Presenter: Sandra R. Holtzman, MS, CCC-SLP, COM, QOM
– J.A., prior course participant
Ankyloglossia, or tongue-tie, has recently become an area of discussion and sometimes controversy for SLPs. To ignore it, or not to ignore it? To refer for surgical procedure, or not to refer? To accept speech that "sounds okay" in the presence of tongue-tie, or to emphasize precise speech production? To delve deep enough to see if there is far more than meets the eye, or to leave it to other professionals to make the decisions?
This course will shed light on all these dilemmas. Participants will get an overview of the consequences of tongue-tie as related to infant feeding issues, dental concerns, emotional and social aspects, swallowing considerations, and most importantly the speech connection. Participants will be introduced to assessments and various techniques used to release the lingual frenum.
Course is offered for 0.25 ASHA CEUs – 2.5 Contact Hours.
Course Overview – Run Time: 2:30:13
– S.F., prior course participant
The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.
Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.
"Treatment of Ankyloglossia was beneficial. I liked the division of the content into smaller subsets of information." E.H. (Mar. 2023)
"Tongue tie assessments and case studies with pictures and videos. To the point and thorough." M.O. (Mar. 2023)
"The entire presentation was extremely informative and helpful. I liked the videos presented." W.S. (Feb. 2023)
"I feel more confident to assess tongue ties. The pictures and videos were helpful." M.G. (Feb. 2023)
"I liked the assessment content, pictures, and videos. The course is short and comprehensive." A.B. (Feb. 2023)
"Excellent overview of diagnosis and treatment. Included both infant and adult." J.J. (Feb. 2023)
"Learning types of surgeries and their differences for ankyloglossia. Great pictures and videos to explain everything." M.K. (Feb. 2023)
"The quick tongue tie assessment will help me when working with toddlers in their home. I liked that course was broken into sections and didn't seem too overwhelming." L.S. (Feb. 2023)
"Learning my role as an SLP. I liked everything." C.A. (Feb. 2023)
"I liked the assessment information. And that course could be completed on my timeline." L.S. (Feb. 2023)
"The sections were separated into different areas and I could easily refer back to an area if needed without having to look through an entire recording." M.F. (Feb. 2023)
"Assessment of tongue tie. I liked the photos and videos." J.C. (Feb. 2023)
"The images of tongue ties were beneficial. Different sections made it easy to watch." D.C. (Feb. 2023)
"Visual and functional assessments. I liked the many examples." C.L. (Feb. 2023)
"Good case study examples." J.W. (Feb. 2023)
"All of it! I liked the slides and videos." S.R. (Feb. 2023)
"Possible SID connection and other physiological connections was beneficial. Learning new, unknown data." M.B. (Feb. 2023)
"All of it!!! I have not had this in-depth of a training on this topic. The course was easy to take." R.S. (Jan. 2023)
"Clear guidelines of how to deal with tongue tie. Learning the importance of the frenectomy and avoiding the “wait and see” approach." A.L. (Jan. 2023)
"Every word is gold." E.M. (Jan. 2023)
"The visuals showing varying levels and types of tongue tie were very helpful. Prior to this course, I was using generic "assessment" criteria to determine the presence of a tongue tie and although I have referred to ENTs for further evaluation, I was fine with the wait and see approach. Now that I understand more, I will be more diligent in advocating for patients to have correction sooner rather than later." K.R. (Jan. 2023)
"Functional assessment. I liked the photos of patients for real examples." A.H. (Jan. 2023)
"The discussion of different assessments and collaboration with the use of visuals was helpful." M.K. (Jan. 2023)
"Course was thorough but concise." Z.W. (Jan. 2023)
"Practical information. I also liked how the course was broken into short segments." J.A. (Jan. 2023)
"The emphasis that tongue tie diagnosis and subsequent treatment need not follow the wait-and-see method was beneficial....that action is warranted upon discovery. The case studies and visuals were very beneficial in tying the presentation altogether." K.W. (Dec. 2022)
"This entire presentation was fabulous. I liked the numerous examples of real clients and variations." C.S. (Dec. 2022)
"I had tons of questions about my patients that present as tongue tied and I found answers to those questions in this course." L.L. (Dec. 2022)
"How to do an assessment before and after surgery was beneficial. I liked the way all the information was organized." F.B. (Dec. 2022)
"Identifying different types of tongue tie and using assessment tools to determine need for surgery was beneficial." X.O. (Dec. 2022)
"I think resources regarding appearance and testing will be helpful for my daily practice. I liked that course was easily accessible." A.A. (Dec. 2022)
"The assessment protocols were great! This course had a great presenter who is very knowledgeable." E.S. (Dec. 2022)
"It was all relevant, well prepared and well delivered. Immediately relevant in clinical practice." J.A. (Dec. 2022)
