A man, in his late fifties, dressed in traditional
dhoti, kurta and paggar entered the outpatient department
(OPD) carrying his 4-year-old grandson. The child had autism with no eye
contact, no meaningful words, hyperactivity and stereotype movements.
"Sirji (even though I am Madamji!!!), he does not
speak…rest everything is fine...eats very well, sleep is very good,
understands everything…everything is fine."
"And what about eye contact and social interaction?
Does he plays by himself, what about his response to his name?"… I
enquired.
"Oh!, He is just a bit shy and naughty…rest
everything is fine...just check whether he has ‘taantua’… I think
because of his ‘taantua‘ he is unable to speak…" He dictated in
his authoritative voice.
An ultra-elite mother, in her latest Vero Moda
collection and Louis Vuitton accessories came with her 2-year-old son
for a neurology consultation. The child had hypoxic ischemic
encephalopathy at birth. He was unable to sit, had fixation and
following, response to sound was present, and could only babble.
I explained the cause of the developmental delay in
detail and the need for physiotherapy and speech therapy. After
answering all her google-searched questions, she came up with her
experience- and knowledge-based suggestion. "Doc, I think he has ‘taantua’…
just check upon it…"
Practising as a Pediatric neurologist in Gurgaon, I
have the privilege of connecting with patients from four neighbouring
states of Northern India. There is marked diversity in their culture,
beliefs, language, custom, attire, cuisine, ideology, standard of living
and educational background. But inspite of so much diversity, there is
an interesting thing that unites them with their differences…they share
an unanimous impeccable knowledge about tongue tie or ‘taantua.’
Any child, who has not achieved age-appropriate
language and speech milestones or even motor milestones, irrespective of
the diagnosis (autism, intellectual disability, cerebral palsy, hearing
impairment etc.) is considered a case of ‘taantua’ or
short frenulum that is supposed to need a surgical intervention
following which the child is expected to speak fluently and run
flawlessly.
In my initial practising years, during one OPD day,
when I got three consecutive patients enquiring about the short frenulum
and speech delay, I had serious doubts about my knowledge. I recalled
that during my fourth year of MBBS, I had jaundice and took a leave for
15 days. Is it possible that this topic was taught in those days, and I
missed the class… May be during my postgraduate training also, similar
coincidences must have happened and I was ingenuous to such an
indispensable and critical entity.
I seriously wonder how this association of frenulum
to speech and language development has reached to the remotest of the
village and the literates of the city alike –crossing all borders
without any visible spread through newspapers or news channels or any
other media involvement.
I think premier management institutes of the country
should include this topic in their case study and research that inspite
of spending scores of countless resources, we are still battling to
educate the masses about the exact place to evacuate one’s bowel or
bladder, and on the contrary, how each and every person in Northern
India has exactly the same knowledge about frenulum despite any official
spread of this ‘knowledge’.
Waiting for the day when science would fly above the
snarls of common myths and beliefs…
