We appreciate the thoughtful letter from Dr Copeland. Much of the growth of the child and adolescent Supplemental Security Income (SSI) program in the past few years has appropriately provided children and adolescents with substantial disabilities in low-income families both financial support and access to Medic-aid. Yet, as Dr Copeland notes, the program has several problems, and the Academy has gone on record in recent months in ways generally consistent with Dr Copeland's concerns.