Dr

This is a fictitious referral letter written by a neurologist. He is referring one of his patient's who sustained a closed head injury to a speech pathologist.

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Dr. Tony Andrews

Wheeling Neurology

123 Main Street

Wheeling, WV 26003

September 9, 2005

To Whom It May Concern:

I am referring Mrs. Andrea Johnson who is a 26-year-old patient of mine to Wheeling’s Speech and Hearing Clinic. She was previously referred to me on August 25, 2005 because she sustained a closed head injury due an automobile accident. When I first saw her on August 27, 2005, two days post-injury, she was functioning at a level IV on the Ranchos Cognitive Scale. She was awake and responsive, but her responses were inconsistent (Brookshire, 2003). She was very agitated, restless, and had impairments with her attention, memory, and reasoning (Brookshire, 2003). Her charts revealed that her brain injury was mild. Her MRI showed focal lesions on the frontal and prefrontal cortex. Damage to these areas has caused her to have several difficulties with a variety of executive functions (Sohlberg, Mateer, & Stuss, 1993 as cited in Coelho, DeRuyter, & Frank, 1996). In addition, she sustained some minor damage to her limbic system.

After working with her for these past several days I noticed that she has moved up to a Rancho's Level V, but still has problems with her short-term memory, tasks that involve multiple demands, concentrating under distracting conditions, and word-finding issues (Coelho, Deruyter, & Frank, 1996). In addition, her husband has informed me that she is never motivated, constantly depressed, and easily irritated (Coelho, Deruyter, & Frank, 1996).

Previous to her accident, Mrs. Johnson was completely independent and had no medical problems of any sort. She was only hospitalized once in her life due to the fact that she was delivering her child. She is not overweight and does not have a past history of smoking or drinking.

She was well educated with a master’s degree in elementary education. She was currently employed as a teacher at South City Elementary School teaching fourth grade. She wishes one day she will be able to re-enter her community and continue her career.

Mrs. Johnson’s entire family is very supportive, and they all are willing to do anything ensure that she will recover fully. Her husband said that he is going to make sure that she has continuous care when he is at work in order for her to be released from the hospital in a few days.

If you have any questions regarding this information please feel free to contact me at 1-800-777-1234 and ask to speak directly to Dr. Tony Andrews.

Thank You,

Tony C. Andrews, M.D.

Tony C. Andrews, M.D. Neurologist

References:

Coelho, C.A., & DeRuyter, F. (1996). Treatment efficacy: Cognitive-communication disorders resulting form traumatic brain injury in adults. Journal of

Speech & Hearing Research, 39 (5), 22-35. Retrieved October 5, 2005, from the ERIC database.

Brookshire, R.H. (2003). Introduction to neurogenic communication disorders (6th ed.). St. Louis: Mosby Inc.