Do you ever wonder why your child’s tongue seems to always be in the way? Or why does your partner’s speech sounds a bit different than others? It could be signs of tongue thrust. This post will explain what is tongue thrust and how you can stop it at home and with speech therapy.
In babies, tongue thrust is normal. It is a reflexive action that helps them with breast or bottle feeding. The tongue pushes forward and the lips close around the nipple. This is called the tongue-thrust reflex and it goes away after a few months.
For some children, the tongue-thrust reflex does not go away. The tongue continues to push forward against the teeth when swallowing. This can cause problems with speech and how the teeth line up.
When is it a concern?
Tongue thrust becomes a condition when children and adults continue to push the tongue against their teeth or position their tongue forward between their teeth when speaking or swallowing. A tongue thrust condition is sometimes called a tongue thrust habit or orofacial myofunctional disorder (OMD). Myofunctional Disorder is a general term describing a tongue thrust, reverse swallow, or other tongue and/or face muscles that do not function correctly.
The biggest concern with tongue thrust is that it can lead to speech problems. If your child has tongue thrust, you may notice that their speech sounds are different from other children their age as it alters the tongue’s natural placement. Adults who are tongue thrusting may sound like they’re mumbling or slurring their words.
Most people tongue thrust when they are sleeping. This is because, during sleep, the tongue falls back into the throat and partially obstructs the airway. This can cause snoring or obstructive sleep apnea.
Characteristics of a Tongue Thrust
There are different tongue thrust characteristics, which may include:
Pushing tongue against teeth at rest
Pushing tongue against teeth when speaking or swallowing
Drawing tongue back into the mouth after a swallow
Smacking lips together after a swallow
Tongue visible at rest or during the speech, especially when the tongue is protruding between the teeth
Get rid of the tongue thrust with speech therapy
Causes of Tongue Thrust
Tongue thrust can be caused by several factors, including:
Anatomical factors such as:
Ankyloglossia or tongue-tie: tongue-tie is a condition where the tongue is tethered to the floor of the mouth by a band of tissue (lingual frenulum), which limits tongue movement. This can make it difficult for children to correctly place their tongues when speaking or swallowing.
Structural deviation to the jaw: An overbite, underbite, or open bite When the teeth and jaws are not properly aligned, it can cause tongue-thrusting habits as the tongue tries to compensate for the misalignment.
Cleft lip or palate: A cleft lip or palate is an abnormal opening in the lip or palate (roof of the mouth). This can cause a tongue thrust because the tongue may try to fill in the opening. Tongue thrust can often be seen in children who have had surgery to repair a cleft lip or palate.
Upper Airway obstruction: people with enlarged tonsils or adenoids can show signs of tongue thrust by partially obstructing the airway and the tongue falling back into the throat.
Missing teeth: When teeth are missing especially in the front of the mouth, the tongue can fill in that space. This can cause tongue thrusting.
Macroglossia: this is a condition where the tongue is larger than average. This can make it difficult to correctly place the tongue when speaking or swallowing.
Neurological conditions such as:
Cerebral palsy: Cerebral palsy is a neurological condition that can cause tongue thrust by affecting the muscles used for speech and swallowing. They may or may not show signs of tongue thrust.
Down syndrome: tongue muscle tone can be affected in people with Down syndrome, which may lead to tongue thrusting. Down syndrome speech therapy can assist in rectifying this, as well as other methods of treatment. Adults/children with Down syndrome and speech therapists often work together.
Autism Spectrum Disorder: Autism spectrum disorder is a neurodevelopmental disorder and tongue thrusting is a common symptom of autism.
Habits such as
Thumb-sucking or extensive use of pacifier: sucking on a pacifier or thumb beyond the age of 4 may develop the habit of pushing the tongue against teeth as it gets used to the sensation.
Nail-biting: like thumb sucking, nail-biting may also show signs of tongue thrust as it can also change tongue muscle tone and movement.
The Consequences of Untreated Tongue Thrust
If tongue thrust is not corrected, it can lead to several problems, such as:
Dental problems: tongue thrusting can cause an overbite or open bite. When the tongue pushes against the teeth, it can cause them to become misaligned.
Speech problems: tongue thrust can cause speech problems in both children and adults. This is because tongue thrust can change the way the tongue moves and the muscles around the tongue can become weak. This can cause problems with articulation, such as lisps or difficulty making certain sounds.
Swallowing problems: tongue thrust can also cause difficulty swallowing. When the tongue pushes against the teeth, it can change the way the tongue moves, and the muscles around the tongue can become weak. This can cause problems with chewing and swallowing food.
Adults with untreated tongue thrusts may also have trouble with:
Kissing: tongue thrust can make it difficult to kiss because it can change the way the tongue moves.
Smoking: tongue thrust can make it difficult to smoke because it can change the way the tongue moves.
How Does Tongue Thrust Impact Speech?
Speech characteristics may include:
Lisp – tongue is protruding between the teeth during speech, making S and Z sounds difficult to produce correctly.
Nasal air escape – tongue is not blocking the air from coming out through the nose, causing M and N sounds to be nasal.
Hypernasal speech – tongue is not blocking the air from coming out through the nose, causing speech to sound “stuffy”.
Monotone or flat vowel production – tongue placement is too far back in the mouth, making it difficult to produce certain vowel sounds correctly.
Hyponasality – tongue is not blocking the air from coming out through the nose, causing speech to sound “stuffy”.
