Tongue-Tie Position Statement I am writing to you because I don’t know what else to do. I feel frustrated about the controversial topic of tongue and lip tie. I looked through ASHA’s website but only found a statement from 2005. I would like to formally request that ASHA update its positions on tongue ... Inbox
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Inbox  |   July 01, 2015
Tongue-Tie Position Statement
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Swallowing, Dysphagia & Feeding Disorders / Practice Management / Professional Issues & Training / Inbox
Inbox   |   July 01, 2015
Tongue-Tie Position Statement
The ASHA Leader, July 2015, Vol. 20, 4. doi:10.1044/leader.IN.20072015.4
The ASHA Leader, July 2015, Vol. 20, 4. doi:10.1044/leader.IN.20072015.4
I am writing to you because I don’t know what else to do. I feel frustrated about the controversial topic of tongue and lip tie. I looked through ASHA’s website but only found a statement from 2005. I would like to formally request that ASHA update its positions on tongue and lip tie. Since the publication of Melanie Potock’s post on the Leader blog “Just Flip the Lip.” I am now including a lip-tie/tongue-tie evaluation in my oral mechanism exams. It seems that I can find a new tongue tie every week. For every one professional (otolaryngologist or pediatrician) who says clip it, there’s another one who says don’t. It appears that it’s crucial to find a provider who knows how to properly assess tongue tie. I’m looking for guidance. I hope to see a more recent position statement from our national organization.
Debra Blatt, Commack, New York

The decision to clip the frenulum is a medical decision made by physicians and is not in the scope of practice for speech-language pathologists. The SLP may play an evaluation and treatment role from a speech, feeding or swallowing standpoint, but ultimately the decision—as it is a medical procedure—is up to the physician.

5 Comments
June 3, 2017
Michelle Staryos
Tie
Whether to clip the tie or not is a medical decision - agreed. But it would be beneficial for clinicians to have information on the best practices for diagnosis including associated conditions. There are many medical providers who list associated symptoms, but it is unclear how much of this is evidence-based versus anecdotal information.
July 17, 2017
Lauren Bernhard
Requesting updated and complete position statement
I agree that a complete position statement would be helpful. I often seen children referred to an SLP for feeding concerns and I strongly suspect a tie. Since speech and feeding concerns are often the primary symptoms, ASHA should provide us with support. There is a dearth of providers (e.g., ENT, dentist) who are able and willing to diagnose and treat tongue ties in my area (outside Washington DC). Parents are also often searching for the best evidence, and although more research is being done by ENTs and lactation consultants, ASHA should embrace and participate, as we are often the providers to whom these families are referred!
December 26, 2017
Danielle Castle
Agreed - ASHA update your position statement
I agree. I think we need to take this all into account as clinicians and need an updated position statement from ASHA.
April 23, 2018
Robyn Merkel-Walsh
Clarification from ASHA
I want to be clear because this is being discussed in many Facebook groups. Of course an SLP cannot decide if surgery is warranted but can we DIAGNOSE the tie itself? Thee are classification systems for ties like the Kotlow Scale and as SLP's we clearly have the expertise to look at the tissue and recognize an abnormality. Quite often the insurances want the letter of medical necessity from the SLP, not the doctor is regard to functional impact. I often write "the signs and symptoms of ankyloglossia based on XYZ".
October 11, 2018
Katja Mercado
Posterior Tongue Tie
I agree with all the above posts. My son was recently diagnosed with a posterior tongue tie and lip tie. Ankyglosia was only thought of as an anterior tongue tie by myself and so many other SLPs I know. My son was struggling to safely manage his food, lateralize, form a bolus, etc. We experienced frequent choking episodes, delayed speech, etc. I thankfully found a surgeon who concurred with my findings and was able to educate me. In our field we are not supported with enough literature and conversation about these kinds of ties.
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FROM THIS ISSUE
July 2015
Volume 20, Issue 7