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Understanding tongue thrust from the perspective of a speech therapist!

Updated: Aug 23, 2023

A girl child with tongue thrust

As speech therapists we often come across various conditions that have a profound impact on the lives of individuals of various age groups ranging from children to old age. One such challenge is tongue thrust, a condition that affects speech and swallowing patterns. In this blog, I aim to help you understand the characteristics, causes, and how tongue thrust influences speech.

Characteristics of Tongue Thrust:

Tongue thrust, medically termed Orofacial Myofunctional Disorder, is characterized by the abnormal placement and function of the tongue during various activities, such as speaking, swallowing, and resting. Unlike the natural resting position against the palate, individuals with tongue thrust often have a forward or lateral tongue movement that places pressure against the teeth or pushes them apart.

During swallowing, the tongue may protrude between the teeth, causing what is commonly known as an "open bite." This positioning during rest or swallowing can lead to dental misalignment over time, leading to both functional and aesthetic issues. Speech sounds involving the "s," "z," "th," and "sh" are particularly affected due to the improper tongue placement.

Various epidemiological studies have reported prevalence of tongue thrusting to be 40-80% in children between age 4 and 6 years, and 3-25% for children between age 12 and 15 years.

Causes of Tongue Thrust:

Tongue thrust can occur due to a variety of causes, both physiological and habitual. Here are some common factors:

  1. Childhood Habits: Prolonged thumb-sucking, pacifier use, or bottle feeding till later ages can influence tongue placement and muscle development, leading to tongue thrust.

  2. Improper Tongue Posture: In some cases, individuals develop incorrect tongue posture due to an imbalance in muscle coordination. This can also occur due to factors such as nasal congestion, allergies, or even habitual mouth breathing.

  3. Genetic Factors: Genetic predisposition can play a role in the development of tongue thrust, due to improper placement of certain oral structures.

  4. Anatomical Abnormalities: Structural issues in the oral cavity, such as a high arched palate, enlarged tonsils, or a restricted lingual frenulum ("tongue tie"), can contribute to tongue thrust.

  5. Neurological Factors: Conditions that affect neuromuscular coordination, such as cerebral palsy, can result in tongue thrust due to difficulty in controlling tongue movement.

A small kid showing the tongue outside

How Does Tongue Thrust Impact Speech:

Tongue thrust can have a significant impact on an individual's speech and communication abilities. The most affected sounds include those involving the tip of the tongue, such as "s," "z," "th," and "sh."

  • Lisping: The most common speech issue associated with tongue thrust is lisping. The tongue's incorrect placement against the teeth can lead to the distortion of "s" and "z" sounds, resulting in lisping.

  • Sound Distortions: Beyond lisping, tongue thrust can lead to distortions in other sounds, impacting overall clarity and understandability of speech.

  • Articulation Challenges: Articulation, the process of forming speech sounds, becomes challenging due to the altered tongue posture, leading to frustration and decreased confidence in communication.

  • Vowel Sound Changes: Tongue thrust can also indirectly affect vowel sounds, as the tongue's incorrect resting position can influence the overall oral posture, altering the quality of vowels.

Treatment of Tongue Thrust:

Treating tongue thrust demands a multifaceted approach, addressing both the physical and behavioral aspects of the condition. Here are a few common approaches employed for its treatment:

  • Orofacial Myofunctional Therapy: This therapeutic technique focuses on retraining the muscles involved in speech, swallowing, and overall oral function. Through targeted exercises, individuals learn to correct tongue posture and strengthen oral muscles, thereby reducing the habitual forward or lateral tongue movement.

  • Articulation Exercises: Speech therapists design exercises that target the specific sounds affected by tongue thrust. By practicing proper tongue placement during sound production, individuals gradually regain control over their articulatory patterns.

  • Collaboration with Orthodontists: In cases where dental misalignment is present, collaboration with orthodontists is vital. It helps in improving structural issues and ensuring proper tooth alignment.

Recognizing that every individual is unique, we create personalized treatment plans that consider the individual's age, severity of tongue thrust, and any concurrent conditions.

A girl child laughing

Psychological Impact of Tongue Thrust on Children:

Beyond the physical challenges, tongue thrust can have psychological implications, particularly on children.

  • Communication Frustration: Children with tongue thrust may experience difficulty communicating clearly, which can lead to frustration, self-consciousness, and withdrawal in social situations.

  • Low Self-Esteem: The awareness of speech differences might negatively impact a child's self-esteem. They often avoid participating in class, group activities, or even engaging in conversations.

  • Teasing and Bullying: Unfortunately, children with noticeable speech differences might become targets for teasing and bullying, further exacerbating their emotional distress.

Tips for Parents to Help Their Child Overcome Tongue Thrust:

Support from parents is invaluable in helping children navigate the challenges of tongue thrust. Here are some tips to guide parents:

1. Open Communication: Create a safe space for your child to express their feelings and concerns about their speech difficulties. Let them know that you're there to listen and support them.

2. Positive Reinforcement: Praise your child's efforts in speech therapy and articulation exercises. Celebrate small victories to boost their confidence.

3. Set Realistic Expectations: Progress in overcoming tongue thrust takes time. Encourage your child to focus on their improvement rather than perfection.

4. Consistency: Encourage your child to practice exercises regularly, as consistency is key to reinforcing new muscle memory and speech patterns.

5. Model Correct Speech: Demonstrate proper tongue posture and clear speech when communicating with your child. Children often learn by imitation.

6. Professional Support: Collaborate closely with the speech therapist and orthodontist to stay informed about your child's progress and to align efforts for optimal results.

Sounderic provides online speech therapy sessions for children with various communication disorders. We would love to help you. Get in touch with us on WhatsApp at or schedule a consultation with us at

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