Date on Master's Thesis/Doctoral Dissertation


Document Type

Master's Thesis

Degree Name



Communicative Disorders

Degree Program

Communicative Disorders, MS

Committee Chair

Pitts, Teresa

Committee Co-Chair (if applicable)

Mattingly, Rhonda

Committee Member

Smith, Alan

Author's Keywords

posterior; tongue-tie; ankyloglossia; mealtime; behaviors; feeding


The tongue is an important muscle used in speech, mastication, swallowing, and breastfeeding. It plays an important role in facial development, dentition, and periodontal status. Posterior ankyloglossia, also known as posterior tongue-tie (PTT), is characterized by a tether beneath the lingual mucosa. Upon visual inspection, the frenulum is non-prominent but with the use of a grooved director it may appear abnormally prominent, short, thick, or cord-like. Palpation of the frenulum may reveal tightness. There is a lack of empirical data about PTT and the impact on feeding beyond early infancy. PTT is not well recognized and can be missed resulting in delayed management. The development of feeding skills is linked to early experiences and is highly relational between a child and his or her caregiver. Undiagnosed or poorly managed conditions that influence early feeding and/or child and parent interaction may have long lasting effects on nutrition outcomes. The purpose of this study is to use the Behavioral Pediatric Feeding Assessment Scale (BPFAS) to determine whether children with PTT have more frequently occurring feeding behaviors and the degree to which those behaviors are considered problematic when compared to normative data. Examination of the impact of late diagnosis and late management on behaviors and the relationship between child and parent actions was also performed.