TREATMENTS FORBIDDEN While still in Gabriella and Eugene's care, Rebecca was under doctor's care for a hearing loss and speech impediment problem.  She was slated for surgery, but by the time it was to have been done, the Treichs has gained custody, and their lawyer immediately wrote the doctors involved, forbidding them to continue the scheduled treatment.  It is not known if this surgery was ever done. This is a copy of the audiological report.  Immediate treatment was recommended and surgery was scheduled at the Cranbrook Regional Hospital, BC, for the end of August, 1993.  AUDIOLOGICAL REPORT (dated April 7, 1993) Infant Development Program British Columbia Ministry of Health, East Kootenay Health Unit, Cranbrook, BC Audiologist:  Karen Verbeurgt, MS, CCC-A, Rebecca was seen at the East Kootenay Health Unit Audiology Clinic for a hearing evaluation.  The reason for referral is concern regarding her speech and language development. Auditory Findings: Results of auditory testing using Visual Reinforcement Audiometry in a soundfield setting were found at mild elevated levels to slightly elevated levels. Bone conduction responses were obtained within normal limits for at least one ear, revealing a significant air-bone gap, indicative of a conductive component.  The stimuli used were  narrow band noise and warble tones through the speech frequencies. A speech awareness threshold was obtained at a slightly elevated level in a soundfield setting.  A speech awareness threshold was obtained at a normal level with the use of a bone conduction. Impedance testing revealed normal middle ear pressure with low tympanic membrane mobility bilaterally. Recommendations: Auditory findings indicated mild rising to slightly elevated hearing levels in a soundfield setting; however, individual ear responses could not be obtained during this assessment.  Audiologic results also revealed a significant air-bone gap, indicative of a conductive component. It was recommended Rebecca be seen by her physician regarding possible middle ear involvement bilaterally.  A hearing re-evaluation will be completed post-medically in May, 1993 THIS IS A COPY OF THE EXAMINATION AND RECOMMENDATION BY DR. L. C. JEWETT OF THE CRANBROOK REGIONAL HOSPITAL CRANBROOK REGIONAL HOSPITAL HISTORY & PHYSICAL EXAMINATION 17/05/93 KLIIM-HANSEN-Rebecca Date of Birth: 15 July 1990 Dr. LC Jewett,MDFRCS This young girl was seen in my office on 17 of May, 1993 with respect to her problem with her hearing.  She has had repeated ear infections in the past with a conductive hearing loss present.  It  has been determined that she has had a serious otitis media during these times with a marked type C impedance audiometry.  Apparently this has been the case on several occasions.  Also, she has had repeated bouts of serious otitis media which has been treated appropriately.  She is just now recovering from a bout of serous otitis media.  She does snore.  She mouth breathes.  She has had no problems with her tonsils that the grandmother is aware of.  It should be noted that this young child recently lost both parents and is now staying with her grandmother. HEAD & NECK EXAMINATION: Examination of the ears today revealed a moderate amount of scarring in keeping with previous middle ear disease.  Impedance audiometry however today was type A.  Tuning fork testing did not indicate a conductive hearing loss on today's visit.  The nose examination was clear.  The throat revealed moderate sized tonsils only.  There was 2+ jugulodigastric lymphadenopathy. It appears that one of the main problems with this child is that of speech delay. IMPRESSION:  This child has had what appears to be repeated bouts of acute otitis media secondary to probable chronic adenoiditis.  This has resulted in some decreased hearing on a fluctuating basis along with speech delay. RECOMMENDATIONS:  I recommend that we proceed with bilateral myringotomies and tubes at the end of August, a date has been saved for the same and booked for the same. I think that we should be extremely aggressive with this young child because of both the psychological effects of her parent's death and because of speech delay. THE FOLLOWING LETTER WAS SENT TO BOTH DR. JEWETT AND KAREN VERBEURGT, BY CAROL TREICH'S LAWYER. RE: REBECCA AND CHRISTINA KLIIM-HANSEN Please be advised that we act on behalf of Andrew and Carol Treich of Cochrane, Alberta, with respect to an application which was heard before Justice Hembroff of the Court of Queen's Bench of Alberta in May of 1993. This notice is to confirm to you that Mr. and Mrs. Treich have been appointed the legal guardians of the children, Rebecca and Christina Kliim-Hansen and have been granted their custody.  I enclose for your reference a copy of the certified copy of the Court Order in that respect.  We are in receipt of copies of your audiological reports dated April 7, 1993 and June 11, 1993 with respect to Rebecca Kliim-Hansen. Please be advised that any further visits to your office are not authorized by the child's lawful guardians, Andrew and Carol Treich, and under no circumstances is any surgical procedure to be undertaken in the Province of British Columbia.  Rebecca has her own physician in Alberta who is treating her. Please be advised that Mr. and Mrs. Pentz are merely entitled to have access to the children and do not have the legal authority to authorize medical care or to deal with medical issues of the children, except on an emergency basis during their access visits. Should you have any questions or require any further information, please do not hesitate to contact the writer. Yours very truly, SOBY BOYDEN LENZ Per: LAURIE McMURCHIE