The imaging study by Loeb et al. that appears in this issue of JAACAP examines the neural correlates of working memory in adults with childhood-onset schizophrenia (COS; defined as onset of illness prior to age 13 years), their unaffected siblings, and healthy controls.¹ Working memory is a system that allows for short-term storage and manipulation of information. Significant deficits in working memory have been well documented in studies of adult-onset schizophrenia (AOS; defined as onset of illness after age 18 years).² Working memory deficits have also been found in unaffected siblings of adults with schizophrenia, as well as in youth with early-onset schizophrenia (EOS; defined as an onset between ages 13 and 18 years)³ and COS.⁴ As the authors point out, working memory continues to develop into late childhood and early adolescence. Therefore, the age of onset of illness may be extremely important, as it may affect working memory maturation during a critical time in cognitive development. Working memory deficits and their neural substrates could potentially vary with age of illness onset as well as with familiality.