Speech sound disorders appear to be an overt manifestation of a complex interaction among variables influencing literacy skills, including nonlanguage cognition, vocabulary, letter knowledge, and phonological awareness. These interrelationships hold across the range of speech sound production skill, as children with superior speech sound production skill experience superior literacy outcomes.

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A four-year follow-up study comparing the performance of intellectually superior children admitted early to school and the performance of normal children admitted at the regular time is presented. Achievement scores, self-emotional adjustment, and school success (promotion/retention) are discussed. Results of a stepwise multiple linear regression reveal nonsignificant findings regarding variables that contribute to school success. The effects of early school admission involving "gifted" children are discussed.The perplexities concerning early admission to kindergarten exist today as they did 50 to 60 years ago. Lincoln (1924) found that children admitted early on the basis of mental age (M.A.) were successful in competing with their age-appropriate classmates. However, many of the early admitted children were below the median for their grade in basic academic areas. Beattie (1970), Evans (1974, and Hamalainen (1952) suggest underage children are at a particular disadvantage when considering social-emotional adjustment. Hemphill (Note 1) reported that children admitted early on the basis of above average mental ability were not earning as high marks as their older counterparts. They tended to be less interested and to have more fears, tensions, and emotional upsets. Forrester (1955) reported that "very bright yet very young" students met with varying degrees of difficulty from the junior high period forward. Beattie (1970) reviewed research contrasting children matched on gender, IQ, and SES and suggested that older children score consistently higher on achievement measures than do younger classmates. Reynolds (1962) reported that early admitted children with strong ability were retained more frequently than normal children who were older. Baer (Note 2), comparing underage vs. overage children matched for IQ during an 1 1-year period, reported that the older students were marked as being more successful than younger students in maintaining progress from grade to grade. Early admission is supported in the literature by gifted proponents (Anderson, 1961; Dickinson & Larson, 1963; Holbrook, 1962; McCandless, 1957; Miller, 1962), as it purportedly benefits the student academically. However, some of the brighter children who entered early had more than the average number of social and emotional problems in secondary school (Hall, 1963). From the available research, it is apparent that no clear-cut decision can be made regarding early admission.The following study proposed to examine whether children admitted early were successful in school, to define variables that contributed to school adjustment, and to encourage the use of empirical information in decision-making processes in educational settings. This was not designed as an experiment in the sense that one group received a unique treatment. Further, the investigators were clearly aware from the onset that the Requests for reprints should be addressed to John E. Obrzut,

Purpose: Demand for oncologists will increase dramatically over the next 15 years. Physician assistants (PAs) and Nurse practitioners (NPs) have been identified as one solution to meet the projected shortages in oncology. It has previously been reported that 56% of oncologists work with PAs and NPs, more than two thirds of whom believe it benefits their practice with some noted productivity advantages. The purpose of this study was to quantify the productivity of PAs and NPs working in oncology in an academic medical center. Methods:A 2-week self-reported time study was performed in a single large academic medical center. Services were categorized as billable, bundled, care facilitation, administrative, and other based on time spent performing services in each category.Current procedural terminology codes were used to determine the economic value of services provided.Results: A total of 54 PAs and NPs were included in the final analysis. PAs and NPs reported similar clinical activities. Overall, there was high variability noted in terms of productivity, notably with PA/NP direct billable revenue. Opportunities were identified to improve utilization of oncology PAs and NPs, with suggestions for future research related to PA and NP productivity tracking. Conclusion:Productivity measurement for PAs and NPs can be challenging. To our knowledge, this is the first study that quantifies PA and NP productivity in oncology according to known economic indicators such as charges and work relative value units.

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