Doctor Stewart, Otorhinolaryngologist-in-chief at New York Presbyterian Hospital, recommends that children have a speech pathology evaluation as it can determine when (or whether) surgery is needed.

Doctor Stewart: I do think it is generally a good idea, in older children to have at least a speech pathology evaluation before surgery. I think it's a good idea to have a speech pathology evaluation at some point in a child who has a tongue tie. It's not something that's mandatory, particularly if it's caught relatively earlier and it's obviously an anatomic problem even before the child has developed much speech, they're probably not a big role for it. Many times the speech pathologist is simply going to confirm, indeed there is a tongue tie which is causing functional problems, and they'll recommend that it be divided. And certainly if there's any questions, the speech pathologist is very sophisticated in their understanding in speech development and can really do a very good job of analyzing what the child is doing and figuring out if they're compensated and so on. I do think it is generally a good idea in older children just to make sure the speech pathologist doesn't tell you, "By the way there's another thing we need to consider, maybe we should do some other things before we divide the tongue tie," for example, that would be unusual but it's possible.