Boys with reading disabilities and/or ADHD: distinctions in early childhood.

We examined distinctions in the early childhood characteristics of boys with reading disabilities (RD) and/or attention-deficit/ hyperactivity disorder (ADHD). A four-group mixed design consisting of boys identified at age 11 with reading disabilities only (RD only; n = 46), reading disabilities and ADHD (RD/ADHD; n = 16), ADHD only (n = 20), and a comparison group (n = 281) was utilized. Differences on receptive and expressive language and temperament for ages 3 and 5 were investigated. Analyses indicated that the boys from the RD-only group performed worse on measures of receptive and expressive language. The results also indicated that boys from the RD/ADHD groups consistently performed worse on measures of receptive language and exhibited more behaviors indicative of an undercontrolled temperament. In summary, we suggest that reading disabilities and ADHD represent moderately unique disorders that frequently co-occur and are characterized by distinct developmental pathways.

The effect of academic self-concept on ADHD and antisocial behaviors in early adolescence.

Using structural equation modeling techniques, we evaluated the effect of academic self-concept (ASC) on the development of attention-deficit/hyperactivity disorder (ADHD) and antisocial behaviors in early adolescence. Participants (n = 445) were recruited from the Dunedin Multidisciplinary Health and Development Research study. Eligibility was determined by the presence of complete data for the following variables at the specified time periods: reading at age 7, teacher reports of ADHD and antisocial behaviors at age 7, self-ratings of ASC at ages 9 and 11, and teacher reports of ADHD and antisocial behaviors at age 13. The results indicated that ASC is an important construct that directly contributes to the development of antisocial behaviors rather than to symptoms of ADHD. The results also indicated that children's early history of behavioral problems and academic performance contribute to the development of a more robust understanding of the impact of ASC on the development of disruptive behaviors in early adolescence.

The affirmation of the scientist-practitioner. A look back at Boulder.

In the aftermath of World War II, several influences were paramount in forcing academic psychology to recognize, albeit reluctantly, the coming professionalization of psychology. The federal government, wishing to avoid a repeat of blunders following World War I that led to significant dissatisfaction among veterans, took proactive steps to ensure that mental health needs of the new veterans would be met. The USPHS and the VA were mandated to expand significantly the pool of mental health practitioners, a direction that led not only to the funding of the Boulder conference but also to the development of APA's accreditation program, funded practical and internship arrangements with the VA, and the USPHS grants to academic departments for clinical training. The GI Bill, amended to include payment for graduate education, created tremendous interest in graduate programs in psychology. As a result, psychology programs were inundated with funded applicants, most of whom were interested in the application of psychology to clinical and other applied fields. Graduate psychology departments were mixed in their views of this "blessing." The reality of a separate curriculum for professional training in psychology was a bitter pill for some academic psychologists to swallow. Graduate departments feared that control of their programs would be taken over by external forces and that they would lose their right to determine their own curriculum. Further, they feared the domination of clinical training within their own departments and the effects of such educational emphasis on their traditional experimental programs. The Boulder conference brought together these disparate needs and concerns, although one can argue about how well some points of view were represented with respect to others. It was a time of high anticipation and fear. The conference could easily have ended in failure, with such diverse interests being unable to reach any consensus. There are many letters in the correspondence of committee members that suggest disagreements serious enough to prevent the development of any single model of training. Instead, by most yardsticks that one could apply, the conference succeeded, perhaps beyond the dreams of many of those in attendance who were most invested in a model for professional training. In evaluating the legacy of Boulder, several points are apparent. First, the conference succeeded because 73 individuals were able to agree to some 70 resolutions in 15 days, creating the scientist-practitioner model of professional training. Such consensus was arguably a remarkable achievement. The endorsement of the model by academic units followed with little evident resistance, although it is clear that some Boulder-model programs were developed that bore little resemblance to the model's insistence on significant training in both research and practice. Second, as a response to social and political needs, the conference was clearly a success. The cooperation of the APA, the USPHS, and the VA benefited all three entities. Clinical psychology was given the financial support and backing to advance it as a profession, and the federal government was able to begin the process of securing the personnel needed to address the mental health needs of the nation. The architects of Boulder were clear that their vision of training for professional psychology should be viewed as dynamic and experimental rather than fixed and prescribed. Certainly there are several variants of professional training extant today, yet the overwhelming majority of currently accredited programs in psychology label themselves as "Boulder-model" programs or "scientist-practitioner" programs. Still, new national conferences on professional training in psychology occur with some regularity as participants seek to resolve many of the same concerns debated by those at Boulder. The grand experiment goes on.

