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Answer: At 2-years-old, Noah develops an extensive expressive speech delay. He speaks, but only his parents are able to easily understand him. A hearing test and other evaluations show that Noah has mild hearing loss due to chronic ear infections and fluid buildup in his ears. Noah’s otolaryngologist (ear, nose, and throat (ENT) specialist) decides that Noah needs a set of ear tubes to allow drainage of fluid. Getting rid of the fluid, the ENT specialist hopes, will increase Noah’s hearing and improve his speech.

Noah undergoes surgery in 1997 and, slowly, his speech improves. As Noah recovers from surgery, the ENT specialist teaches Tanya how to evaluate her son for obstructive sleep apnea. At home, Tanya picks random times at night to listen to Noah sleep, and records every time he snores or takes a breathing pause. After watching Noah for several nights, she is certain he does not have sleep apnea and reports this to his ENT specialist.

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