title: The effect of a basic home stimulation programme on the development of young children infected with HIV.
abstract: OBJECTIVE
  The human immunodeficiency virus (HIV) potentially causes a significant encephalopathy and resultant developmental delay in infected children. The aim of this study was to determine whether a home-based intervention programme could have an impact on the neurodevelopmental status of children infected with HIV.
  
  
  METHODS
  A longitudinal, randomized, controlled trial was conducted. A total of 122 children aged less than 2 years 6 months were assigned to either a comparison or an experimental group. Children in the experimental group were given a home stimulation programme that was updated every 3 months. The home programme included activities to promote motor, cognitive, and speech and language development. Children in the comparison group received no developmental intervention. Children were assessed by a blinded assessor at baseline, 6 months, and 12 months using the Bayley Scales of Infant Development, 2nd edition.
  
  
  RESULTS
  The children in this study came from poor socioeconomic backgrounds and their nutritional status was suboptimal. The experimental group included 60 children (30 males, 30 females) with a mean age of 18 months (SD 8.1 mo). The comparison group included 62 children (32 males, 30 females) with a mean age 19 months (SD 8.2 mo). Cognitive and motor development were severely affected at baseline, with 52% of the children having severe cognitive delay and 72% having severe motor delay at baseline. Children in the experimental group showed significantly greater improvement in cognitive (p=0.010) and motor (p=0.020) development over time than children in the comparison group.
  
  
  CONCLUSIONS
  A home stimulation programme taught to the caregiver can significantly improve cognitive and motor development in young children infected with HIV.
authors.affiliation: Department of Physiotherapy, University of the Witwatersrand, and Charlotte Maxeke Johannesburg Hospital, Johannesburg, South Africa. joanne.potterton@wits.ac.za
authors.forename: Joanne
authors.initials: J
authors.lastname: Potterton
authors.forename: Aimee
authors.initials: A
authors.lastname: Stewart
authors.forename: Peter
authors.initials: P
authors.lastname: Cooper
authors.forename: Pieter
authors.initials: P
authors.lastname: Becker
mesh_terms: D000886:Anthropometry; D018791:CD4 Lymphocyte Count; D017028:Caregivers; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D002658:Developmental Disabilities / Q000628:therapy; D004032:Diet; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009048:Motor Skills; D012959:Socioeconomic Factors; D013019:South Africa; D013997:Time Factors; D016896:Treatment Outcome