Developmental change associated with human immunodeficiency virus infection in school‐age children with hemophilia

Abstract

This study was designed to examine (a) developmental change associated with human immunodeficiency virus (HIV) infection in hemophilic boys ages 6 to 16 years and (b) whether age at infection was a critical variable in developmental change for children with HIV disease. Of the 11 subjects, 5 were HIV‐seronegative (HIV‐), and 6 were HIV‐seropositive (HIV+). The HIV+ children were asymptomatic at entry, but by the end of the study, one child had received a diagnosis of AIDS. All subjects were medically well at each time of assessment Standardized measures of general intelligence, academic achievement, neurological development, and problem behaviors were administered to each child every 6 months for 2 years. Both the HIV‐ and HIV+ children performed within age expectations at each time of assessment, and their parents reported very few behavior problems, indicating that the children were adjusting well to chronic illness. Both groups obtained lower achievement test scores than expected for their level of general intellectual ability. Differences were found in the pattern of retest effects for the two groups. There were improvements in Wechsler intelligence test performance over time for the HIV‐ children, but the HIV+ children demonstrated subtle declines in performance on measures of verbal and perceptual abilities. The HIV+ children infected at a younger age (M = 3 years, 11 months) performed more poorly on measures of perceptually related skills and demonstrated more deficient retest effects generally on tasks requiring visual‐motor coordination and perceptual organization than those infected at an older age (M = 9 years, 4 months). In addition, they exhibited more frequent signs of neurological problems than those infected later in life. The findings are discussed in terms of percolation theory, and implications for the children's educational planning are considered.