Yesterday was Thomas' appointment with Dr. Jahng (an Ear, Nose, and Throat specialist/surgeon) to determine if his speech delay is being caused by a short frenulum. The verdict from the doctor: yes.
I liked the doctor. When I called for an appointment they scheduled it for the next day. We arrived on time and were seen less than five minutes later. The doctor was kind, gentle, competent, and readily answered all my questions. Although the referral from Thomas' pediatrician stated that they had ruled out hearing issues, Dr. Jahng checked his ears anyway before even looking at his tongue. I appreciated the thoroughness.
So the diagnosis is speech impairment due to Ankyloglossia. Dr. Jahng treats this by doing surgery under light general anesthesia. This worries me a bit - general anesthesia in a 17 month old just sounds scary - but he says that it is safe. He does not treat this condition by "clipping" the frenulum in office, because he says that doing it that way risks worse problems due to improper healing (fusion of the two parts, etc.) Surgery allows him to take his time, do it right, and suture both sides to minimize risks of future problems. This makes sense to me.
Part of me wants to say "we love our pediatrician, who referred us to Dr. Jahng, who seems entirely competent, so let's go ahead and act on his recommendation." This is especially true since tongue-tie runs in the family (Gabe is tongue tied, spoke very late, and feels that it affects his speech even now) and Gabe feels that it would be best to free Thomas from that difficulty. I'm also leaning this way because it seems rather awful to just leave a bright child frustrated and unable to communicate well because of a condition that is very fixable.
Still, this surgery is pretty controversial, at least in the world of the internet. Look it up and you'll find LOTS of people against it, including doctors who think that you should "wait and see", as the child may outgrown the condition by age six. Age six? What about talking? I don't think I can cope with a preschooler who communicates via signing and "nanana AHHHHHH!" Then there are the doctors who say that it has absolutely nothing to do with speech impairment, and that two year olds who are tongue-tied and don't talk are just going at their own pace. I'm not sure I buy that idea, especially given Gabe's history.
Sigh. Surgery is scary, and I can definitely understand not wanting to subject your child to it if it isn't necessary. It's just that tricky question of "necessary".
The referral paperwork is in process right now. Gabe and I will probably discuss it some more, but at this point I'm guessing we'll go ahead and do it.
Updated to add these links because I found them the most helpful:
Bandolier: Evidenced based thinking on healthcare: Ankyloglossia
Tongue-Tie: from confusion to clarity