Linda Pfiffner, PhD
Professor
Psychiatry
School of Medicine
Linda Pfiffner, PhD is a Professor in Residence and Director of the Hyperactivity, Attention and Learning Problems (HALP) Program in the Department of Psychiatry and is a licensed Clinical Psychologist. She received her B.A. from UCLA and her Ph.D. from the State University of New York at Stony Brook. Prior to joining UCSF in 2001, she held academic appointments at UC Irvine and the University of Chicago.
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Her program of research centers on the development and evaluation of collaborative school-home psychosocial treatments for school-aged children with ADHD, the inattentive presentation of ADHD, and family/social factors in developmental models of ADHD and related problems. She has over 200 refereed articles, chapters, and scientific conference abstracts and has published a second edition to her handbook for teachers “All About ADHD: The Complete Practical Guide for Classroom Teachers,” Scholastic, 2011. For the past 25 years her research has been supported by multiple grants from NIMH and the Institute of Education Sciences (IES), US Department of Education.
She developed the Child Life and Attention Skills (CLAS) Program, an integrated multi-component behavioral intervention for children with ADHD-Inattentive Presentation. CLAS has been evaluated in two NIMH-funded RCTs, one being a dual-site study, with positive effects on inattention symptoms and impairments. The program was awarded Innovative Program of the Year in 2004 by CHADD. She and her team adapted the program for youth with attention and behavioral concerns, developing the Collaborative Life Skills Program (CLS) for delivery by school-based mental health professionals in school settings. A recently completed IES-funded RCT shows significant treatment-related improvement on children’s ADHD symptoms, behavior, and academic and social functioning. She is currently developing a web-based, remote training program for school mental health providers in implementation of CLS with funding from IES. She also is developing a dHealth tool (parenting app) for parents of youth with attention and behavior challenges with funding from NIMH.
Dr. Pfiffner serves as Director of the Clifford Attkisson Clinical Services Research Training Program, an NIMH funded T32 which provides education and support to postdoctoral scholars from a variety of disciplines who plan to pursue careers in mental health services research. She serves on multiple editorial boards of leading psychology journals, was a former standing member of the NIMH ITVC IRG study section and a principal member of the Institute of Education Sciences’ Social and Behavioral Education Research Scientific Review Panel.
Awards
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- President, Past President International Society for Research in Child and Adolescent Psychopathology, 2017-2021
- CHADD Hall of Fame Award, 2012
- CHADD ADHD and Family Issues Award, 2009
- CHADD Innovative Program of the Year Award, 2004
Education & Training
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- Diversity, Equity and Inclusion Champion Training University of California 2021
- MA, PhD Clinical Psychology State University of New York at Stony Brook 1987
- BA Psychology University of California Los Angeles 1981
Websites
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- Hyperactivity and Learning Problems Clinic (psychiatry.ucsf.edu)
- Collaborative Life Skills Program (clsprogram.ucsf.edu)
- Clinical Profile at UCSF Benioff Children's Hospital (ucsfbenioffchildrens.org)
Grants and Projects
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- Hybrid Effectiveness-Implementation Trial of a School Clinician Training and Psychosocial ADHD/ODD Intervention Program Adapted for Schools across Mexico (CLS-A-FUERTE), Fogarty International Center/Fogarty Global Brain Disorders, 2024-2029
- Extending the reach of evidence-based practices to support student attention and behavior through technology, IES/US Department of Education, 2024-2028
