books on Physical Disabilities on Amazon!). It’s a gentle way to introduce these concepts to younger kids, empowering them from a young age.

Practical Resources to Foster Self-Advocacy in Kids Who Stutter

And for my fellow educators and therapists working with older students, keep an eye out! I’m diving into the brain research behind stuttering in an upcoming book aimed at those mid to upper grades – because they deserve those deeper answers that empower their understanding of stuttering.

In the meantime, I’ve also put together a resource on Teachers Pay Teachers called “Affirming Stuttering Activities”. It’s packed with activities designed to help students who stutter explore and discuss their experiences, thoughts, and feelings related to their speech. It’s really great for giving voice to kids who stutter.

One tool I’ve found helpful in shifting this perspective is a simple “Speech Self-Rating Scale”. Instead of just focusing on how many stutters they had, students can rate their overall ease of speaking, the tension they felt, how effectively they communicated their message, and their satisfaction with the interaction. This helps them recognize that communication is about more than just fluency.

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Let’s move beyond just the “tricks” and empower our students with knowledge and self-acceptance. Because communication comes in all forms, and every voice deserves to be heard and valued, just the way it is. When we do this, we’re truly empowering kids who stutter to see their voice as valuable and unique.

What comes after the strategies? In my next post, I’ll be exploring the importance of stutter affirming, student-centered goals in stuttering therapy. Don’t miss it!

Talk soon,

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The post Empowering Kids Who Stutter: Practical Tips & Resources appeared first on Mrs. Speech Online.