• Jenny Ingram, Debbie Johnson, Marion Copeland, Cathy Churchill, Hazel Taylor, and Alan Emond.
• School of Social and Community Medicine, University of Bristol, Bristol, UK.
• Arch. Dis. Child. Fetal Neonatal Ed. 2015 Jul 1; 100 (4): F344-8.

AimTo produce a simple tool with good transferability to provide a consistent assessment of tongue appearance and function in infants with tongue-tie.MethodsThe Bristol Tongue Assessment Tool (BTAT) was developed based on clinical practice and with reference to the Hazelbaker Assessment Tool for Lingual Frenulum Function (ATLFF). This paper documents 224 tongue assessments using the BTAT. There were 126 tongue assessments recorded using the BTAT and ATLFF tools to facilitate comparisons between them. Paired BTAT assessments were obtained from eight midwives who were using the new assessment tool.ResultsThere was acceptable internal reliability for the four-item BTAT (Cronbach's α=0.708) and the eight midwives who used it showed good correlation in the consistency of its use (ICC=0.760). The BTAT showed a strong and significant correlation (0.89) with the ATLFF, indicating that the simpler BTAT could be used in place of the more detailed assessment tool to score the extent of a tongue-tie. Midwives found it quick and easy to use and felt that it would be easy to teach to others.ConclusionsThe BTAT provides an objective, clear and simple measure of the severity of a tongue-tie, to inform selection of infants for frenotomy and to monitor the effect of the procedure.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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