The effects of prenatal HIV exposure on language functioning in Kenyan children: establishing an evaluative framework

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Abstract

Background

HIV infection has been associated with impaired language development in prenatally exposed children. Although most of the burden of HIV occurs in sub-Saharan Africa, there have not been any comprehensive studies of HIV exposure on multiple aspects of language development using instruments appropriate for the population.

Methods

We compared language development in children exposed to HIV in utero to community controls (N = 262, 8–30 months) in rural Kenya, using locally adapted and validated communicative development inventories.

Results

The mean score of the younger HIV-exposed uninfected infants (8–15 months) was not significantly below that of the controls; however older HIV-exposed uninfected children had significantly poorer language scores, with HIV positive children scoring more poorly than community controls, on several measures.

Conclusions

Our preliminary data indicates that HIV infection is associated with impaired early language development, and that the methodology developed would be responsive to a more detailed investigation of the variability in outcome amongst children exposed to HIV, irrespective of their infection status.

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Most cited references 25

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Monitoring psychomotor development in a resource-limited setting: an evaluation of the Kilifi Developmental Inventory.

Charles Newton, G. Gaudenzi, P Holding … (2008)

Modifications made to the Kilifi Developmental Checklist and the psychometric characteristics of the new measure (The Kilifi Developmental Inventory) which assess the psychomotor functioning of children aged 6-35 months are described. Two groups of community children (319 rural and 104 urban dwellers) and nine children with neurodevelopmental disorders were recruited for a cross-sectional study. In both a rural and urban reference population, the inventory showed excellent internal consistency, interobserver agreement, test-retest reliability and sensitivity to maturational changes. Children with neurodevelopmental impairment and those who were underweight had significantly lower scores than the community sample, attesting to the sensitivity of the measure. Mothers found the assessment procedures acceptable and informative. The Kilifi Developmental Inventory is a culturally appropriate measure that can be used to monitor and describe the development of at-risk children in resource-limited settings in Kenya.

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Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo.

Annelies van Rie, Aimee Mupuala, Anna Dow (2008)

Pediatric HIV infection is a growing problem in most regions of the world. Data on the effects of HIV on the neurodevelopment of children in resource-poor settings are scarce but necessary to guide interventions. The purpose of this study was to compare the neurodevelopment of preschool-aged HIV-infected, HIV-affected (HIV-uninfected AIDS orphans and HIV-uninfected children whose mother had symptomatic AIDS), and healthy control children in Kinshasa, Democratic Republic of Congo. Thirty-five HIV-infected, 35 HIV-affected, and 90 control children aged 18 to 72 months were assessed by using the Bayley Scales of Infant Development II, Peabody Developmental Motor Scales, Snijders-Oomen Nonverbal Intelligence Test, and Rossetti Infant-Toddler Language Scale, as appropriate for age. Overall, 60% of HIV-infected children had severe delay in cognitive function, 29% had severe delay in motor skills, 85% had delays in language expression, and 77% had delays in language comprehension, all significantly higher rates as compared with control children. Young HIV-infected children (aged 18-29 months) performed worse, with 91% and 82% demonstrating severe mental and motor delay, respectively, compared with 46% and 4% in older HIV-infected children (aged 30-72 months). HIV-affected children had significantly more motor and language expression delay than control children. The impact of the HIV pandemic on children's neurodevelopment extends beyond the direct effect of the HIV virus on the central nervous system. AIDS orphans and HIV-negative children whose mothers had AIDS demonstrated significant delays in their neurodevelopment, although to a lesser degree and in fewer developmental domains than HIV-infected children. Young HIV-infected children were the most severely afflicted group, indicating the need for early interventions. Older children performed better as a result of a "survival effect," with only those children with less aggressive disease surviving.

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Communicative gestures in children with delayed onset of oral expressive vocabulary.

D R Thal, Geoffrey Tobias (1992)

Use of communicative gestures in a group of children with delayed onset of expressive oral vocabulary (late talkers) was compared with such use among normal-language-matched controls and age-matched controls. Analyses revealed that late talkers used significantly more communicative gestures and for a greater variety of communicative functions than did language-matched controls. However, a 1-year follow-up revealed that 4 of the late talkers remained delayed (truly delayed late talkers) and 6 caught up (late bloomers). Reanalyses of Year 1 data based on these follow-up outcomes demonstrated that only late bloomers used more communicative gestures than did language-matched controls. Truly delayed late talkers did not differ from language-matched controls either for number of gestures, type of gestures (symbolic vs. nonsymbolic), or number of different functions for which gestures were used. Late bloomers also used more communicative gestures than did age-matched controls, suggesting that they (the late bloomers) were using gestures to compensate for their small oral expressive vocabulary. Results are discussed in the context of early predictors of risk for language impairment and relationships between language and cognition.

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Author and article information

Contributors

K. J. Alcock: k.j.alcock@lancaster.ac.uk

Amina Abubakar: AAbubakar@kemri-wellcome.org

Charles R. Newton: charles.newton@psych.ox.ac.uk

Penny Holding: penny.holding@uclmail.net

Journal

Journal ID (nlm-ta): BMC Res Notes

Journal ID (iso-abbrev): BMC Res Notes

Title: BMC Research Notes

Publisher: BioMed Central (London )

ISSN (Electronic): 1756-0500

Publication date (Electronic): 12 October 2016

Publication date PMC-release: 12 October 2016

Publication date Collection: 2016

Volume: 9

Electronic Location Identifier: 463

Affiliations

[1 ]Department of Psychology, Fylde College, Lancaster University, Lancaster, LA1 4YF UK

[2 ]Centre for Geographic Medicine Research-Coast, KEMRI, Kilifi, Kenya

[3 ]Department of Public Health, Pwani University, Kilifi, Kenya

[4 ]Department of Psychiatry, University of Oxford, Oxford, UK

[5 ]Saving Brains Platform Team, Mombasa, Kenya

Article

Publisher ID: 2264

DOI: 10.1186/s13104-016-2264-3

PMC ID: 5062875

PubMed ID: 27733206

SO-VID: ef2c03e0-3d38-4b11-9d1a-40fa4d262a8f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 23 January 2016

Date accepted : 1 October 2016

Funding

Funded by: NIH

Award ID: Grant MH72597-02

Award Recipient : Penny Holding

Funded by: Wellcome Trust; UK

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: hiv,language,africa,children

Data availability:

ScienceOpen disciplines: Medicine

Keywords: hiv, language, africa, children

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The effects of prenatal HIV exposure on language functioning in Kenyan children: establishing an evaluative framework

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Abstract

Background

Methods

Results

Conclusions

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HIV Self-Testing

Most cited references 25

Monitoring psychomotor development in a resource-limited setting: an evaluation of the Kilifi Developmental Inventory.

Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo.

Communicative gestures in children with delayed onset of oral expressive vocabulary.

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Cited by 4

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