In this issue of CHEST (see page 1204), Chervin et al1 provide important information that should influence how we treat young children who have OSA syndrome (OSAS). The reported data came from the Childhood Adenotonsillectomy Trial (CHAT), a multicenter research project that included 464 children 5 to 9 years of age who had OSAS.2 Each child underwent polysomnography (PSG), neuropsychologic testing, and symptom scoring using widely accepted questionnaires before being randomly assigned to either an early adenotonsillectomy (AT) group or a watchful waiting group. The protocol called for repeat PSG, neuropsychologic testing, and symptom scoring 7 months later. Of the 397 children who completed CHAT, PSGs normalized in 79% of the AT group and 46% of the watchful waiting group. Symptom scores also improved following AT, but neuropsychologic testing showed no significant improvement in attention or executive function. These findings raised important questions for clinicians about the indications of AT in a child with OSAS. Chervin et al1 present a detailed look at the children who did not have AT.