When Speech Therapy Is Not Working

If your child has been in speech therapy and you are not seeing the progress you expected, it can feel confusing and exhausting. Many parents start questioning everything, including whether they should add more sessions, change therapists, or wait it out.

There is another possibility that is often missed. Speech therapy can slow down or plateau when the body cannot physically perform the movements needed for clear speech. One of the most overlooked reasons is restricted tongue function, sometimes related to a tongue tie. MyoWay Centers for Kids often sees children who have worked hard in therapy for a long time, yet remain stuck because a functional restriction was never evaluated as part of the full picture.

If speech therapy is not working, restricted tongue function may be a reason. Tongue tie can limit tongue mobility, which can make it harder to build clear speech skills, support effective chewing and swallowing, and maintain healthy oral posture. A comprehensive evaluation that includes tongue mobility, breathing, oral posture, and swallowing can help identify what is limiting progress.

Why Speech Therapy Can Plateau

Speech therapy is skill building. Your child is learning to coordinate tongue placement, lip movement, jaw stability, and airflow to create specific sounds. Practice helps the brain and muscles learn these patterns. Speech also requires range of motion. When the tongue cannot lift, extend, or move side to side as needed, a child may still understand what to do and struggle to do it consistently. This can cause the same speech errors to repeat, even with strong effort and consistent therapy.

A plateau often looks like one or more of these patterns:

• Progress happens at first, then slows down

• Certain sounds improve in therapy but do not carry over at home or school

• Speech clarity remains inconsistent

• Your child becomes frustrated or avoids speaking

A plateau does not automatically mean therapy is wrong. It can mean a functional barrier is limiting what therapy can accomplish.

What Is Tongue Tie?

Tongue tie refers to a restriction of the lingual frenulum, the tissue under the tongue. Everyone has a frenulum. The key question is whether that tissue restricts tongue movement enough to affect function. Tongue ties can be obvious or subtle. Some are easy to see. Others are less visible and may be missed if the screening is based on appearance only. Tongue function is more important than what the tongue looks like. A tongue can look normal at rest while still having limited mobility during speech, swallowing, or rest posture.

Why Tongue Function Matters for Speech

Clear speech requires precise tongue movements. Many speech sounds depend on the tongue lifting toward the palate, stabilizing in specific positions, and moving quickly with good control. When tongue mobility is limited, children often compensate. They may shift the jaw, tighten the lips, or use the cheeks more than needed to approximate a sound. These compensations can become habits, making speech errors harder to change through repetition alone.

Restricted tongue function may contribute to:

• Ongoing articulation errors despite consistent therapy

• Difficulty producing certain sounds clearly and consistently

• Fatigue during longer speaking tasks

• Speech that improves in structured practice but not in daily conversation

• Frustration when the child cannot consistently do what they are being taught

Speech therapy can be more efficient when the tongue can move through typical ranges and coordinate smoothly.

Tongue Tie Is Not Only a Baby Issue

Many families have heard about tongue tie in relation to breastfeeding. That is only one part of the story. Restricted tongue function can affect older children in ways that are easier to overlook.

Tongue movement supports chewing, swallowing, and clearing food from the mouth. If tongue mobility is limited, feeding patterns can become less efficient, which can show up as texture preferences or slow eating.

Signs that can suggest a feeding component include:

• Avoiding tougher textures

• Gagging on certain foods

• Taking a long time to eat

• Chewing with an open mouth

• Fatigue during meals

• Difficulty clearing food from the cheeks and teeth

• Preference for softer foods

If speech concerns and feeding challenges happen together, tongue function deserves a closer look.

The Link Between Tongue Posture, Oral Development, and Airway Support

Tongue posture is not just a speech issue. It can also influence how the mouth develops over time. In typical development, the tongue rests gently on the palate with the lips closed. This resting posture helps support the shape of the upper jaw and dental arch as a child grows.

When the tongue rests low in the mouth because it cannot elevate comfortably, the palate may develop differently. Over time, this pattern can contribute to:

• Narrow palate and crowding

• Open mouth posture

• Mouth breathing habits

• Swallowing compensations

• Changes in facial growth patterns

Oral development and airway space are connected. That is one reason MyoWay Centers for Kids evaluates tongue function as part of a broader view that includes breathing and oral posture.