- Center for Team Effectiveness to Accelerate EBP Implementation in Children’s Mental Health Services: TEAMS R01 ADHD Intervention in Schools, NIMH, 2022-2027
- Clinical Services Research Training Program, NIH, 1985-2026
- Guided ADHD Therapy for Managing the Extent and Severity of Symptoms, Lumos Labs Medical, 2022-2024
- A Digital Health Solution for Improving Parent Adherence and Sustainability of ADHD Treatment Outcomes, NIH, 2020-2023
- Web-based professional development for school mental health providers in evidence-based practices for attention and behavior challenges, Institute of Education Sciences, US Department of Education, 2017-2022
- A Remote, Web-Based Parenting Program to Support Families of Youth with ADHD Coping with COVID-19, UCSF Department of Psychiatry and Behavioral Sciences, 2020-2021
- A Digital Health Solution for Improving Parent Adherence to Behavioral Treatment for ADHD: Preliminary Development, UCSF Academic Senate, 2019-2020
- Efficacy of the Collaborative Life Skills Program, Institute of Education Sciences, US Department of Education, 2012-2018
- Integrated Multi-Setting Psychosocial Treatment for ADHD-Inattentive Type, NIH, 2008-2015
- Collaborative School-Home Behavioral Intervention for ADHD, Institute of Education Sciences, 2008-2012
- Psychosocial Treatment for ADHD Inattentive Type 1, NIH, 2002-2007
- Family Factors and Comorbid Disorders in Adhd Children, NIH, 1993-1999
Publications (74)
Top publication keywords:
Attention Deficit and Disruptive Behavior DisordersSocial SkillsChild BehaviorTreatment Adherence and ComplianceSchool Health ServicesCognitionParentsSchoolsFacultySocial BehaviorAttention Deficit Disorder with HyperactivityParentingFamily TherapyBehavior TherapyChild
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Research Review: Mechanisms of change and between-family differences in parenting interventions for children with ADHD - an individual participant data meta-analysis.
Journal of child psychology and psychiatry, and allied disciplines 2025 Psyllou C, Luman M, van den Hoofdakker BJ, Van der Oord S, Aghebati A, Boyer B, Buitelaar J, Chronis-Tuscano A, Daley D, Dekkers TJ, DuPaul GJ, Fabiano GA, Ferrin M, Franke N, Tsahor NG, Harvey E, … -
The Role of Externalizing Problems and Empathy on the Daily Report Card. School Mental Health
School Mental Health 2024 Bansal, P., Meza, J., Chung, S., Henry, L., Dvorsky, M., Haack, L.M., Owens, E., & Pfiffner, L.J. -
Feasibility study of a telehealth school-based behavioral parent training group program for attention-deficit/hyperactivity disorder.
Journal of pediatric psychology 2024 Chung S, Lai J, Hawkey EJ, Dvorsky MR, Owens E, Huston E, Pfiffner LJ -
Emotion Regulation and Organizational Skills in Children With ADHD Symptoms Are Associated With Behavioral Parent Training Adherence.
Journal of attention disorders 2024 Hawkey EJ, Williams AI, Chung S, Owens EB, Pfiffner LJ -
Implementation of a Multi-Site Digitally-Enhanced School Clinician Training and ADHD/ODD Intervention Program in Mexico: Randomized Controlled Trial of CLS-R-FUERTE.
Journal of technology in behavioral science 2024 Haack LM, Pfiffner LJ, Darrow SM, Lai J, Alcaraz-Beltrán DK, Martínez-Beltrán JU, Moreno-Candil E, Delgado-García K, Arriaga-Guerrero MF, Ledesma-Saldaña DM, Urquídez-Valdez ME, Angelina Araujo E
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Integrating Treatment for Maternal Depression and Young Children's Behavior Problems.
Journal of psychiatry and brain science 2023 Roubinov D, Ivins B, Frame L, Simms S, Pfiffner L -
Enhancing accessibility and scalability of school-based programs to improve youth attention and behavior: Open feasibility trial of the remote CLS-R-FUERTE program in Mexico.
School psychology (Washington, D.C.) 2023 Haack LM, Pfiffner LJ, Darrow SM, Lai J, Alcaraz Beltrán DK, Beltrán JUM, Moreno Candil E, Delgado García K, Arriaga Guerrero MF, Ledesma Saldaña DM, Urquídez Valdez ME, Araujo EA -
Parental Cognitions, Treatment Engagement, and Child Outcomes of ADHD Behavioral Treatment among Asian American Families.
