DEVELOPMENTAL-CHANGE ASSOCIATED WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN SCHOOL-AGE-CHILDREN WITH HEMOPHILIA

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 var iable 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 developme nt, and problem behaviors were administered to each child every 6 mont hs for 2 years. Both the HIV- and HIV+ children performed within age e xpectations at each time of assessment, and their parents reported ver y few behavior problems, indicating that the children were adjusting w ell to chronic illness. Both groups obtained lower achievement test sc ores than expected for their level of general intellectual ability. Di fferences were found in the pattern of retest effects for the two grou ps. There were improvements in Wechsler intelligence test performance over time for the HIV- children, but the HIV+ children demonstrated su btle declines in performance on measures of verbal and perceptual abil ities. The HIV+ children infected at a younger age (M = 3 years, 11 mo nths) performed more poorly on measures of perceptually related skills and demonstrated more deficient retest effects generally on tasks req uiring visual-motor coordination and perceptual organization than thos e infected at an older age (M = 9 years, 4 months). In addition, they exhibited more frequent signs of neurological problems than those infe cted later in life. The findings are discussed in terms of percolation theory, and implications for the children's educational planning are considered.