Tod­dler Q&A

Your Baby & Toddler - - Contents - Dr Si­mon Stra­chan Pae­di­a­tri­cian

Q: My two-year-old daugh­ter has a prob­lem say­ing any­thing with a “t”, “d” and “i” sound. Be­cause of this, she’s quite shy around her peers and only talks when prompted by her dad and me or her teach­ers.

Her lower teeth also have gaps between them. A friend men­tioned that I should con­sider that my daugh­ter may have tongue-tie. I’ve never heard of this be­fore. What is tongue-tie, and how is it fixed?

A: Dr Stra­chan an­swers: The frenu­lum is the cord that at­taches the un­der­side of the tongue to the floor of the mouth. Tongue-tie refers to the con­di­tion that oc­curs when the cord re­stricts the move­ment of the tongue and this presents as:

• Poor feed­ing and prob­lems with suck­ing

• Poor ar­tic­u­la­tion and dif­fi­culty with the sounds per­formed by the tip of the tongue, for ex­am­ple, “t”, “d”, “n”

• Ab­nor­mal den­ti­tion, with gaps between the in­cisors

• The in­abil­ity to push the tongue over the bot­tom teeth

• In­vis­i­bil­ity of the tip of the tongue, which is also heart shaped

I would not ex­pect a two-year-old to be pro­nounc­ing all sounds cor­rectly. On aver­age, two year olds say 50 words, are able to name body parts when they are pointed out, and will be say­ing sim­ple two-word com­mands. Your two-yearold has no idea that she’s not say­ing the sounds cor­rectly.

Chil­dren of this age have just reached the stage where they are com­fort­able play­ing on their own, out of sight of their care­givers, for short pe­ri­ods of time. I think that she should be given the time to de­velop. Ac­cept that this is a process that will hap­pen at dif­fer­ent paces in dif­fer­ent chil­dren.

She’s prob­a­bly way ahead of the aver­age for a two-year-old in terms of her vo­cab­u­lary, but her mis­takes in pro­nun­ci­a­tion may well be com­pletely nor­mal for her age.

The abil­ity to com­mu­ni­cate re­quires the de­vel­op­ment of speech, which is the abil­ity to say words clearly and cor­rectly, and the de­vel­op­ment of lan­guage, which is the abil­ity to com­mu­ni­cate ver­bally, non-ver­bally and in writ­ing.

As far as speech is con­cerned, a twoyear-old is still very much in the phase of ac­quir­ing words and learn­ing how to struc­ture un­der­stand­able sen­tences. The pro­nun­ci­a­tion will de­velop with time. We should not cor­rect the mis­pro­nun­ci­a­tions but rather let chil­dren speak freely.

As long as a two-year-old is com­mu­ni­cat­ing ef­fec­tively, can hear prop­erly and re­sponds to and un­der­stands com­mands, pro­nun­ci­a­tion can be dealt with from about three years of age. Gaps between baby teeth are very com­mon and do not re­flect the ap­pear­ance of the per­ma­nent teeth.

All that hav­ing been said, there are def­i­nitely chil­dren who bat­tle to speak be­cause of tongue-tie.

Tongue-tie looks dif­fer­ent in each child, so if you sus­pect that your child has tongue-tie, see your doc­tor.

Tongue-tie is cor­rected by snip­ping the cord, and this will re­lease the tongue to work nor­mally. Tongue-tie in new­born ba­bies is usu­ally a tem­po­rary prob­lem be­cause the cord length­ens as the jaw and the tongue grow.

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