Amsterdam 2015
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| Abstract #3430 - Cognitive development in children and adolescents | ||||
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Session: 16.5: 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 Michael Boivin - Michigan State University, United States |
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| Additional Authors: | ||||
| Aim: One of the principal risks to children born to mothers with HIV in low-resource settings is compromised caregiving due to the disease's effects on the mother. The purpose of this study is to evaluate the relationship between emotional wellbeing of the principal caregiver, quality of the home environment and caregiving, and neurocognitive performance outcomes in rural eastern Ugandan children infected with HIV and born to mothers with HIV but not infected(HEU). | ||||
| Method / Issue: Study participants were 118 HIV and 211 HEU boys and girls 2 to 5 years of age. 71% of the HIV children and 92% of the HEU children were cared for by biological mothers. Caregivers’ wellbeing was evaluated using the Hopkins Symptoms Checklist (HSCL-25), as well as with assessments for functionality for everyday tasks, social support, and negative coping tendencies. Quality of home environment was evaluated with a modified Caldwell HOME scale and socio-economic status (SES) was measured through a check list of material possessions and housing quality. Quality of caregiving was evaluated through the scoring of videotaped caregiver/child interactions during feeding, bathing, and shared work recorded in the home. Children were also evaluated with the Mullen Scales of Early Learning (MSEL), the Color Object Association Test (COAT) for memory and learning, the Early Childhood Vigilance Test (ECVT) for attention, and the caregiver-reported Behavior Rating Inventory of Executive Function (BRIEF). | ||||
| Results / Comments: Physical growth for the HIV children was significantly related to an index of compiled neurocognitive performance outcomes (P < 0.01), but less so in the HEU cohort. HIV children whose clinical status necessitated initiation on HAART intervention performed especially poorly on these neurocognitive performance measures. Multiple linear regression models with caregiver wellbeing, caregiving quality, and home quality as the predictors, caregiver functionality and quality was significantly related to overall child neurocognitive performance as assessed by a combined index of the MSEL, ECVT, and COAT (P < 0.01) for the HEU, but not the HIV cohort. Caregiver depression symptoms were significantly related to lower overall performance on the BRIEF for the HIV cohort (P < 0.01), but marginally so for the HEU cohort (P = 0.055). These relationships changed over the course of a year-long caregiver training intervention designed to improve the quality of caregiving for the HIV and HEU children in the home. | ||||
| Discussion: Caregiver functionality and EWB in the face of HIV disease is a very important predictor of cognitive development and behavior in young children living in rural eastern Uganda. This suggests the need for caregiver training programs in order to improve EWB and the quality of both caregiving and home environments for young children growing up in HIV-affected households in low-resource settings. We have recently completed a biweekly year-long training program to improve caregiving provided for both HIV and HEU children in these settings. We are in the process of evaluating our findings as to the extent to which a this program has improved emotional wellbeing, caregiving quality and functionality of the mother as well as enhanced developmental outcomes for their children. | ||||
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