Research on child and adolescent psychopathology 2023 Chung S, Williams A, Owens E, McBurnett K, Hinshaw SP, Pfiffner LJ -
Investigation of the feasibility and acceptability of a school-based intervention for children with traits of ADHD: protocol for an iterative case-series study.
BMJ open 2023 Russell AE, Dunn B, Hayes R, Moore D, Kidger J, Sonuga-Barke E, Pfiffner L, Ford T -
Development of a Web-Based Training Platform for School Clinicians in Evidence-Based Practices for ADHD.
School mental health 2022 Pfiffner LJ, Dvorsky MR, Friedman LM, Haack LM, Chung S, Charalel JM, Hawkey E, Spiess M -
Improving Adherence to Behavioral Parent Training for ADHD Using Digital Health Tools.
Journal of psychiatry and brain science 2022 Pfiffner LJ, Dvorsky MR, Hawkey EJ, Chung S, Haack LM, Owens EB -
The Two-Factor Structure of the Parent Cognitive Error Questionnaire: A Measure of Parental Cognitive Errors in Relation to Child Problems.
Research on child and adolescent psychopathology 2022 Jiang Y, Delucchi K, Kaiser N, Hinshaw SP, McBurnett K, Pfiffner LJ -
Synthesising the existing evidence for non-pharmacological interventions targeting outcomes relevant to young people with ADHD in the school setting: systematic review protocol.
Systematic reviews 2022 Russell AE, Moore D, Sanders A, Dunn B, Hayes R, Kidger J, Sonuga-Barke E, Pfiffner L, Ford T -
An Individual Participant Data Meta-analysis: Behavioral Treatments for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder.
Journal of the American Academy of Child and Adolescent Psychiatry 2021 Groenman AP, Hornstra R, Hoekstra PJ, Steenhuis L, Aghebati A, Boyer BE, Buitelaar JK, Chronis-Tuscano A, Daley D, Dehkordian P, Dvorsky M, Franke N, DuPaul GJ, Gershy N, Harvey E, Hennig T, Herbert S… -
Do Parents' ADHD Symptoms Affect Treatment for their Children? The Impact of Parental ADHD on Adherence to Behavioral Parent Training for Childhood ADHD.
Journal of abnormal child psychology 2020 Friedman LM, Dvorsky MR, McBurnett K, Pfiffner LJ -
Patterns of Parental Adherence and the Association to Child and Parenting Outcomes Following a Multicomponent School-Home Intervention for Youth With ADHD.
Behavior therapy 2020 Dvorsky MR, Friedman LM, Spiess M, Pfiffner LJ -
42.3 DEVELOPMENT OF A WEB-BASED TRAINING PLATFORM FOR SCHOOL CLINICIANS IN EVIDENCE-BASED PRACTICES FOR ADHD
Journal of the American Academy of Child & Adolescent Psychiatry 2020 Pfiffner LJ, Dvorsky MR, Haack LM, Friedman LM, Spiess M, Morgan J, Chung, S, Griest S. -
Can School Mental Health Providers Deliver Psychosocial Treatment Improving Youth Attention and Behavior in Mexico? A Pilot Randomized Controlled Trial of CLS-FUERTE.
Journal of attention disorders 2020 Haack LM, Araujo EA, Meza J, Friedman LM, Spiess M, Alcaraz Beltrán DK, Delucchi K, Mojardín Herladez A, Pfiffner L -
Co-Occurring Psychopathology Moderates Social Skills Improvement in a Randomized Controlled Trial of a Collaborative School-Home Intervention for Children with ADHD.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2020 Morgan JE, Dvorsky MR, Meza JI, Schumacher LT, Pfiffner LJ -
Outcomes of School-Home Intervention for Attention and Behavior Problems: Teacher Adherence Matters
School Mental Health 2020 Meza, J.I., Friedman, L.M., Dvorsky, M.R., Kass, P., Karanchhabra, D., & Pfiffner, L.J. -
Outcomes of School-Home Intervention for Attention and Behavior Problems: Teacher Adherence Matters.
