WEBINAR | TOTs and Speech: What You Need to Know! [February 22, 2024][12:00PM – 2:00PM Eastern US/UTC-4]

Current Status
Course ended


Robyn Merkel-Walsh, MA, CCC-SLP, COM


As we have learned from Mills et al. in 2019, frena are dynamic structures comprised of collagen fibers and fascia. When ankyloglossia is present the tethering of these fibers may restrict normal tongue movement resulting in functional implications. Ankyloglossia often referred to as “tethered oral tissues/TOTs” and is often the cause of disruptions to the orofacial complex known as an Orofacial Myofunctional Disorder (OMD).

OMDs are also associated with speech sound errors such as an interdental lisp and /or abnormal lingual dental articulatory placement for /t, d, l, n, ʧ, ʤ, ʃ, ʓ/ (ASHA, n.d.). It seems logical that if a tongue cannot move freely, that the movements required for speech sounds may be impacted resulting in atypical or compensatory oral placements, yet it has been suggested that individuals with a tongue-tie can compensate for limited range and speak with alternative articulatory placements.

Clinicians working with Speech Sound Disorders (SSDs) often note a correlation between tongue-tie and speech errors, but this is controversial, and therapists are left confused on which assessment tools and treatment methods are evidence-based. Robyn will discuss possible correlations between SSDs and ankyloglossia, provide an evidence-based review dating back to the 1950’s, and will discuss SSDs in tongue tied speakers and the clinical implications for assessment and treatment.

Participants will be able to:
  1. State at least 1 type of articulation error correlated with ankyloglossia.
  2. List 1 way in which ankyloglossia may impact speech sound production.
  3. Describe an example of how ankyloglossia and speech are correlated in the literature.
  • 10 mins: Introduction
  • 15 mins: Part 1: “but there is no evidence!”
  • 30 mins: Part 2: “but as long as it sounds ok…”
  • 15 mins: Part 3: “but it is just a string!”
  • 30 mins: Part 4: Intervention
  • 10 mins: Summary
  • 10 mins: Q and A

NOTE: there may changes to handouts/resources prior to the start of the workshop -- be sure you have reviewed any versions you may have downloaded to make sure you have the latest version


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Course Content

Continuing 05 Jan 24