Early Childhood Development Caregiver Training and Neurocognition of HIV-Exposed Ugandan Siblings

Michael J. Boivin; Jura L. Augustinavicius; Itziar Familiar-Lopez; Sarah M. Murray; Alla Sikorskii; Jorem Awadu; Noeline Nakasujja; Judith K. Bass

doi:10.1097/DBP.0000000000000753

Early Childhood Development Caregiver Training and Neurocognition of HIV-Exposed Ugandan Siblings

Michael J. Boivin, Jura L. Augustinavicius, Itziar Familiar-Lopez, Sarah M. Murray, Alla Sikorskii, Jorem Awadu, Noeline Nakasujja, Judith K. Bass

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Objective:Early childhood development (ECD) programs can enhance neurocognitive development outcomes through caregiver training. This study explores whether school-age siblings benefited from a program provided to HIV-infected caregivers and their preschool-aged target children.Methods:Siblings of target 2-to 3-year-old children in ECD intervention households were evaluated at school age (5-12 years) on neurocognitive outcomes with the Kaufman Assessment Battery for Children (KABC), computerized Test of Variables of Attention, Behavior Rating Inventory for Executive Function (BRIEF; parent), and attention-deficit/hyperactivity disorder rating inventory (ADHD-R)-IV (parent). Households from 18 geographic clusters in eastern Uganda were randomized to individualized biweekly sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation/enrichment or (2) health/nutrition/development [Uganda Community-Based Association For Women & Children Welfare (UCOBAC)] program. Siblings with baseline and at least 1 follow-up assessment (n = 216) were included in the analysis. Three repeated postbaseline measures of sibling neurocognitive outcomes were analyzed using the linear mixed-effects model while adjusting for socioeconomic status and behavioral outcome at baseline.Results:Siblings in the MISC arm had better performance on KABC sequential processing at 6 months (p = 0.02) and simultaneous processing at 12 months (p = 0.03). MISC mothers rated their children as having significantly more problems on the BRIEF and ADHD-RS-IV (p < 0.01) than UCOBAC mothers across all time points.Conclusion:Mediational Intervention for Sensitizing Caregivers training resulted in some short-term neurocognitive benefits for school-aged siblings, but these differences were not sustained at 1-year follow-up. Exploring potential impacts of parenting programs on other children in the home is an important development for the field.

Original language	English (US)
Pages (from-to)	221-229
Number of pages	9
Journal	Journal of Developmental and Behavioral Pediatrics
Volume	41
Issue number	3
DOIs	https://doi.org/10.1097/DBP.0000000000000753
State	Published - Apr 1 2020

Keywords

HIV
caregiver training
early childhood development
neurocognition
neuropsychology

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology
Psychiatry and Mental health

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10.1097/DBP.0000000000000753

Cite this

@article{a80421865fd14f7cad5e111ddb3b4177,

title = "Early Childhood Development Caregiver Training and Neurocognition of HIV-Exposed Ugandan Siblings",

abstract = "Objective:Early childhood development (ECD) programs can enhance neurocognitive development outcomes through caregiver training. This study explores whether school-age siblings benefited from a program provided to HIV-infected caregivers and their preschool-aged target children.Methods:Siblings of target 2-to 3-year-old children in ECD intervention households were evaluated at school age (5-12 years) on neurocognitive outcomes with the Kaufman Assessment Battery for Children (KABC), computerized Test of Variables of Attention, Behavior Rating Inventory for Executive Function (BRIEF; parent), and attention-deficit/hyperactivity disorder rating inventory (ADHD-R)-IV (parent). Households from 18 geographic clusters in eastern Uganda were randomized to individualized biweekly sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation/enrichment or (2) health/nutrition/development [Uganda Community-Based Association For Women & Children Welfare (UCOBAC)] program. Siblings with baseline and at least 1 follow-up assessment (n = 216) were included in the analysis. Three repeated postbaseline measures of sibling neurocognitive outcomes were analyzed using the linear mixed-effects model while adjusting for socioeconomic status and behavioral outcome at baseline.Results:Siblings in the MISC arm had better performance on KABC sequential processing at 6 months (p = 0.02) and simultaneous processing at 12 months (p = 0.03). MISC mothers rated their children as having significantly more problems on the BRIEF and ADHD-RS-IV (p < 0.01) than UCOBAC mothers across all time points.Conclusion:Mediational Intervention for Sensitizing Caregivers training resulted in some short-term neurocognitive benefits for school-aged siblings, but these differences were not sustained at 1-year follow-up. Exploring potential impacts of parenting programs on other children in the home is an important development for the field.",

keywords = "HIV, caregiver training, early childhood development, neurocognition, neuropsychology",

author = "Boivin, {Michael J.} and Augustinavicius, {Jura L.} and Itziar Familiar-Lopez and Murray, {Sarah M.} and Alla Sikorskii and Jorem Awadu and Noeline Nakasujja and Bass, {Judith K.}",