School mental health 2020 Meza JI, Friedman LM, Dvorsky MR, Kass P, Chabbra D, Pfiffner LJ -
Learning Disorder Confers Setting-Specific Treatment Resistance for Children with ADHD, Predominantly Inattentive Presentation.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2019 Friedman LM, McBurnett K, Dvorsky MR, Hinshaw SP, Pfiffner LJ -
The roles of student gender, race, and psychopathology in teachers' treatment referrals for children
School Mental Health 2019 Villodas, M., Pfiffner, L.J., Moses, J.O., Hartung, C., & McBurnett, K. -
The Collaborative Life Skills Program in Spanish (CLS-S): Pilot Investigation of Intervention Process, Outcomes, and Qualitative Feedback.
Evidence-based practice in child and adolescent mental health 2019 Haack LM, Araujo EJ, Delucchi K, Beaulieu A, Pfiffner L -
Correction to: Influences to ADHD Problem Recognition: Mixed-Method Investigation and Recommendations to Reduce Disparities for Latino Youth.
Administration and policy in mental health 2018 Haack LM, Meza J, Jiang Y, Araujo EA, Pfiffner L -
Influences to ADHD Problem Recognition: Mixed-Method Investigation and Recommendations to Reduce Disparities for Latino Youth.
Administration and policy in mental health 2018 Haack LM, Meza J, Jiang Y, Araujo EJ, Pfiffner L -
Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type.
Administration and policy in mental health 2018 Tran JLA, Sheng R, Beaulieu A, Villodas M, McBurnett K, Pfiffner LJ, Wilson L -
Processing Speed Predicts Behavioral Treatment Outcomes in Children with Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type.
Journal of abnormal child psychology 2018 Adalio CJ, Owens EB, McBurnett K, Hinshaw SP, Pfiffner LJ -
Sustained Effects of Collaborative School-Home Intervention for Attention-Deficit/Hyperactivity Disorder Symptoms and Impairment.
Journal of the American Academy of Child and Adolescent Psychiatry 2018 Pfiffner LJ, Rooney ME, Jiang Y, Haack LM, Beaulieu A, McBurnett K -
Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation.
Behavior therapy 2017 Jiang Y, Haack LM, Delucchi K, Rooney M, Hinshaw SP, McBurnett K, Pfiffner LJ -
Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation.
Journal of abnormal child psychology 2017 Haack LM, Villodas M, McBurnett K, Hinshaw S, Pfiffner LJ -
Patterns and Predictors of Service Utilization Among Youth With ADHD-Predominantly Inattentive Presentation.
Journal of attention disorders 2017 Capriotti MR, Pfiffner LJ -
Parent Adherence in Two Behavioral Treatment Strategies for the Predominantly Inattentive Presentation of ADHD.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2016 Rooney M, Hinshaw S, McBurnett K, Pfiffner L -
Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2016 Owens EB, Hinshaw SP, McBurnett K, Pfiffner L -
Parental Cognitive Errors Mediate Parental Psychopathology and Ratings of Child Inattention.
Family process 2016 Haack LM, Jiang Y, Delucchi K, Kaiser N, McBurnett K, Hinshaw S, Pfiffner L -
Assessing Impairment in Childhood ADHD: Validation of the Parent and Teacher ADHD-FX Rating Scale in a Dual-Site Clinical Sample.
Journal of attention disorders 2016 Haack LM, Gonring K, Harris M, Gerdes A, Pfiffner L -
A Randomized Controlled Trial of a School-Implemented School-Home Intervention for Attention-Deficit/Hyperactivity Disorder Symptoms and Impairment.
Journal of the American Academy of Child and Adolescent Psychiatry 2016 Pfiffner LJ, Rooney M, Haack L, Villodas M, Delucchi K, McBurnett K -
Sleep habits in children with attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms.