Protecting life and health in the midst of electronic and Internet mayhem.

The Internet offers huge benefits at a time when health care desperately needs cost-effective solutions that improve quality, reduce medical errors, and reach out to consumers. However, the abundant benefits offered by the Internet come with a price--new risks to patient privacy and safety. These risks must be understood well and managed skillfully if health care is to reap the benefits of Internet use without jeopardizing the safety of patients. Solutions are not simple; they involve technology, people, and fundamental principles of safe system design.

Assurance: the power behind PCASSO security.

The need for security protection in Internet-based healthcare applications is generally acknowledged. Most healthcare applications that use the Internet have at least implemented some kind of encryption. Most applications also enforce user authentication and access control policies, and many audit user actions. However, most fall short on providing strong assurances that the security mechanisms are behaving as expected and that they cannot be subverted. While no system can claim to be totally "bulletproof," PCASSO provides assurance of correct operation through formal, disciplined design and development methodologies, as well as through functional and penetration testing. Through its security mechanisms, backed by strong system assurances, PCASSO is demonstrating "safe" use of public data networks for health care.

PCASSO: a design for secure communication of personal health information via the internet.

The Internet holds both promise and peril for the communications of person-identifiable health information. Because of technical features designed to promote accessibility and interoperability rather than security, Internet addressing conventions and transport protocols are vulnerable to compromise by malicious persons and programs. In addition, most commonly used personal computer (PC) operating systems currently lack the hardware-based system software protection and process isolation that are essential for ensuring the integrity of trusted applications. Security approaches designed for electronic commerce, that trade known security weaknesses for limited financial liability, are not sufficient for personal health data, where the personal damage caused by unintentional disclosure may be far more serious. To overcome these obstacles, we are developing and evaluating an Internet-based communications system called PCASSO (Patient-centered access to secure systems online) that applies state of the art security to health information. PCASSO includes role-based access control, multi-level security, strong device and user authentication, session-specific encryption and audit trails. Unlike Internet-based electronic commerce 'solutions,' PCASSO secures data end-to-end: in the server; in the data repository; across the network; and on the client. PCASSO is designed to give patients as well as providers access to personal health records via the Internet.

Protecting clinical data on Web client computers: the PCASSO approach.

The ubiquity and ease of use of the Web have made it an increasingly popular medium for communication of health-related information. Web interfaces to commercially available clinical information systems are now available or under development by most major vendors. To the extent that such interfaces involve the use of unprotected operating systems, they are vulnerable to security limitations of Web client software environments. The Patient Centered Access to Secure Systems Online (PCASSO) project extends the protections for person-identifiable health data on Web client computers. PCASSO uses several approaches, including physical protection of authentication information, execution containment, graphical displays, and monitoring the client system for intrusions and co-existing programs that may compromise security.

PCASSO: a secure architecture for access to clinical data via the Internet.

Patient Centered Access to Secure Systems Online (PCASSO) is a National Information Infrastructure research project funded by the US National Library of Medicine (NLM). PCASSO is specifically designed to address the problem of enabling secure access to health information over the Internet, not just for healthcare providers and medical researchers, but also for patients to view their own medical records. The project is using familiar Web technologies to support the search and retrieval of information, including patient demographics, medications, lab tests, and transcription reports. State-of-the-art security technologies protect patient privacy and the integrity of patient information. This paper describes the security architecture of the PCASSO system.

Patient-Centered Access to Secure Systems Online (PCASSO): a secure approach to clinical data access via the World Wide Web.

