A Year-Long Caregiver Training Program Improves Cognition in Preschool Ugandan Children with Human Immunodeficiency Virus

Abstract

Objective To evaluate if mediational intervention for sensitizing caregivers (MISC) MISC biweekly caregiver training significantly enhanced child development, compared with biweekly training on health and nutrition (active control) and to evaluate whether MISC training improved the emotional well-being of the caregivers compared with controls. Study design Sixty of 120 rural Ugandan preschool child/caregiver dyads with HIV were assigned by randomized clusters to biweekly MISC training alternating between home and clinic for one year. Control dyads received a health and nutrition curriculum. Children were evaluated at baseline, 6 months, and 1 year with the Mullen Early Learning Scales and the Color-Object Association Test (COAT) for memory. Caldwell HOME and videotaped child/caregiver MISC interactions also were evaluated. Caregivers were evaluated for depression and anxiety with the Hopkins Symptoms Checklist. Results Between-group repeated-measures ANCOVA comparisons were made with age, sex, CD4 levels, viral load, material SES, physical development, and HAART treatment status as covariates. The children given MISC had significantly greater gains compared with controls on the Mullen Visual Reception scale (visual-spatial memory) and on COAT memory. MISC caregivers significantly improved on HOME scale and total frequency of MISC videotaped interactions. MISC caregivers also were less depressed. Mortality was less for children given MISC compared with controls during the training year. Conclusions MISC was effective in teaching Ugandan caregivers to enhance their children’s cognitive development through practical and sustainable techniques applied during daily interactions in the home.

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

“…It is likely that central nervous system HIV infection in children results in frontostriatal dysfunction (Adam et al, 2003). Consistent with other studies, children with HIV infection in our study tended to score lowest in verbal, memory, and quantitative scales compared to their uninfected peers, though it is not statistically significant (Baillieu & Potterton, 2008;Boivin et al, 2013;Levenson, Mellins, Zawadzki, Kairam, & Stein, 1992;Sherr et al, 2009;Van et al, 2008). Two studies (Bisiacchi, Suppiej, & Laverda, 2000;Koekkoek et al, 2008) reported executive function deficits as the most sensitive cognitive measure in relation to HIV disease progression.…”

Socio-demographic correlates of depression and anxiety among female caregivers living with HIV in rural Uganda

“…This secondary analysis utilizes baseline data from 288 HIV-infected women participating in a randomized controlled trial testing the Meditational Intervention for Sensitizing Caregivers (MISC), a one-year program aimed at enhancing child physical and neuropsychological development (Boivin et al, 2013). Details of the parent study are described elsewhere (Bass, Nakasujja, Familiar-Lopez, Sikorskii, Murray,…& Boivin, 2016).…”

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV

“…33 It has been previously used by our group in pediatric HIV research in Uganda. 35,36 Although the CBCL can provide a wide array of DSM-V and Syndrome scale scores, our principal outcomes were Internalizing, Externalizing, and Total symptoms.…”