Effects of Individual,Peer, and Family Factors on Child Alcohol Abuse in Ukraine

The present study aims to estimate the relationship between child alcohol problems, sociodemographic characteristics, externalizing behavior, parental and peer alcohol use, and family violence by using a cross-sectional community sample of 320 Ukrainian children (9–16 years of age, 50% boys) and their parents. Participants answered questions from the Drinking and Drug History and Current Use Patterns Questionnaire, the Revised Conflict Tactics Scales, the Alabama Parenting Questionnaire, and the Child Behavior Checklist. Fifty-two percent of children reported alcohol use within the past year and 32% experienced alcohol-related problems. The average number of reported alcohol problems was 11.19 (SD?=?63.65). Five robust regression models examined correlates of early problem drinking in Ukraine. The final model indicated older child age (β?=?0.21, p?<?0.001), more symptoms of externalizing behavior (β?=?0.17, p?<?0.01), and higher peer alcohol use (β?=?0.23, p?<?0.001) were significantly and positively associated with child alcohol problems. Results of the final model explained 32% of the variance in child alcohol problems, F(8, 311)?=?10.76, p?<?0.001. In conclusion, the findings suggest that older age, exposure to high-risk alcohol permeated peer environments, impulsivity, and rule-breaking behaviors are linked with the trajectory of early alcohol abuse among Ukrainian children. Mechanisms that reduce the harmful influence of these risk factors on alcohol consumption need to be in place.     

Association between Child Abuse and Health Risk Behaviors among Chinese College Students

Little is known about the link between child abuse and health risk behaviors among Chinese college students. This cross-sectional study examined the prevalence of child abuse and its relations with individual and clusters of health risk behaviors among Chinese college students. A total of 507 students participated in this survey. The prevalence of child abuse from the highest to the lowest was emotional neglect (53.9%), physical neglect (49.0%), emotional abuse (21.8%), physical abuse (18.3%), and sexual abuse (18.1%), respectively. Males were more likely to report child abuse than females (p?<?0.01). For males, emotional abuse was associated with internet addiction [OR?=?2.28; 95%CI (1.00, 5.20)] and suicidal behavior [OR?=?12.47, 95%CI (2.61, 59.54)]; while sexual abuse was associated with internet addiction [OR?=?2.30, 95%CI (1.14, 4.66)]. For females, emotional abuse was significantly associated with increased risks for self-harm behavior [OR?=?15.03, 95%CI (3.59, 63.07)] and suicidal behavior [OR?=?5.16, 95%CI (1.63, 16.40)]. Physical abuse was related to risks for internet addiction [OR?=?2.50, 95%CI (1.03, 6.04)] significantly. Two-step cluster analysis showed that participants in clusters with more health risk behaviors reported higher scores of child abuse. These findings suggest that child abuse was associated with both individual and clustering of health risk behaviors among Chinese college students.     

Socioeconomic Factors in Relation to Discrepancy in Parent versus Teacher Ratings of Child Behavior

Discrepancies between observers are common in studies of child behavior problems that rely on behavior ratings. Although modest concordance between informants is well-documented, little is known about characteristics that predict discrepancies. In 477 children aged 5 to 12 years, maternal age and indicators of socioeconomic status (SES; maternal education, family income) were evaluated in relation to score discrepancies between the Child Behavior Checklist and Teacher Report Form for Total, Externalizing and Internalizing Problems. Family income <?$35,000 was independently associated with discrepancies in which mothers rated more clinically significant child behavior problems than teachers for Total, Externalizing and Internalizing Problems [odds ratio (OR)?=?3.26, 95 % confidence interval (CI), 1.19–8.96, OR?=?2.76, 95 % CI 1.03–7.34 and OR?=?3.07, 95 % CI 1.30–7.26, respectively]. Maternal education was not associated with discrepancies, but younger mothers were less likely to rate child’s behavior in the clinical range for Externalizing Problems than teachers (OR per year of age?=?0.88, 95 % CI 0.81–0.96). These results suggest that studies that utilize only maternal or teacher report of child behavior may have misclassification of outcomes that is dependent on SES and could produce biased results.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Acquiring a Taste: Alcohol Experiences of German Elementary School Children