If left untreated, tongue thrust can cause problems with speech. Children who tongue thrust may have difficulty making certain speech sounds such as “t”, “d”, “n”, “l”, and “s” because tongue placement is altered. They may also have trouble with tongue movements needed to make “k”, “g”, and ” hard c” sounds. This can lead to sound distortions or omissions in speech. Additionally, tongue thrust can cause problems with teeth alignment which can further impact speech development.
Tongue thrust is especially common in children who have had surgery to repair a cleft lip or palate. This is because tongue movement may be affected by the surgery. Children who tongue thrust after cleft surgery may have difficulty making certain speech sounds such as “p”, “b”, “m”, and “w”.
Children with habits such as thumb-sucking or nail-biting can also cause tongue thrusts. This is because these habits can change tongue muscle tone and movement. Children who tongue thrust because of these habits may have difficulty making certain speech sounds such as “t”, “d”, “n”, and “l”.
What is Tongue Thrust and its Impact on Swallowing?
Swallowing Characteristics may include:
Eating or drinking slowly
Chew each bite for a long time
Taking small bites or sips
Spills food from the mouth when eating
Tongue thrust can also impact the way a person swallows. People who tongue thrust may have difficulty with tongue movement needed for normal chewing and swallowing. This can lead to drooling, changes in eating habits, and/or messiness when eating. Additionally, tongue thrust can cause problems with teeth alignment which can further impact chewing and swallowing.
Children with Down Syndrome, cerebral palsy, and autism often have difficulty with tongue movement needed for normal swallowing. This can lead to drooling, changes in eating habits, and/or messiness when eating.
How is Tongue Thrust Diagnosed?
If you’re concerned that your child may show signs of tongue thrust, the best thing to do is to consult a physician to cancel out any other medical conditions that may be causing tongue thrusting. You may also consult a dentist or an orthodontist to check for any problems with teeth alignment.
Your physician may refer you to a speech-language pathologist (SLP) for further evaluation. The SLP will ask about your medical history and your family’s medical history. They will also ask about your child’s development, eating habits, and speech patterns and explain to you what is tongue thrust.
During the evaluation, the SLP will observe your child’s tongue movement during various tasks such as at rest, speaking, chewing, and swallowing. They will also assess your child’s speech production and teeth alignment. Based on the evaluation, the SLP will develop a treatment plan to help your child correct tongue thrusting.
What is the treatment for a Tongue Thrust?
The good news is that tongue thrust is treatable! If caught early, tongue thrust can be corrected with speech therapy. Tongue thrust therapy will likely focus on changing tongue placement to improve the habit of pushing the tongue against teeth and position as well as retraining the muscles to correctly place the tongue when speaking or swallowing. In some cases, myofunctional speech therapy may also be recommended. This type of tongue thrust speech therapy focuses on tongue muscle exercises to improve tongue movement and placement.
Tongue thrust braces are also an option for treatment. These devices work by holding the tongue in the correct position and help to retrain the muscles to correctly place the tongue when speaking or swallowing.
If you think your child may be tongue thrusting, don’t hesitate to reach out to a speech-language pathologist for an assessment. With treatment, tongue thrust can be corrected and your child can get back on track for developing clear speech!
Psychological Effect of Children or Adults with Tongue Thrust
While tongue thrusting is a common condition, it can still have a psychological effect on both children and adults. Many people feel embarrassed or self-conscious about their tongue thrusting, which can lead to low self-esteem and social anxiety. If you or your child are tongue thrusting, it’s important to seek treatment to correct the condition. With treatment, tongue thrusting can be corrected and you can regain confidence in your speech!
Tips for Parents:
If you think you still are not sure what is tongue thrust or your child may be tongue thrusting, the best thing to do is to consult with a speech-language pathologist (SLP). In the meantime, there are some things you can do at home to help!
Encourage your child to use their tongue when eating. This will help them get used to the sensation of tongue movement and placement.
Have your child practice tongue exercises such as tongue twisters. This will help them to improve tongue muscle coordination.
Make sure your child is getting enough oral sensory input. This can be done by chewing on different textures of foods or using a tongue vibrator.
If your child is sucking their thumb or using a pacifier, try to break the habit. This will help to prevent tongue thrusts from becoming a permanent habit.
By following these tips, you can help your child get on track for improving their tongue thrust!
When To Seek Professional Help
If you or your child still tongue thrusts after trying some of these tips at home, it’s important to seek professional help. A speech-language pathologist can provide you with tongue exercises and other treatments to help correct tongue thrust. With treatment, tongue thrusting can be corrected and you can regain confidence in your speech!
As always, if you have questions, and would like to speak with a speech-language pathologist, please reach out to us at Better Speech for a consultation.
We will do our very best to answer your questions and offer you more guidance as to how you can start working toward solving your speech problems and start receiving speech therapy for your child! At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.
About the Author
Mikee Larrazabal
I am a Speech-Language Pathologist with 14 years of experience working with children and adults who have communication difficulties. I completed my Bachelor of Science degree in Health Science at Cebu Doctors' University and have been helping people overcome their communication challenges ever since.
I have worked with individuals of different ages, including toddlers, preschoolers, school-aged children, adults and seniors. I'm passionate about speech therapy and take great satisfaction in helping people overcome their communication challenges and improve their lives through better communication skills. In my spare time I like reading books, going hiking in nature and taking care of my dog Locas.