Sleep medicine 2015 Becker SP, Pfiffner LJ, Stein MA, Burns GL, McBurnett K -
Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2014 Haack LM, Villodas MT, McBurnett K, Hinshaw S, Pfiffner LJ -
Behavior management for school-aged children with ADHD.
Child and adolescent psychiatric clinics of North America 2014 Pfiffner LJ, Haack LM -
Meta-analysis supports efficacy of behavioral interventions for attention-deficit/hyperactivity disorder-related problems.
Journal of the American Academy of Child and Adolescent Psychiatry 2014 Pfiffner LJ -
Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD.
Child psychiatry and human development 2014 Villodas MT, McBurnett K, Kaiser N, Rooney M, Pfiffner LJ -
A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type.
Journal of consulting and clinical psychology 2014 Pfiffner LJ, Hinshaw SP, Owens E, Zalecki C, Kaiser NM, Villodas M, McBurnett K -
Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder.
Journal of abnormal child psychology 2014 McBurnett K, Villodas M, Burns GL, Hinshaw SP, Beaulieu A, Pfiffner LJ -
Negative social preference in relation to internalizing symptoms among children with ADHD predominantly inattentive type: girls fare worse than boys.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2013 Becker SP, McBurnett K, Hinshaw SP, Pfiffner LJ -
Educational outcomes of a collaborative school-home behavioral intervention for ADHD.
School psychology quarterly : the official journal of the Division of School Psychology, American Psychological Association 2013 Pfiffner LJ, Villodas M, Kaiser N, Rooney M, McBurnett K -
Prevention of serious conduct problems in youth with attention deficit/hyperactivity disorder.
Expert review of neurotherapeutics 2012 Villodas MT, Pfiffner LJ, McBurnett K -
Child ADHD severity and positive and negative parenting as predictors of child social functioning: evaluation of three theoretical models.
Journal of attention disorders 2010 Kaiser NM, McBurnett K, Pfiffner LJ -
Treatment of aggressive ADHD in children and adolescents: conceptualization and treatment of comorbid behavior disorders.
Postgraduate medicine 2009 McBurnett K, Pfiffner LJ -
Can executive functions explain the relationship between Attention Deficit Hyperactivity Disorder and social adjustment?
Journal of abnormal child psychology 2009 Huang-Pollock CL, Mikami AY, Pfiffner L, McBurnett K -
A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type.
Journal of the American Academy of Child and Adolescent Psychiatry 2007 Pfiffner LJ, Yee Mikami A, Huang-Pollock C, Easterlin B, Zalecki C, McBurnett K -
Sibling relationships among children with ADHD.
Journal of attention disorders 2007 Mikami AY, Pfiffner LJ -
ADHD subtype differences in motivational responsivity but not inhibitory control: evidence from a reward-based variation of the stop signal paradigm.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2007 Huang-Pollock CL, Mikami AY, Pfiffner L, McBurnett K -
Social skills differences among attention-deficit/hyperactivity disorder types in a chat room assessment task.
Journal of abnormal child psychology 2007 Mikami AY, Huang-Pollock CL, Pfiffner LJ, McBurnett K, Hangai D -
Family correlates of comorbid anxiety disorders in children with attention deficit/hyperactivity disorder.
Journal of abnormal child psychology 2006 Pfiffner LJ, McBurnett K -
Treatment-related changes in objectively measured parenting behaviors in the multimodal treatment study of children with attention-deficit/hyperactivity disorder.
Journal of consulting and clinical psychology 2006 Wells KC, Chi TC, Hinshaw SP, Epstein JN, Pfiffner L, Nebel-Schwalm M, Owens EB, Arnold LE, Abikoff HB, Conners CK, Elliott GR, Greenhill LL, Hechtman L, Hoza B, Jensen PS, March J, Newcorn JH, Pelham… -
Impact of visual impairment on measures of cognitive function for children with congenital toxoplasmosis: implications for compensatory intervention strategies.
