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Investigating Tongue Strength and Endurance in Children Aged 6 to 11 Years

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Abstract

Objective measures of tongue strength and endurance are used to assess lingual weakness and fatigue, and may have significant clinical value for dysphagia management. Recent studies investigating age and gender effects on tongue strength in children are limited by small sample sizes. The current study investigated age and gender effects on tongue strength with a larger sample size, and collected preliminary normative data for a paediatric population. This study also investigated the reliability of tongue endurance measures in children using a modified method, which has not previously been investigated. Using a cross-sectional design, this study examined tongue strength and endurance in 119 children aged 6 to 11 years, with no history of speech sound disorders, oro-motor deficits, dysphagia or cognitive impairment. Measures were collected using the Iowa Oral Performance Instrument. Children participated in two sessions, 45 min and 10 min in duration. Tongue strength was found to significantly increase with age (p < 0.001), while no gender effects were found. Modified tongue endurance measures involved using only one measure of maximal tongue strength to set parameters for tongue endurance scores. Despite this modification, data did not reach acceptable test–retest reliability, ICC = 0.68, p < 0.001; however, reliability improved from previous studies. These findings provide normative data for tongue strength, as a basis to compare individuals, and highlights the need for more reliable protocols for measuring tongue endurance. Normative data was collected from city-dwelling Australian children.

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Authors and Affiliations

  1. Curtin University, GPO Box U1987, Perth, WA, 6845, Australia

    R. McKay, S. Smart & N. Cocks

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  1. R. McKay
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  2. S. Smart
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  3. N. Cocks
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Correspondence to N. Cocks.

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Appendix: Semi-structured Script Used for Tongue Strength and Endurance Tasks

Appendix: Semi-structured Script Used for Tongue Strength and Endurance Tasks

I’m going to see you twice today. The second time I see you will be later in the day. In these sessions you will be naming pictures and moving your tongue in different ways. Then I’m going to put a small bulb in your mouth, which you’ll push your tongue against. This will let us see how strong your tongue is. Do you want to do this? You can stop at any point if you change your mind, without getting into trouble. You can also ask any questions you want.

Tongue Strength Task

I’m going to put this bulb in your mouth, just behind your front teeth. When I say go I want you to push your tongue against it as hard as you can for 2 s. We’re going to do this 6 times. I’ll give you a rest in between, because your tongue might get tired. Remember to only use your tongue and not your teeth.

Tongue Endurance Task

When I put the bulb in your mouth this time, you’re going to push your tongue against the bulb until the light goes green. I want you to try to keep the light green for as long as you can. If the light goes to red you have to push a bit harder and get it back up to green. Remember to only use your tongue and not your teeth.

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McKay, R., Smart, S. & Cocks, N. Investigating Tongue Strength and Endurance in Children Aged 6 to 11 Years. Dysphagia 35, 762–772 (2020). https://doi.org/10.1007/s00455-019-10081-2

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