Teaching program for caregivers improves cognition of Ugandan children infected with HIV

Abstract

In this issue of The Journal, Boivin et al report extensive, objective one-year outcomes measured in 120 dyads of Ugandan children infected with HIV/caregivers prospectively assigned to a caregiver training program aimed to enhance the child's cognitive and social development versus a routine health and nutrition curriculum. Mediational intervention for sensitizing caregivers (MISC) versus routine health interventions were taught in the homes by trained field teams twice weekly. Videos were used to determine fidelity to training. Using the statistical method of between-group repeated-measures ANCOVA comparisons, MISC children had significantly greater gains in visual-spatial, immediate, and total memory. MISC caregivers improved not only on measures of caregiving quality, but also were less depressed. Mortality during the year was lower for MISC children compared with controls. Several aspects of the study and findings are important. The data provide evidence for the MISC approach in children infected with HIV and their affected families. The training is practical, sustainable, culture-appropriate, and benefits both children's cognitive development and caregivers' sense of well-being. The study also reminds us of the extraordinary vulnerabilities of children in families affected with HIV. Article page 1409▶ A Year-Long Caregiver Training Program Improves Cognition in Preschool Ugandan Children with Human Immunodeficiency VirusThe Journal of PediatricsVol. 163Issue 5PreviewTo evaluate 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. Full-Text PDF