This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: Is the best approach for ankyloglossia to do a back r?
If the tongue-tip is tied down, the client will be unable to stretch the tip up and back far enough for a Tip R (retroflex R). You will have no choice but to teach a Back R. But, as you know, the Back R can be much harder for many kids. That’s an excellent reason to have the frenum surgically altered.
I always refer a client with a restricting lingua frenum for surgery, no matter their speech problem. This is because the restricting tongue-tip movement does not affect only speech. It also affects oral rest, stage one swallow, stage two swallow, dentition, occlusion, and the client’s overall facial appearance.
The stage one swallow problem is perhaps the most important reason because without the ability to clear the mouth of all food particles in preparation for the swallow, the child can be at risk of aspiration.