Amsterdam 2015
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| Abstract #2076 - Cognitive development in children and adolescents | ||||
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Session: 16.2: Cognitive development in children and adolescents (Parallel) on Wednesday @ 14.30-16.00 in C001 Chaired by Xiaoming Li, Igor Grant Authors: Presenting Author: Prof Lorraine Sherr - University College London, United Kingdom |
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| Additional Authors: | ||||
| Aim: Child cognitive and mental health may be adversely affected by HIV. The virus crosses the blood brain barrier. In addition HIV+ve children may be affected by HIV+ve caregivers in terms of quality of parenting and adult availability. | ||||
| Method / Issue: Children aged 4-13yrs and their primary caregivers were interviewed. Ethical approval and data collector training preceded data gathering. Child cognitive development was measured using parental report on the Ten Questions inventory, direct child testing measures using the Draw a Man test and a Digit Span test. Educational measures were generated including school enrolment, attendance and achievement. Parents completed the Strengths and Difficulties inventory for the child. In addition children reported on quality of life using standardised age appropriate measures. | ||||
| Results / Comments: 135 HIV+ve and 844 comparison children participated in the study. Children who were HIV positive showed significant levels of developmental delay on the screening test (70.4% versus 41.7% scoring delay), X2(1)=28.2,p<0.0001. On examination of the subscales, the HIV+ve children showed delay for motor milestones (sitting, standing, walking) hearing difficulties, speech problems, and mental difficulties. HIV status remained a predictor of delay after adjusting for all demographic and socio-economic indicators. At follow up HIV+ children were more likely to suffer from multiple disabilities (3+) compared to the non-infected group (15%% vs. 4.9%p<0.0001). Being HIV positive was also associated with lower quality of life in the physical, social, emotional and educational domains. HIV+ve children were more often in the incorrect class (50% vs. 25.8%, p<0.0001), slow learners (41.5% vs. 24.7%, p<0.0001), struggled at school (32.2% vs. 14.1%, p<0.0001, and attended less regularly (8.5% vs. 3.6%, p<0.0001). Digit span scaled scores and draw-a-person test were significantly lower than comparison children (M=7.19, SD=3.87vs. M=7.19, SD=3.87p<.0001). In a regression analysis, adjusted for demographic confounders (age, gender, level of education, poverty, parental bereavement, family illness, stigma), HIV status remained a significant predictor of poor performance (ß=.084, p=.008). On the Strengths and Difficulties Questionnaire (SDQ), emotional and behavioural difficulties HIV+ve children presented more problems (M=3.42, SD=0.21 vs. M=2.94,SD=0.08), t(977)=2.17,p=0.03. When controlling for other factors, HIV status remained a significant predictor. At follow-up, we found positive changes in children’s cognitive performance and health-related quality of life, but these were independent of HIV status. There was a significant decrease over time of number of educational risks. | ||||
| Discussion: Our data clearly presents solid evidence of challenges which could benefit from interventions, special needs provision and support – well suited to CBO provision. | ||||
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