Evidence suggests that children with the human immunodeficiency virus (HIV) may experience difficulties with sustained attention, an important skill for academic success and daily functioning. While the exact cause of this difficulty is unknown, it likely arises from a combination of factors. Research suggests that effects of the virus, compromised child-caregiver interactions, and challenges surrounding food and basic healthcare may all influence the neurocognitive development of children with HIV and possibly result in difficulties with sustained attention. The present study aimed to evaluate the effects of an intervention to enhance caregiver-child interactions, the Mediational Intervention for Sensitizing Caregivers (MISC), and an intervention to improve knowledge about and access to healthcare and nutrition on the sustained attention skills of young Ugandan children with HIV. Semi-extant data for 111 caregiver-child dyads were used in the present study. These dyads were grouped by geographic region of residence and then groups were randomly assigned to one of two interventions. One group received a health and nutrition education intervention and the other received MISC. Both groups received nutritional supplements in the form of monthly food packages. Children’s sustained attention was measured at baseline, six months into the intervention, and at the conclusion of the yearlong intervention using the Early Childhood Vigilance Task (ECVT). Mixed-effects modeling was used to examine the effects of the two interventions while controlling for children’s age, children’s gender, children’s viral load, children’s HAART status, children’s height and weight, children’s exposure to video screens, use of a translator during the intervention, caregiver depression, and caregiver functioning. Mixed-effects modeling was also used to examine how the length of the interventions influenced sustained attention skills. Finally, a path analysis was used to evaluate how caregiver depression, caregiver functioning, and child viral load were related to children’s sustained attention before intervention.The results indicated that both intervention groups made significant gains in sustained attention across the yearlong intervention. However, there was no significant difference between the gains made by the two groups. The gains made in the second six months of the intervention were significantly different than the gains made in the first six months of the intervention, such that significant gains were made during the second half of the intervention and not during the first half. This finding did not differ between groups. Finally, the proposed conceptual model that was tested to examine the relation of child and caregiver variables to children’s sustained attention skills at baseline was found to have good overall fit. Evaluation of the specific paths in the model indicated that the proposed pathways do not explain baseline performance in children’s sustained attention skills. Overall, this study highlights the potential benefits of interventions addressing health, nutrition, and caregiver-child interactions for young children with HIV. This study also provides a foundation for future research to examine additional questions surrounding interventions to promote sustained attention growth in children with HIV and to better understand the factors that contribute to sustained attention skills in children with HIV.
Read