Pediatrics 2006 Roizen N, Kasza K, Karrison T, Mets M, Noble AG, Boyer K, Swisher C, Meier P, Remington J, Jalbrzikowski J, McLeod R, Kipp M, Rabiah P, Chamot D, Estes R, Cezar S, Mack D, Pfiffner L, Stein M, Danis B… -
Family correlates of oppositional and conduct disorders in children with attention deficit/hyperactivity disorder.
Journal of abnormal child psychology 2005 Pfiffner LJ, McBurnett K, Rathouz PJ, Judice S -
Antisocial personality, substance abuse, and exposure to parental violence in males referred for domestic violence.
Violence and victims 2001 McBurnett K, Kerckhoff C, Capasso L, Pfiffner LJ, Rathouz PJ, McCord M, Harris SM -
Father absence and familial antisocial characteristics.
Journal of abnormal child psychology 2001 Pfiffner LJ, McBurnett K, Rathouz PJ -
Symptom properties as a function of ADHD type: an argument for continued study of sluggish cognitive tempo.
Journal of abnormal child psychology 2001 McBurnett K, Pfiffner LJ, Frick PJ -
Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study.
Journal of abnormal child psychology 2000 Wells KC, Epstein JN, Hinshaw SP, Conners CK, Klaric J, Abikoff HB, Abramowitz A, Arnold LE, Elliott G, Greenhill LL, Hechtman L, Hoza B, Jensen PS, March JS, Pelham W, Pfiffner L, Severe J, Swanson … -
Interventions to enhance social competence.
Child and adolescent psychiatric clinics of North America 2000 Pfiffner LJ, Calzada E, McBurnett K -
Evaluation of the validity of the Wechsler Intelligence Scale for Children--Third Edition comprehension and picture arrangement subtests as measures of social intelligence.
Psychological assessment 2000 Beebe DW, Pfiffner LJ, McBurnett K -
The child with congenital toxoplasmosis.
Current clinical topics in infectious diseases 2000 McLeod R, Boyer K, Roizen N, Stein L, Swisher C, Holfels E, Hopkins J, Mack D, Karrison T, Patel D, Pfiffner L, Remington J, Withers S, Meyers S, Aitchison V, Mets M, Rabiah P, Meier P -
Association of parental psychopathology to the comorbid disorders of boys with attention deficit-hyperactivity disorder.
Journal of consulting and clinical psychology 1999 Pfiffner LJ, McBurnett K, Lahey BB, Loeber R, Green S, Frick PJ, Rathouz PJ -
Experimental cross-validation of DSM-IV types of attention-deficit/hyperactivity disorder.
Journal of the American Academy of Child and Adolescent Psychiatry 1999 McBurnett K, Pfiffner LJ, Willcutt E, Tamm L, Lerner M, Ottolini YL, Furman MB -
Social skills training with parent generalization: treatment effects for children with attention deficit disorder.
Journal of consulting and clinical psychology 1997 Pfiffner LJ, McBurnett K -
ADHD and LD.
Journal of learning disabilities 1991 McBurnett K, Pfiffner LJ -
Effects of maternal discipline and nurturance on toddler's behavior and affect.
Journal of abnormal child psychology 1989 Pfiffner LJ, O'Leary SG -
Marital conflict, parenting, and toddler conduct problems.
Journal of abnormal child psychology 1988 Jouriles EN, Pfiffner LJ, O'Leary SG -
The efficacy of all-positive management as a function of the prior use of negative consequences.
Journal of applied behavior analysis 1987 Pfiffner LJ, O'leary SG -
The efficacy of an all-positive approach to classroom management.
Journal of applied behavior analysis 1985 Pfiffner LJ, Rosén LA, O'Leary SG -
The importance of prudent negative consequences for maintaining the appropriate behavior of hyperactive students.
Journal of abnormal child psychology 1984 Rosén LA, O'Leary SG, Joyce SA, Conway G, Pfiffner LJ