Approaches to Assessment of Very Young Children in Africa in the Context of HIV

Despite major advances in the treatment and prevention of HIV/AIDS, there remains a significant impact on children living with the disease as well as the many more children secondarily affected by the disease in Africa. Clearly, there are many risk factors influencing the overall development of these children including known neurodevelopmental deficits associated with the disease and environmental factors that impact multiple areas of functioning. Given these complex issues, there is undoubtedly a need to effectively disentangle causes and create effective interventions as early as possible. Although assessment methodologies and interventions are relatively well developed in Western countries, these do not necessarily directly translate to appropriate use in other countries/cultures. This chapter reviews the current status of assessment of very young children in Africa focusing on the impact of exposure to HIV. Specific tests that have been either developed in and/or adapted for use in Africa are reviewed as are adaptation guidelines, considerations regarding the adaptation of tests, practical constraints that exist when choosing assessment appropriate assessment instruments, and other assessment considerations.