Q: My elementary-age client injured her tongue-tip. It has been a few weeks post the accident and her speech is moderately distorted and she still complains of pain. Her doctor says she is just trying to get attention. Do you have experience with this?  

I have worked with a few patients who had injury to the tongue-tip.  In my experience it can take up to a year to fully recover from it.  If some of the nerves were damaged, longer.

The client may have pain and/or tingling in her tongue-tip for some time, so she probably is babying it right now.  Speech will be altered as a result.  She will be trying to protect it by limiting its movement.

The mouth is the most sensitive part of the human body and the tongue-tip is the most sensitive part.  There are more tactile receptors in the tip of the tongue than anywhere else on the human body.  Injuries there feel far worse that anything else.  Damage to the tongue-tip causes a small but very significant area of pain.

I would not brush aside her pain and uncertainty.  Treat this as a severe injury.  The injury there is causing her to re-arrange all her feelings about her speech, which, as you know, are integral to the personality and the self.  Let her feelings about this unfold over time.  An injury to the tongue-tip affects us like nothing else.  It is somehow more personal and scary than other injuries.

I broke both my arms when I was 10 years old and I did not experience near the trauma as the clients I have seen with tongue-tip damage — the adults I have seen have told me that their injury had a significant impact on them.