Signs Your Child May Have Restricted Tongue Function

Not every child with speech challenges has restricted tongue function. These signs can indicate it is worth evaluating.

Speech related signs:

• Speech therapy progress has plateaued

• Persistent articulation errors remain despite consistent practice

• Speech improves during sessions but not at home or school

• Your child seems frustrated by speaking tasks

Breathing and oral posture signs:

• Mouth breathing during the day

• Open mouth posture at rest

• Dry lips or chronic chapped lips

• Snoring or noisy breathing at night

• Restless sleep or frequent waking

• Teeth grinding during sleep

Feeding and oral function signs:

• Picky eating with textures

• Gagging easily

• Slow chewing or fatigue during meals

• Difficulty licking lips or clearing food from teeth

• Drooling beyond early childhood

One sign alone does not confirm anything. Multiple signs across categories often indicate the need for a functional assessment.

Why Tongue Tie Is Often Missed

Tongue tie is frequently overlooked because many screenings focus on what is visible. Subtle restrictions can be missed without function testing. Another reason is symptom separation. Speech may be addressed by one provider, feeding by another, and sleep by another. When the care team is not looking at the whole child, patterns can be harder to connect.

Some children compensate well, especially when they are young. The problem becomes clearer later when speech demands increase, orthodontic concerns appear, or mouth breathing and sleep quality issues become more noticeable.

What a Tongue Function Evaluation Should Include

A meaningful evaluation looks beyond whether a tie is visible. It evaluates mobility, coordination, posture, and compensations.

A comprehensive tongue function evaluation often considers:

• Tongue mobility, including elevation, extension, and side to side movement

• Tongue resting posture and lip seal at rest

• Swallowing pattern and compensations

• Breathing pattern, including signs of mouth breathing

• Oral muscle coordination and endurance

• Habits that may influence development and therapy carryover

This type of evaluation can help explain why speech therapy is not producing the expected results.

What MyoWay Centers for Kids Looks For

MyoWay Centers for Kids evaluates tongue function within the full picture of oral and facial development. The goal is to identify barriers that may be limiting speech progress and to support healthy patterns that influence growth.

• Tongue mobility and coordination

• Oral resting posture of the tongue and lips

• Swallowing patterns

• Breathing habits and mouth breathing patterns

• Oral muscle strength and endurance

• Functional habits that may affect development

This approach supports a clearer next step for families who feel stuck, especially when speech therapy is no longer producing steady improvement.

Can tongue tie cause speech problems?

Restricted tongue function may contribute to speech challenges when the tongue cannot move into positions needed for clear articulation. A functional evaluation can help determine whether tongue mobility is affecting speech for your child.

How do I know if my child has a tongue tie?

A tongue tie assessment should be based on function rather than appearance alone. If speech therapy is not working and your child shows signs of restricted tongue mobility, a comprehensive evaluation can help identify whether tongue function is limited.

Should my child stop speech therapy if progress is slow?

Speech therapy often remains valuable. If progress has plateaued, it may help to evaluate whether a functional restriction or oral pattern is limiting the effectiveness of therapy.

Can tongue tie affect sleep or breathing?

Tongue posture and oral development can influence breathing patterns. Some children with low tongue posture and mouth breathing may also have disrupted sleep. A comprehensive evaluation can identify patterns that may be affecting airway support and sleep quality.

Next Steps If You Feel Something Is Being Missed

If speech therapy is not working, consider these steps:

• Ask whether your child has had a tongue function evaluation, not only a visual screening

• Note patterns across speech, feeding, breathing, and sleep

• Seek a whole child assessment that includes oral posture and swallowing

• Avoid assuming your child is not trying when progress is slow

Families often feel relief when they identify a missing functional piece. Clarity helps create a more effective plan and reduces the cycle of guessing. When speech therapy is not working, the solution is not always more practice or more sessions. Sometimes progress stalls because the tongue cannot move well enough to build and stabilize the skills being taught. Restricted tongue function, including tongue tie, can be an overlooked barrier that affects articulation, feeding, oral posture, and oral development.

A comprehensive evaluation can help you understand what is happening and what steps may support better progress.

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