note = "Funding Information: Received February 2019; accepted September 2019. Supported by National Institutes of Health grants RO1 HD070723 and HD070723S1 (PIs: M. J. Boivin and J. K. Bass). S. M. Murray was supported by NIMH Global Mental Health training grant (MH103210). The study sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Disclosure: The authors declare no conflict of interest. Publisher Copyright: {\textcopyright} 2020 Lippincott Williams and Wilkins. All rights reserved.",

year = "2020",

month = apr,

day = "1",

doi = "10.1097/DBP.0000000000000753",

language = "English (US)",

volume = "41",

pages = "221--229",

journal = "Journal of Developmental and Behavioral Pediatrics",

issn = "0196-206X",

publisher = "Lippincott Williams and Wilkins",

number = "3",

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T1 - Early Childhood Development Caregiver Training and Neurocognition of HIV-Exposed Ugandan Siblings

AU - Boivin, Michael J.

AU - Augustinavicius, Jura L.

AU - Familiar-Lopez, Itziar

AU - Murray, Sarah M.

AU - Sikorskii, Alla

AU - Awadu, Jorem

AU - Nakasujja, Noeline

AU - Bass, Judith K.

N1 - Funding Information: Received February 2019; accepted September 2019. Supported by National Institutes of Health grants RO1 HD070723 and HD070723S1 (PIs: M. J. Boivin and J. K. Bass). S. M. Murray was supported by NIMH Global Mental Health training grant (MH103210). The study sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Disclosure: The authors declare no conflict of interest. Publisher Copyright: © 2020 Lippincott Williams and Wilkins. All rights reserved.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Objective:Early childhood development (ECD) programs can enhance neurocognitive development outcomes through caregiver training. This study explores whether school-age siblings benefited from a program provided to HIV-infected caregivers and their preschool-aged target children.Methods:Siblings of target 2-to 3-year-old children in ECD intervention households were evaluated at school age (5-12 years) on neurocognitive outcomes with the Kaufman Assessment Battery for Children (KABC), computerized Test of Variables of Attention, Behavior Rating Inventory for Executive Function (BRIEF; parent), and attention-deficit/hyperactivity disorder rating inventory (ADHD-R)-IV (parent). Households from 18 geographic clusters in eastern Uganda were randomized to individualized biweekly sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation/enrichment or (2) health/nutrition/development [Uganda Community-Based Association For Women & Children Welfare (UCOBAC)] program. Siblings with baseline and at least 1 follow-up assessment (n = 216) were included in the analysis. Three repeated postbaseline measures of sibling neurocognitive outcomes were analyzed using the linear mixed-effects model while adjusting for socioeconomic status and behavioral outcome at baseline.Results:Siblings in the MISC arm had better performance on KABC sequential processing at 6 months (p = 0.02) and simultaneous processing at 12 months (p = 0.03). MISC mothers rated their children as having significantly more problems on the BRIEF and ADHD-RS-IV (p < 0.01) than UCOBAC mothers across all time points.Conclusion:Mediational Intervention for Sensitizing Caregivers training resulted in some short-term neurocognitive benefits for school-aged siblings, but these differences were not sustained at 1-year follow-up. Exploring potential impacts of parenting programs on other children in the home is an important development for the field.

AB - Objective:Early childhood development (ECD) programs can enhance neurocognitive development outcomes through caregiver training. This study explores whether school-age siblings benefited from a program provided to HIV-infected caregivers and their preschool-aged target children.Methods:Siblings of target 2-to 3-year-old children in ECD intervention households were evaluated at school age (5-12 years) on neurocognitive outcomes with the Kaufman Assessment Battery for Children (KABC), computerized Test of Variables of Attention, Behavior Rating Inventory for Executive Function (BRIEF; parent), and attention-deficit/hyperactivity disorder rating inventory (ADHD-R)-IV (parent). Households from 18 geographic clusters in eastern Uganda were randomized to individualized biweekly sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation/enrichment or (2) health/nutrition/development [Uganda Community-Based Association For Women & Children Welfare (UCOBAC)] program. Siblings with baseline and at least 1 follow-up assessment (n = 216) were included in the analysis. Three repeated postbaseline measures of sibling neurocognitive outcomes were analyzed using the linear mixed-effects model while adjusting for socioeconomic status and behavioral outcome at baseline.Results:Siblings in the MISC arm had better performance on KABC sequential processing at 6 months (p = 0.02) and simultaneous processing at 12 months (p = 0.03). MISC mothers rated their children as having significantly more problems on the BRIEF and ADHD-RS-IV (p < 0.01) than UCOBAC mothers across all time points.Conclusion:Mediational Intervention for Sensitizing Caregivers training resulted in some short-term neurocognitive benefits for school-aged siblings, but these differences were not sustained at 1-year follow-up. Exploring potential impacts of parenting programs on other children in the home is an important development for the field.

KW - HIV

KW - caregiver training

KW - early childhood development

KW - neurocognition

KW - neuropsychology

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Early Childhood Development Caregiver Training and Neurocognition of HIV-Exposed Ugandan Siblings

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