"Very easy to understand and contrasting with a study that does not think tongue tie affects speech. Learning how to determine the different types of tongue ties was helpful." K.H. (Nov. 2022)
"Great pictures and examples! I have some children with combination of feeding issues (chewing, forming bolus, and open mouth) and stubborn, peculiar speech errors/patterns. I have been suspicious of tongue tie for a while, and now I know more and feel more prepared at what to look for and feel more empowered to refer to the ENT." K.S. (Nov. 2022)
"All of the material was extremely helpful. I liked the videos." L.K. (Nov. 2022)
"Covered specific things to look for when diagnosing tongue tie. I liked the pictures of tongues with examples of ties." S.M. (Nov. 2022)
"Very thorough and with case study examples." A.B. (Oct. 2022)
"It was both informational and brief with good assessment and therapy recs." K.G. (Oct. 2022)
"I found it helpful to hear the benefits of eliminating tongue tie for a pt's well-being with feeding, speech, etc. I liked how the course was divided into sections so that I could complete the course at various times." S.A. (Oct. 2022)
"Clear and informative. Learning information not received elsewhere. Learning signs of possible ankyloglossia in babies." S.H. (Oct. 2022)
"I found the diagnostics the most beneficial. I now feel more confident when I get referrals for tongue tie." D.L. (Oct. 2022)
"All of the material was very helpful. The photos help give a better visual when determining tongue tie." R.M. (Oct. 2022)
"I liked the case studies and pictures for examples." J.T. (Sept. 2022)
"I liked the images of different presentations of tongue tie." M.C. (Sept. 2022)
"I enjoyed the entire presentation. I liked how the assessments and treatments were laid out." J.M. (Aug. 2022)
"Great information in a timely manner." C.S. (Aug. 2022)
"I liked that the presentation was sectioned off into various parts to help with the flow of information." L.G. (Aug. 2022)
"Thorough presentation." C.C. (July 2022)
"I found the case studies beneficial. And really thinking it through before using the "wait and see" approach." T.S. (July 2022)
"This was a great course to play for the student I have in clinic this semester. The background information was great for her, as she is just learning about tongue ties. The last section was most helpful for me. My student is just learning about TOTs and I wanted her to hear some of this information from someone other than myself!" A.P. (July 2022)
"It was very informative and the videos were helpful. Learning the multitude of complications (aside from speech) that can result from not having tongue tie release!" S.K. (July 2022)
"Learning some keywords to use to describe what I am seeing during assessments was good. The course was filled with content, yet highly interesting and not drawn out." V.G. (June 2022)
"It was interesting and an eye opener to learn about the different kinds of lingual attachments. Prior to this course, I hadn't seen one where the tongue tip attached to the lower mandibular. Lots of visual and examples to review! Thank you!" B.D. (June 2022)
"The whole course was extremely helpful! I will be able to reassess those articulation cases that are not generalizing and teams (including parents) have had questions about. Every detail of therapy was covered - diagnostics, treatment, programs. Liked the ease of accessing, home study, and ability to stop when needed. I really liked that the topics were broken into specific sections. The flow of information - organization - speaker's descriptions - discussion, backed by videos and pictures - and evidence based - all great." K.H. (June 2022)
"Exposure to different assessments as well as information regarding issues possibly related to tongue-tie were good." K.G. (June 2022)
"The various ways of assessing tongue ties were very useful information, as were the case studies." M.K. (May 2022)
"How it applied to infants as that is the population that I work with. I was very interested in the information that the labial frenulum should be checked when the tongue is checked as it also can affect breast feeding and production of bi-labial sounds." J.D. (May 2022)
"Information was well organized and easily applied. I liked the tests to determine severity of tongue tie." A.P. (Apr. 2022)
"I liked the different case examples, and learning how to assess tongue ties and the type of assessments that can be used." G.B. (Apr. 2022)
"The video and picture examples are very helpful." E.E. (Mar. 2022)
"All sections were extremely valuable and informative." J.L. (Mar. 2022)
"Gave a lot of information and examples of what to look for in terms of tongue tie." A.S. (Mar. 2022)
"The assessment protocols were very enlightening. Excellent examples and pictures." R.J. (Feb. 2022)
"At your own pace; broken into sections provides a break from a large amount of information at one time." S.C. (Feb. 2022)
"Great videos/photos as examples. I like the use of case studies." J.P. (Feb. 2022)
"The examples of real cases were great and I loved the overview of assessments. The course was well organized." J.C. (Jan. 2022)
"The whole presentation was excellent. I only wish I had had this level of depth back in school. The presentation was well organized. The examples were frequent and relevant. The information was top notch, and the importance of the work was highlighted well." L.M. (Dec. 2021)
