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Risk and resilience in the cognitive functioning of children born to HIV-1-infected mothers: a preliminary report
J M Coscia1, B K Christensen, R R Henry
1Department of Psychology, Vanderbilt University, Nashville, Tennessee 37203, USA.
Insights
Biologic factors like HIV-1 serostatus impact early cognitive development in exposed children, while environmental factors like caregiver status become more influential as children age. This highlights a risk and resilience model for cognitive outcomes.
Area of Science:
- Pediatric Neuroscience
- Developmental Psychology
- Infectious Disease Epidemiology
Background:
- Biologic and environmental factors influence child cognitive development.
- Limited research exists on these factors in children born to HIV-1-infected women.
- Understanding age-dependent effects is crucial for this population.
Purpose of the Study:
- To investigate the age-dependent impact of biologic and environmental risk factors on cognitive functioning.
- To explore the differential effects in children exposed to HIV-1 in utero.
- To examine the interplay of risk and resilience in cognitive development.
Main Methods:
- Eighty-two children exposed to HIV-1 in utero were assessed using standardized cognitive measures.
- Participants were divided into two age groups: 2–29 months (Group 1) and 30–101 months (Group 2).
- Correlations between cognitive scores and risk factors (serostatus, CD4 count, caregiver status) were analyzed.
Main Results:
- An age-related double-dissociation was observed in risk factor correlations.
- Biologic factors (serostatus, CD4%) correlated with cognition in younger children (Group 1) but not older children (Group 2).
- Environmental factors (caregiver status) correlated with cognition in older children (Group 2) but not younger children (Group 1).
Conclusions:
- Findings support a risk and resilience model of cognitive development.
- Biologic risks have a more pronounced effect on younger children exposed to HIV-1.
- Environmental factors play a more significant role in cognitive development for older children in this cohort.
Abstract:
Although biologic and environmental risk factors show an age-dependent effect on children's cognitive development, outcome studies have yet to consider the role such factors play in the development of children born to HIV-1-infected women. This study explored the age-dependent differential impact of such risk factors on the cognitive functioning of children exposed in utero to HIV-1. Eighty-two children were administered a standardized measure of cognitive functioning and divided into two groups depending on their age when tested. Group 1 included children age 2 to 29 months (n = 46); Group 2 included children age 30 to 101 months (n = 36). Correlations between cognitive test scores and specific risk factors revealed an age-related double-dissociation. Serostatus and percent of CD4 cells correlated moderately with cognitive test scores in Group 1; however, these correlations were attenuated and nonsignificant in Group 2. Conversely, caregiver status and cognitive test scores were uncorrelated in Group 1, but were correlated in Group 2. These findings support a risk and resilience model of development. That is, in the context of biologic risk factors, aspects of the child's environment may either facilitate or hinder cognitive development.
