Doctor Stewart, Otorhinolaryngologist-in-chief at New York Presbyterian Hospital, explains how children with tongue tie have trouble pronouncing certain sounds correctly.

Doctor Stewart: The classic sounds that are tongue tip sounds are things like L, D, Z. Those all require contact between the tip of the tongue and the teeth. It's interesting, many children don't have a lot of speech problems or they're relatively mild, and many times people don't pay much attention to it. They think it's just kind of cute, child-like speech. Doctor Stewart: Say John Luke. Billy: John Guke. Doctor Stewart: Or they sound a little bit muffled in the way they say certain things. Doctor Stewart: Say doggy dog. Billy: Doggy dog. Doctor Stewart: It's important to try to distinguish that from what's actually a real problem. You can learn to compensate pretty well, and kids do, and actually make something that sounds very like the sound you're trying to make, even with a pretty significant tongue tie. You generally can't see it, but what they're actually doing is that they can't pull their tongue forward, to make a T, they will actually do it by using some other you know contact point in the mouth, he, or something where they're using the sides of the tongue or they're using something with their teeth, for example, and it's sort of subconscious. Doctor Stewart: Say lollipop. Billy: Lollipop. Doctor Stewart: But the classic sounds that are tongue tip sounds are things like L, D, Z, those all require contact between the tip of the tongue and the teeth or the upper part of the pallet. And when that's missing, then in fact children can't make those sounds. Billy: You're supposed to do it right. Doctor Stewart: So they'll develop speech. They'll be acquiring language, they'll be understanding words, there's no problem related to that, but it'll be some sounds aren't quite right and the articulation's not quite right.