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Laura Kee
555 St. of Dreams
Parkersburg, WV 25288
Phone 555-6792

April 26, 2002

Diana Taylor
2012 Crystal Brook Lane
Parkersburg, WV 25288

Dear Mrs. Taylor,

Dr. John Sutton referred your son, Ethan Taylor, to me on April 13, 2002 for a speech-language evaluation. Dr. Sutton reported Ethan to have a mild conductive hearing loss, which is thought to be a result of Ethan’s history of Chronic Otitis Media. With a moderate hearing loss, a child may not hear or may hear very faintly the soft sounds at the beginnings and ends of words, such as the "s" in "sun" and the "t" in "cat, and words spoken quickly such as "and."

I conducted a speech and language evaluation on Ethan on April 25, 2002. The results of the evaluation indicate that Ethan’s receptive and expressive language skills are delayed. In other words, Ethan displays an inability to understand spoken language at his age level and does not use spoken language appropriate for his age. Ethan’s vocabulary is also not age appropriate.

Difficulty pronouncing and hearing sounds could affect Ethan’s reading ability and may make him difficult to understand. In order to better prepare Ethan for entering kindergarten in the fall, I recommend that he begin language therapy as soon as possible. I am currently taking applications for summer therapy sessions. I have enclosed with this letter an application, which can be returned to my office or mailed to me at the above address.

If you have any questions or would like to discuss this evaluation, please call me.

Sincerely,
Laura Kee

John Sutton
1049 N. Queen St.
Huntington, WV 25701
(304) 555-6879

April 13, 2002

Laura Kee
555 St. of Dreams
Huntington, WV 25703

Dear Ms. Kee,

RE: Referral for speech-language evaluation

I am referring Ethan Taylor to you for a speech-language evaluation. Ethan is five years old. Medical records obtained from Ethan's pediatrician, Dr. Edward Arnette show a history of chronic otitis media. The first occurance was on August 20, 1997 when Ethan was 5 months old. Since then, there has been a reoccurance of three to four middle ear infections each year. The middle ear infections were treated with prescriptions of oral antibiotics, as well as ear drops. Treatments were given by Dr. Edward Arnett, and emergency room physicians, Dr. Nancy Stevens and Dr. Mark Sloan.

Pure-tone and bone conduction tests indicate a mild flat conductive hearing loss in the right ear and a mild to moderate flat conductive hearing loss in the left ear. Tympanometry results are Type B, flat.
(I'm going to include other test results, but I'll have to wait until I return to Huntington to review my audiology notes.)

After completing a hearing evaluation on Ethan, I have diagnosed him with a mild flat conductive hearing loss in the right ear and a mild to moderate flat conductive hearing loss in left ear.

After speaking with Mrs. Taylor and observing Ethan during the hearing evaluation, I am concerned about Ethan's language skills. For this reason and because of Ethan's history of chronic otitis media, I am referring Ethan for a speech-language evaluation.

Thank you,
John Sutton