Doctor, my son is still having difficulty pronouncing certain sounds and words clearly. In particular, he struggles to pronounce sounds such as “ra,” “ksha,” and “sh.” His speech is not always clear. He underwent tongue-tie surgery at the age of six, but unfortunately, we have not noticed any significant improvement in his pronunciation. I would like to understand the underlying cause of his speech difficulties and know what further evaluation or treatment he may need. Could you please assess his speech and advise us on the next steps?