My two-year-old son was diagnosed with autism in August 2017. While it was an uphill journey for our family, we eventually got into a good routine. We decided to put speech therapy on hold, until he has better eye contact and a longer attention span. He is in occupational therapy twice a week.

Occupational therapy sessions are quite heart-wrenching for me as I sit outside the classroom listening to him cry for the full hour. I am slightly consoled by the fact that no tears accompany this crying of his, yet my heart still breaks a little with every outburst. Therapy, although still in the very early stages, is helping. We see some improvements in my son.

One of the biggest changes I noticed was the fact that he started to play with his tongue. He would stick it out and this is when I realised his tongue would curl inwards to the bottom ever so slightly. I also noticed that he did not move his tongue in an upwards directions. Some months ago, I was told about a condition called ‘tongue tie’ – a condition where the strip of skin connecting the tongue to the bottom is shorter than usual. So, I began to research this condition only to confirm my suspicion. My toddler was tongue tied.

How to spot it?

Medically, tongue tie is called ankyloglossia. Most tongue ties are detected at birth or during newborn check-ups. Signs include: trouble breastfeeding, restricted movements of the tongue, and the tongue looking like a notch or shaped like a heart when stuck out. Since I went through a C-Section, I assumed that I was unable to breastfeed, so he was a formula baby.

Treatment

For young babies (below the age of one), releasing the tongue tie is a fairly simple procedure done under local anaesthetic in a clinic. However, with older toddlers who already have teeth, it can be performed under General Anaesthetic (GA). Tongue ties are commonly treated by Oral and Maxillofacial Surgeons (sometimes referred to as Dental or Oral Surgeons) and ENT specialists.

Our experience

I made an appointment with an Oral & Maxillofacial Surgeon. I knew the physical examination was going to prove challenging as my son did not like strangers or anyone touching him. To my surprise, his crying loudly at the sight of the doctor worked in our favour as it gave him a clear view of the tongue tie. The doctor confirmed it immediately and also told us the procedure would be done under GA.

Pre-operation

My son and I checked into the hospital the night before the procedure. Needless to say it was a sleepless night. We had two other neighbours. All three patients took turns keeping their parents awake the entire night. The next morning, it was time to wheel him into the operating theatre. The operating theatre and its bright lights intimidated me ever so slightly. The anesthesiologists and surgeons assured me that I could stay with my son until he was unconscious. It took five people (including me, hugging him) to hold him down, and get the gas mask on him. The next part happened very quickly – he was put onto the operating table and I was told to leave the room. This was when anxiousness set in. I felt a sense of dread as I walked to the waiting area. Yes, it was a small procedure, but seeing my son unconscious on an operating table is something I hope to never see again. Safe to say, it was the longest hour of my life.

Post-op

My name was called and I ran into the recovery room without looking back at my husband and mother who were waiting with me. Something told me my son was awake and true enough he was. He was scared and groggy from the anaesthetic. I tried my best to calm him down, but I needed help, so my husband was called in to assist. After some time, my son simmered down. The surgeons came over to update us.

There are four classes of tongue tie according to the length of free tongue – the distance from the tip of the tongue to the attachment of the frenum. Class I (12-16 mm) is mild, Class II (8-11 mm) is moderate, Class III (3-7 mm) is severe, and Class 4 (<3 mm) is complete.

The length of my son’s free tongue was 3mm and after the release, it is now 15mm. He had 4 dissolvable stitches under his tongue. Within the next two hours, my son managed to drink water and even had a good lunch. Since his vitals were normal, and he was active, we were discharged and went home the same day. His recovery was quick. As soon as we were home, he was back into his normal routine, eating well and there were no signs of pain from his ordeal.

 

What next?

Following these type of procedures, speech therapy is usually prescribed. So far, my son has been for one session but due to his lack of eye contact and reduced attention span, the session was not as effective as we hoped. He is still in Occupational Therapy and his eye contact and attention span is slowly improving. My husband and I are not in a hurry for our son to be speaking in full sentences. With the right kind of help, we believe our son will develop in his own time. We are just glad to remove any obstacles that may be preventing his speech.

 

By Desiree Kaur

Desiree Kaur worked in Public Relations for over 8-years until she ventured into teaching. She now owns a tuition centre and spends most of her time with her 2-years old son.