The Impact of Perinatal HIV Infection on Older School-Aged Children's and Adolescents' Receptive Language and Word Recognition Skills

HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, New York 10032, USA.
AIDS patient care and STDs (Impact Factor: 3.5). 05/2009; 23(6):415-21. DOI: 10.1089/apc.2008.0197
Source: PubMed


Perinatally HIV-infected youths are reaching adolescence in large numbers. Little is known about their cognitive functioning. This study aims to describe and compare the receptive language ability, word recognition skills, and school functioning of older school-aged children and adolescents perinatally HIV infected (HIV-positive) and perinatally HIV-exposed but uninfected (seroreverters; HIV-negative). Participants included 340 youths (206 HIV-positive, 134 HIV-negative), 9-16 years old, and their caregivers. Youths completed the Peabody Picture Vocabulary Test, Third Edition (PPVT-III) and the Reading Subtest of the Wide Range Achievement Test, Third Edition (WRAT-3). Caregivers were interviewed regarding demographic characteristics and school placement of youths. Medical information was abstracted from medical charts. Both groups of youths scored poorly on the PPVT-III and WRAT-3 with about one third of youths scoring in less than the 10th percentile. The HIV-positive youths scored lower than the seroreverters (M = 83.8 versus 87.6, t = 2.21, p = 0.028) on the PPVT-III and on the WRAT-3 (M = 88.2 versus 93.8, t = 2.69, p = 0.008). Among the HIV-positive youths, neither CD4+ cell count, HIV RNA viral load or Centers for Disease Control and Prevention (CDC) classification were significantly associated with either PPVT-III or WRAT-3 scores. However, youths who were taking antiretroviral medication had lower WRAT-3 scores than youths not taking medication (M = 95.03 versus 86.89, t = 2.38, p = 0.018). HIV status remained significantly associated with PPVT-III and WRAT-3 standard scores after adjusting for demographic variables. Many youths had been retained in school and attended special education classes. Findings highlight poor language ability among youths infected with and affected by HIV, and the importance of educational interventions that address this emerging need.

Download full-text


Available from: Ezer Kang, Oct 08, 2014
    • "Paediatric HIV is now viewed as a chronic illness characterised by a progressive course of symptomatic periods of acute illness and possible developmental and psychological disabilities (Bachanas et al., 2001b). Research has shown that children living with a HIVpositive caregiver are at increased risk for a wide range of emotional and behavioural problems that impact on school readiness and success of these children (Bauman, Silver, Draimin, & Hudis, 2007; Brackis-Cott, Kang, Dolezal, Abrams, & Mellins, 2009; Knitzer, Theberge, & Johnson, 2008; Puthanakit et al., 2010). There is evidence to show that children raised by depressed caregivers display a spectrum of cognitive and socioemotional problems (Gagliardi & Honigfeld, 2008; Patcher, Auinger, Palmer, & Weitzman, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger children's psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes.
    No preview · Article · Feb 2016 · AIDS Care
    • "In our study, the cognitive functions among HIV-infected children were impaired despite they received the ART for 2 years with undetectable viral load and normal CD4 cell. This is similar to a South African study which reported that HIV-infected children with a median age of 5 years were not shown improvement in neurocognitive functions after 6 months of ART.[18] Another study has also shown that neurocognitive functions do not improve with ART.[24] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and Objectives: Children infected with HIV are at risk for significant neurological and neuropsychological problems. This study is aimed at identifying cognitive deficits in HIV-infected children and to compare them with equal number of normal controls. Materials and Methods: Twenty children with HIV infection who are currently on antiretroviral therapy were recruited. They were assessed for their intelligence using Malin's Intelligence Scale for Indian Children and also evaluated for their cognitive abilities with a comprehensive neuropsychological battery. They were matched with equal number of normal controls. Results: HIV-infected children have shown substantial impairments in the domains of attention, language, verbal learning and memory, visuomotor functions, fine motor performance, and executive functions. Conclusion: HIV-infected children have average intelligence, but they performed poorly on several neuropsychological measures.
    No preview · Article · Jul 2014 · Indian Journal of Psychological Medicine
  • Source
    • "As children transition to early and middle adolescence, language and reading skills are the critical building blocks for literacy and future academic success, with an important transition from “learning to read and reading to learn” [50]. There is evidence that verbal skills are negatively affected in PHIV+ children [14, 24, 36, 50, 51]. In a large study in New York City, vocabulary and reading were worse in PHIV+ youths compared to PHEU, even after adjusting for demographic variables [50]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Globally, an estimated 3.4 million children are living with HIV, yet little is known about the effects of HIV and antiretroviral treatment (ART) on the developing brain, and the neurodevelopmental and behavioural outcomes of perinatally HIV-infected (PHIV+) adolescents. We reviewed the literature on neurodevelopmental outcomes in PHIV+ children and adolescents, and summarized the current evidence on behaviour, general cognition, specific domains, hearing and language, school performance and physical disabilities due to neurological problems. Evidence suggests that PHIV+ children do not perform as well as controls on general cognitive tests, processing speed and visual–spatial tasks, and are at much higher risk for psychiatric and mental health problems. Children with AIDS-defining diagnoses are particularly at risk for poorer outcomes. A striking finding is the lack of published data specific to the adolescent age group (10–25 years), particularly from resource-constrained countries, which have the highest HIV prevalence. In addition, extreme heterogeneity in terms of timing and source of infection, and antiretroviral experience limits our ability to summarize findings of studies and generalize results to other settings. Due to the complex nature of the developing adolescent brain, environmental influences and variation in access to ART, there is an urgent need for research on the longitudinal trajectory of neurodevelopment among children and adolescents perinatally infected with HIV, especially in high burden resource-constrained settings.
    Full-text · Dataset · Jun 2013
Show more