The extent of delay of language, motor, and cognitive development in HIV-positive infants.

PURPOSE The aim of this study was to determine the extent of delay in acquisition of language, cognitive, and motor skills of children infected with human immunodeficiency virus (HIV). METHODS Forty HIV-positive, antiretrovirus-naive children aged 18 to 30 months attending the Harriet Shezi Pediatric HIV clinic at Chris Hani Baragwanath Hospital, Johannesburg, South Africa, were assessed using the Bayley Scales of Infant Development II (BSID II). The facet scoring section was used to descriptively analyze cognitive, language, and motor development. The Mental and Psychomotor Developmental Indices of the BSID II were used to determine the extent of mental and motor delays. RESULTS Mean cognitive development was 7.63 months delayed (P < 0.001) and mean motor development was 9.65 months delayed (P < 0.001), with 97.5% of the sample functioning below expected motor and cognitive age. Eighty-five percent of the sample demonstrated gross motor delay, which was the most adversely affected skill. Language was descriptively analyzed, revealing global language delay in 82.5% of the children. Gross motor delay may be attributed to decreased strength or to HIV encephalopathy. CONCLUSION Cognitive delay may be because of disease progression and structural damage to the brain, and language delay may be attributed to neurological impairment, cognitive delay, or environmental deprivation. Based on these results, infants and children should be referred to physiotherapy to address the gross motor deficits noted.