Cognitive Assessment of Human Immunodeficiency Virus-Exposed Children

• Objective. —To determine (1) the level of impairment in cognitive and motor functioning in human immunodeficiency virus (HIV)-exposed and HIV-infected preschool and school-age children; (2) cognitive strengths and weaknesses that characterize HIV-infected children; and (3) potential contributions of serostatus, neurologic impairment, and prenatal drug-exposure to cognitive functioning. Design. —Cross-sectional, single-blind study. Setting. —Pediatric neurology clinic at a large metropolitan hospital in New York, NY. Participants. —Forty-one HIV-infected and eight seroreverter school-age children. Interventions. —The McCarthy Scales of Children's Abilities were administered to all children, as was the Neurologic Examination for Children. Measurements/Main Results. —The obtained mean of the sample on the McCarthy Scales' General Cognitive Index was in the Borderline range, with 44% of the subjects scoring in the Mentally Retarded range. The most severe cognitive deficits were found on the Quantitative, Verbal, and Memory scales (Borderline range). Children infected with HIV with neurologic impairment performed significantly worse than did seroreverters and neurologically normal HIV-infected children. There were no significant differences in cognitive functioning due to gender, ethnicity, and prenatal drug exposure. Conclusions. —Cognitive deficits were detected in HIV-infected and seroreverted children. The presence of neurologic dysfunction in HIV-infected children markedly intensified these deficits. ( AJDC . 1992;146:1479-1483)