This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Coplan, J.
Right arrow Articles by Kirkwood, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Coplan, J.
Right arrow Articles by Kirkwood, K.
Related Collections
Right arrow Infectious Disease & Immunity

PEDIATRICS Vol. 102 No. 1 July 1998, p. e8

ELECTRONIC ARTICLE:
Early Language Development in Children Exposed to or Infected With Human Immunodeficiency Virus

Received May 28, 1997; accepted Feb 6, 1998.

James Coplan, Kathie A. Contello, Coleen K. Cunningham, Leonard B. Weiner, Timothy D. Dye, Linda Roberge, Martha A. Wojtowycz, and Kim Kirkwood

From the Departments of Pediatrics and Obstetrics and Gynecology, State University of New York, Health Science Center, Syracuse, New York.

Objectives.  To compare language development in infants and young children with human immunodeficiency virus (HIV) infection to language development in children who had been exposed to HIV but were uninfected, and (among subjects with HIV infection) to compare language development with cognitive and neurologic status.

Design.  Prospective evaluation of language development in infected and in exposed but uninfected infants and young children.

Setting.  Pediatric Infectious Disease Clinic, State University of New York-Health Science Center at Syracuse.

Subjects.  Nine infants and young children infected with HIV and 69 seropositive but uninfected infants and children, age 6 weeks to 45 months.

Results.  Mean Early Language Milestone Scale, 2nd edition (ELM-2) Global Language scores were significantly lower for subjects with HIV infection, compared with uninfected subjects (89.3 vs 96.2, Mann-Whitney U test). The proportion of subjects scoring >2 SD below the mean on the ELM-2 on at least one occasion also was significantly greater for subjects with HIV infection, compared with uninfected subjects (4 of 9 infected subjects, but only 5 of 69 uninfected subjects; Fisher's exact test). Seven of the 9 subjects with HIV infection manifested deterioration of language function. Four manifested unremitting deterioration; only 1 of these 4 demonstrated unequivocal abnormality on neurologic examination. Three subjects with HIV infection and language deterioration showed improvement in language almost immediately after the initiation of antiretroviral drug treatment. Magnetic resonance imaging or computed tomography of the brain were performed in 6 of 7 infected subjects with language deterioration, and findings were normal in all 6. ELM-2 Global Language scaled scores showed good agreement with the Bayley Mental Developmental Index or the McCarthy Global Cognitive Index (r = 0.70). Language deterioration, or improvement in language after initiation of drug therapy, coincided with or preceded changes in global cognitive function, at times by intervals of up to 12 months.

Conclusions.  Language deterioration occurs commonly in infants and young children with HIV infection, is seen frequently in the absence of abnormalities on neurologic examination or central nervous system imaging, and may precede evidence of deterioration in global cognitive ability. Periodic assessment of language development should be added to the developmental monitoring of infants and young children with HIV infection as a means of monitoring disease progression and the efficacy of drug treatment.

Key words: language, speech, HIV, children, development.




This article has been cited by other articles:


Home page
 Arch. Dis. Child.Home page
S Resino, J M Bellon, S Sanchez-Ramon, D Gurbindo, J Ruiz-Contreras, J A Leon, J T Ramos, and M A Munoz-Fernandez
Impact of antiretroviral protocols on dynamics of AIDS progression markers
Arch. Dis. Child., February 1, 2002; 86(2): 119 - 124.
[Abstract] [Full Text] [PDF]