US Gymnast Maroney Suffers Nasal Fracture

World vault champion McKayla Maroney on the US gymnastics team suffered a nasal fracture during pre-meet training when she over-rotated at the end of a tumbling run and fell hard earlier this month. She also suffered a concussion. A visit to the ER revealed her injuries. Apparently no surgical intervention was pursued.

This case illustrates that most nasal and even facial fractures do NOT require surgical repair.

The key elements that lead towards a decision for facial and/or nasal fracture surgery are the following (not all-inclusive, but general pointers):

- Any functional deficit including inability to open and close the jaw.
- Change in your occlusion (the way your teeth come together).
- Double vision (blurry vision does not count).
- Cosmetic deformity due to nasal/facial fracture (bruising and swelling does not count).
- Nasal obstruction not due to swelling.

The two main specialties able to assess whether surgery is required or not is ENT and Plastic Surgery as well as some oral surgeons.

Source:
Maroney suffers concussion, nasal fracture. ESPN 6/10/12

Toddlers Unable to Tell If They Mispronounce a Word (Thereby Can't Auto-Correct)

Older children and adults constantly monitor what they say and automatically correct or self-adjust when they hear a peach error... oops, sorry I meant to say "speech" error.

Such auditory feedback error correction however is not something we are born with. Rather it seems to be a skill that develops sometime between ages 2 and 4 years according to a new study.

"Researchers had adults, four-year-olds, and two-year-olds say “bed” repeatedly. But scientists filtered the sound so that the subjects heard themselves through headphones pronouncing it as “bad.” Adults spontaneously compensated, and changed so that the word sounded correct to their own ears. They wound up saying “bid.”

Four-year olds also adjusted their speech.

But the two-year olds kept saying “bed” even though they kept hearing “bad.”"

So, how do young children learn to speak correctly if they can't even hear themselves say something incorrectly?

The answer to this question has great import, especially to speech therapists whose job is to "fix" this problem. ENTs are often consulted as well to ensure a child does not have a tongue tie or hearing loss that can also lead to speech difficulties in a young child.

It's possible that young children depend on their parents to correct them when they say something incorrectly.

However, nobody quite knows for sure.

A follow-up study (not sure if will pass muster with an IRB) would be to have 2 sets of 2 year olds... one group where the parent constantly corrects any speech errors the child makes immediately. The other set would have parents NEVER correct a child's speech errors and let the child learn on their own.

Two possible outcomes... By the age of 5 years, there may be no difference in speech skills between the two groups OR there is a big difference and all the parental anxiety over their 3 years old child's inability to say "pizza" may be unnecessary (along with speech therapy sessions)... after all, they will "grow" or "learn" out of it with time.

Reference:
Toddlers Don't Monitor Their Own Speech. Scientific American 12/24/11

Children's Development of Self-Regulation in Speech Production. Current Biology, 10.1016/j.cub.2011.11.052