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Associations of Memory and Executive Functioning With Academic and Adaptive Functioning Among Youth With Perinatal
Patricia A Sirois1, Miriam C Chernoff2, Kathleen M Malee3
1Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana.
Insights
Children with perinatally acquired HIV (PHIV) and their HIV-exposed peers show similar math and adaptive skills. However, PHIV with severe symptoms had lower reading scores, highlighting memory and executive functions as key intervention targets.
Area of Science:
- Neuroscience
- Pediatric Medicine
- Infectious Diseases
Background:
- Perinatally acquired HIV (PHIV) is linked to neurocognitive impairments affecting children's academic and functional abilities.
- Understanding the impact of HIV on cognitive domains like memory and executive function (EF) is crucial for this population.
Purpose of the Study:
- To examine the associations between memory, EF, and academic/adaptive skills in youth with PHIV and perinatally HIV-exposed but uninfected (PHEU) youth.
- To compare neurocognitive and academic outcomes across PHIV with Centers for Disease Control and Prevention class C diagnosis (PHIV/C), PHIV without class C (PHIV/non-C), and PHEU youth.
Main Methods:
- A cohort of 258 participants aged 9 to <19 years from the Pediatric HIV/AIDS Cohort Study completed assessments.
- Standardized measures evaluated reading, math, and adaptive behavior; retrospective memory (RM), prospective memory (PM), and EF were analyzed.
- General linear regression models adjusted for sociodemographics compared outcomes among PHIV/C, PHIV/non-C, and PHEU groups.
Main Results:
- No significant differences in math and adaptive behavior scores were found between PHIV/C, PHIV/non-C, and PHEU youth.
- Youth with PHIV/C exhibited lower adjusted mean reading scores compared to PHIV/non-C and PHEU youth.
- Positive associations were observed between RM, PM, EF, and academic performance, as well as between memory, PM, EF, and adaptive behavior.
Conclusions:
- Memory and executive functions are critical for academic and adaptive skills in children, irrespective of HIV status.
- These cognitive domains represent potential targets for interventions aimed at improving functional outcomes in youth affected by HIV.
Background:
Perinatally acquired HIV (PHIV) confers risk for neurocognitive impairment, which potentially affects school performance and functional independence of infected children. In this study, we examined the associations of 2 key neurocognitive domains, memory and executive function (EF), with academic and adaptive skills among youth with PHIV and perinatally HIV-exposed but uninfected (PHEU) youth.
Methods:
Participants ages 9 to <19 years enrolled in the Pediatric HIV/AIDS Cohort Study's Memory and Executive Functioning Study completed standardized measures of reading and math. The primary caregivers completed a standardized measure of their child's adaptive behavior. Participants with PHIV, those with (PHIV/C) and without (PHIV/non-C) a Centers for Disease Control and Prevention class C diagnosis, and PHEU participants were compared. Retrospective memory (RM), prospective memory (PM), and EF were evaluated relative to outcomes using general linear regression models adjusted for sociodemographic characteristics.
Results:
Of the participants (N = 258; mean age, 14.1 years), 46% were male, 75% were black, and 18% were Hispanic. Adjusted mean scores in math and adaptive behavior did not differ among the youth with PHIV/C (n = 45), those with PHIV/non-C (n = 128), and PHEU youth (n = 85). Youth with PHIV/C had lower adjusted mean reading scores than PHIV/non-C and PHEU youth (86.9 vs 93.8 [P = .02] and 93.2 [P = .04], respectively). There were positive associations of RM, PM, EF, and some sociodemographic characteristics with higher reading and math scores. Immediate and delayed verbal memory, delayed visual memory, PM, and some EF measures were positively associated with adaptive behavior.
Conclusions:
Higher-order cognitive abilities such as memory and EF seem to play a key role in academic and adaptive capacities, regardless of a child's HIV status, and might serve as intervention targets for improving functional outcomes.
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