Document Detail


A year-long caregiver training program to improve neurocognition in preschool Ugandan HIV-exposed children.
MedLine Citation:
PMID:  23535340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Mediational intervention for sensitizing caregivers (MISC) is a structured program enabling caregivers to enhance their child's cognitive and emotional development through daily interactions. The principal aim was to evaluate if a year-long MISC caregiver training program produced greater improvement in child cognitive and emotional development compared with a control program.
METHODS: One hundred and nineteen uninfected HIV-exposed preschool children and their caregivers were randomly assigned to 1 of 2 treatment arms: biweekly MISC training alternating between home and clinic for 1 year or a health and nutrition curriculum. All children were evaluated at baseline, 6 months, and 1 year with the Mullen Early Learning Scales, Color-Object Association Test for memory, and Achenbach Child Behavior Checklist for psychiatric symptoms. Caregivers were evaluated on the same schedule with the Hopkins Symptoms Checklist-25 for depression and anxiety.
RESULTS: The treatment arms were compared using repeated-measures analysis of covariance with child age, gender, weight, socioeconomic status, caregiving quality, caregiver anxiety, and caregiver education as covariates. The MISC children had significantly greater gains compared to controls on the Mullen Receptive and Expressive Language development, and on the Mullen composite score of cognitive ability. Color-Object Association Test total memory for MISC children was marginally better than controls. No Achenbach Child Behavior Checklist differences between the groups were noted. Caldwell Home Observation for Measurement of the Environment scores and observed mediational interaction scores from videotapes measuring caregiving quality also improved significantly more for the MISC group.
CONCLUSIONS: The MISC enhanced cognitive performance, especially in language development. These benefits were possibly mediated by improved caregiving and positive emotional benefit to the caregiver.
Authors:
Michael J Boivin; Paul Bangirana; Noeline Nakasujja; Connie F Page; Cilly Shohet; Deborah Givon; Judith K Bass; Robert O Opoka; Pnina S Klein
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of developmental and behavioral pediatrics : JDBP     Volume:  34     ISSN:  1536-7312     ISO Abbreviation:  J Dev Behav Pediatr     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-14     Completed Date:  2014-02-10     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  8006933     Medline TA:  J Dev Behav Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-78     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anxiety / psychology
Caregivers / education*,  psychology
Child Development*
Child of Impaired Parents / psychology
Child, Preschool
Cognition
Depression / psychology
Female
HIV Infections / psychology*
Humans
Male
Neuropsychological Tests
Psychiatric Status Rating Scales
Uganda
Grant Support
ID/Acronym/Agency:
D43 NS078280/NS/NINDS NIH HHS; R01 HD070723/HD/NICHD NIH HHS; R01 HD070723/HD/NICHD NIH HHS; R34 MH082663/MH/NIMH NIH HHS; R34 MH084782/MH/NIMH NIH HHS
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