A: Jody, be sure to have your son checked by his doctor to confirm whether he is “tongue-tied.” Approximately 1-2% of children are born with this condition, also known as “ankyloglossia.” This means that your son’s frenulum—the tissue that secures the underside of his tongue to the floor of the mouth—is tighter than usual. As a result, your son’s tongue may be shorter and may not move as well, which might interfere with his speech.

Ask your doctor whether surgery to clip your son’s frenulum would be helpful. Currently, experts recommend having the frenulum clipped if children are experiencing problems such as:

• For newborns—having difficulty sucking, not getting enough milk and failing to grow properly. This is usually apparent in the newborn period.
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• For toddlers—having problems with speech, which usually apparent by 2 to years of age.

By age 3½, most children can speak in three-four-word sentences and have fairly clear speech that adults other than their parents can understand. If your son speaks like a baby, is this getting in the way of his communication and relationships with his brothers, friends, and adults? Might his speech problems be causing him to be frustrated and act out? Talk with your doctor or call your local school district to have your son’s speech evaluated—his speech may be delayed because he’s tongue-tied, or it may be due to other factors such as hearing or developmental problems. They will be able to tell you whether surgery or speech therapy might be helpful. This is the time to get help for your son so he’ll be ready for kindergarten.