"I loved the presenters passion and really value the information on a person level as all 3 of my children were born tied." S.B. (Dec. 2021)
"I liked all of the picture examples and explanations." A.S. (Dec. 2021)
"All of the course was beneficial! I'm really glad you reviewed that article in the end. I'm sure I read that at some point-and sadly, it was the extent of my knowledge. It was all information that I always wondered about and searched for, but couldn't find." S.N. (Nov. 2021)
"I've never understood the significance of the short frenum to non-speech performance such as swallowing. I haven't given tongue tie enough attention in my evaluations. I will be much more careful in my future examinations. Excellent exposure to the topic of tongue tie. Pictures and videos very helpful" L.S. (Nov. 2021)
"The discussion about use of standardized assessment tools to present the results to Drs (and insurance companies ) to report the degree of tongue-ties in need of Frenectomy was beneficial for my daily practice. I liked the descriptions of photos and videos of children and adults with different types of tongue-ties and lip-tie and problems they can cause." T.D. (Oct. 2021)
"Diagnosing of tongue ties based on visual and functional assessments. Practical information on how to evaluate and treat clients with tongue tie." M.M. (Oct. 2021)
"I have a feeding and language evaluation for a 22 month old this week. Her mother has concern for lip and tongue tie. Clearly, this course will be very beneficial in my evaluation procedures and treatment with this client, as well as others on my caseload. My graduate school professor strongly felt as though frenectomies were performed too frequently. I am thankful for this course to give me a different perspective and new considerations toward the procedures. I will definitely use my knowledge gained in this area moving forward. The presenter gave clinically relevant and research based information. The content was heavily clinically based and therefore can easily be applied in daily practice." S.F. (Sept. 2021)
"The prevalence of a tongue tie and its effect on lots of skills was helpful." L.D. (Aug. 2021)
"Explanation of the varying degrees of tongue tie & specific tests to determine the need for surgery were helpful for my daily practice. Videos and photo support during the presentation were good." K.T. (Aug. 2021)
"The course was so thorough on the topic of tongue ties and provided ways to assess and determine if there is a tongue tie." C.M. (Aug. 2021)
"The importance of a thorough assessment and impact of tongue-tie will help my daily practice." C.C. (July 2021)
"Excellent photographs and examples to help SLPs be more comfortable with the wide range of positions of the frenulum. Great data driven information and case studies which show the importance of considering surgery or not." A.F. (July 2021)
"I am just finishing the Myo one year course with Hallie Bulkin and she mentioned you several times so I wanted to get the benefit of your course. This was a great overview. The descriptions with pictures of tongue ties, the definitions, the assessments were all very clear and concise." H.S. (June 2021)
“I really enjoyed all of it and will review and study the material so that I can better serve the children I see in my practice.” J.B. (Mar. 2021)
“It was very thorough, and the instructor was clear and highly knowledgeable. I took this course as a refresher as I took an in-depth course with Sandra before. Her expertise is essential to our field to be effective with our clients. The visuals and thorough examination of the lingual frenulum (areas of attachment, size, and appearance) were for me the best part.” R.T. (Feb. 2021)
Sandra R. Holtzman, MS, CCC-SLP, COM, QOM, is an ASHA certified speech-language pathologist who has specialized in orofacial myology for most of her career. She is director of Neo-Health Services, Inc., an organization that provides continuing education training and supplies related to orofacial myology. Sandra and her team developed the Qualification in Orofacial Myology (QOM) to provide this highly respected and recognized credential to professionals in speech pathology and dentistry/orthodontics. She is author of Orofacial Myology: From Basics to Habituation (aka the “Myo Manual”) as well as programs for elimination of oral habits.
Financial — Sandra Holtzman is a presenter of online CE courses sponsored by Northern Speech Services; receives royalties.
Financial — Sandra Holtzman is the author of the text "Orofacial Myology: From Basics to Habituation"; receives royalties.
Financial — Sandra Holtzman is the owner of Neo-Health Services, Inc; ownership interests.
Nonfinancial — Sandra Holtzman has no relevant nonfinancial relationships to disclose.
This program is offered for 0.25 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
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You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.
However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.
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ASHA CE Registry Submission:
During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
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NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
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