The Internet's World-Wide Web (WWW) provides an appealing medium for the communication of health related information due to its ease of use and growing popularity. But current technologies for communicating data between WWW clients and servers are systematically vulnerable to certain types of security threats. Prominent among these threats are "Trojan horse" programs running on client workstations, which perform some useful and known function for a user, while breaching security via background functions that are not apparent to the user. The Patient-Centered Access to Secure Systems Online (PCASSO) project of SAIC and UCSD is a research, development and evaluation project to exploit state-of-the-art security and WWW technology for health care. PCASSO is designed to provide secure access to clinical data for healthcare providers and their patients using the Internet. PCASSO will be evaluated for both safety and effectiveness, and may provide a model for secure communications via public data networks.

Behavioral distinctions in children with reading disabilities and/or ADHD.

OBJECTIVE: To investigate behavioral distinctions between children with reading disabilities (RD) and attention-deficit hyperactivity disorder (ADHD). METHOD: A four-group mixed design consisting of children with reading disabilities only (RD only), reading disabilities and ADHD (RD/ADHD), ADHD only, and a comparison group was used. Differences between parent reports, from age 5 to 15 years, and teacher reports, from age 5 to 13 years, were examined on measures of hyperactive and antisocial behaviors. RESULTS: The analyses indicated that, at home, children from the ADHD only and RD/ADHD groups exhibited significantly more hyperactive behaviors than children from the RD only and comparison groups. At school, children from the RD only, ADHD only, and RD/ADHD groups typically exhibited significantly more hyperactive and antisocial behaviors than children from the comparison group. With regard to antisocial behaviors, children from the RD/ADHD group exhibited significantly more antisocial behaviors than children from any other group. CONCLUSIONS: The results of the study indicate that children from these groups may exhibit either a "pervasive" or "situational" presentation of behavioral problems, a finding which suggests that in conducting an evaluation of ADHD it is important to obtain both parent and teacher reports of problem behaviors.

Two little-known nineteenth century collectors: Dr Thomas Dowler and John Keast Lord, Esq., F.Z.S.

Neither Dowler nor Lord seems personally to have left any record in the entomological literature, but both made or obtained significant collections of insects in areas which at the time, and for a considerable period subsequently, were entomological terrae incognitae. Their collections were drawn on extensively by contemporary describers, for example, by Frederick Smith and Francis Walker, and what remains of their material is concentrated in the collections of The Natural History Museum, London. There is no entry for Dowler in D.N.B., and no entries for either in Horn and Kahle (1935-37), Gilbert (1977) or Horn, Kahle, Friese and Gaedike (1990), and an appeal for information published in Newsletter 51 (January 1995) of the Society for the History of Natural History elicited no response. The present note, which is written with particular reference to their Hymenoptera, is published with the intention of drawing attention to their material and in the hope that the wider circulation of the Archives may bring further biographical detail to light.

Continuous performance tests: a comparison of modalities.

Continuous Performance Tests (CPTs) are popular instruments for the assessment of sustained attention and impulsivity in individuals thought to have attentional deficits. CPTs used in research and clinical practice rely on visual presentations of stimulus material with little consideration given to the effects on CPT performance when stimuli are presented in an auditory mode. This study examined CPT performance in normal adult subjects. The mode of presentation (visual or auditory) and the type of task (vigilance or distractibility) were varied and their effects on performance measured. Data were collected on 82 subjects; results indicated that auditory presentation of stimuli increased the difficulty of both tasks. Results also showed that distractibility tasks were more difficult than vigilance tasks.

Monocular congenital cataracts: psychological effects of treatment.

Visual success in the treatment of monocular congenital cataracts requires early surgery, and aggressive, long-term amblyopia management and optical correction. These children will have their only normally seeing eye patched for a significant percentage of their early childhood years. We have been concerned about the possibility of an adverse psychological impact of this form of treatment. This study utilized two standardized testing instruments to evaluate the incidence of developmental delay and behavioral problems in children treated for monocular congenital cataracts. A total of 22 children were evaluated with one or both of these instruments and compared to a control group of 18 normal siblings. There was no statistically significant evidence of developmental delay or increased behavioral problems in the treatment group.