Few data are available on alcohol experiences among elementary school children, although early onset and trying of alcohol use is known to be a risk factor for adolescent alcohol abuse. Until now, research leaves open the question on which factors encourage early trying behavior. In a cross-sectional study design, a written survey was conducted in 49 randomly selected elementary schools in Germany. The survey was carried out among 3rd and 4th graders with a median age of 9 years during class time in the school year 2010/2011. 1806 questionnaires were included in the study. The risk behavior of having tried alcohol was analyzed. A total of 37.7% (n = 681) of all children reported to have already tried alcohol. While grade and age had no significant influence in the final multivariate model, the gender effect stayed relevant (Male: aOR 1.2, 95%-CI 1.0–1.5), as did the question of whether the child liked going to school (No: aOR 1.4, 95%-CI 1.1–1.7), a lack of parental monitoring (aOR 1.5, 95%-CI 1.1–2.1), consistent parenting (Sometimes/never: aOR 1.5, 95%-CI 1.1–1.9), a regularly provided break-time snack (No: aOR 2.2, 95%-CI 1.3–3.8), as well as parents’ drinking (Yes: aOR 2.0, 95%-CI 1.6–2.6) and drinking among peers (Yes: aOR 8.5, 95%-CI 6.2–11.6). Our study shows that alcohol experiences can be highly prevalent among 3rd and 4th grade elementary school children in Germany. Our findings suggest that especially those variables which may be controlled by the parents are strongly associated with children’s alcohol experiences suggesting a starting point for preventative intervention measures. The results also indicate the need for innovative gender-sensitive approaches in the living environment of elementary school children.     

CAREGIVER'S DEPRESSIVE SYMPTOMS AND YOUNG CHILDREN'S SOCIOEMOTIONAL DEVELOPMENT DELAYS: A CROSS‐SECTIONAL STUDY IN POOR RURAL AREAS OF CHINA

Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross‐sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face‐to‐face caregiver interviews. DS were assessed by the Zung Self‐Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, 2016b ), and SED was evaluated by the Ages and Stage Questionnaires: Social‐Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ² test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low‐income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single‐parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.     

Mothers’ Mental Health Treatment Associated with Greater Adolescent Mental Health Service Use for Depression

Despite concerns surrounding depression in adolescence and the existence of effective treatments, adolescent depression often goes untreated. In 2014, only 41.2% of adolescents experiencing a major depressive episode (MDE) received mental health treatment. Parents play a key role in adolescents’ treatment utilization. We examined whether among mothers with any mental illness, mothers’ utilization of mental health treatment was associated with greater likelihood of their adolescent children who experienced an MDE receiving mental health treatment. Using nationally representative data from the National Survey on Drug Use and Health (2008–2014), we performed logistic regression analysis to model the odds of adolescents (aged 12 to 17 years) with a past year MDE receiving any mental health treatment in the past year as a function of their mothers’ mental health treatment utilization in the past year, adjusting for control variables. The rate of adolescent treatment utilization was 66% when mothers had utilized treatment, as compared to 45% when mothers did not utilize treatment (p?<?0.001). The odds of an adolescent with an MDE receiving mental health treatment were two times greater when the mother received mental health treatment as compared to adolescents whose mothers did not receive any mental health treatment (OR?=?2.09, 95% CI [1.04, 4.17]). There was no effect of adolescent gender (OR?=?1.15, 95% CI [0.40, 3.28]) or interaction between gender and mothers’ treatment (OR?=?0.95, 95% CI [0.26, 3.46]). Barriers to adolescent mental health treatment may be lower when mothers receive mental health treatment.     

Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: findings from a community-recruited sample

In India men who have sex with men (MSM) are a stigmatized and hidden population, vulnerable to a variety of psychosocial and societal stressors. This population is also much more likely to be HIV-infected compared to the general population. However, little research exists about how psychosocial and societal stressors result in mental health problems. A confidential, quantitative mental-health interview was conducted among 150 MSM in Mumbai, India at The Humsafar Trust, the largest non-governmental organization serving MSM in India. The interview collected information on sociodemographics and assessed self-esteem, social support and DSM-IV psychiatric disorders using the Mini International Neuropsychiatric Interview (MINI). Participants' mean age was 25.1 years (SD?=?5.1); 21% were married to women. Forty-five percent reported current suicidal ideation, with 66% low risk, 19% moderate risk, and 15% high risk for suicide per MINI guidelines. Twenty-nine percent screened in for current major depression and 24% for any anxiety disorder. None of the respondents reported current treatment for any psychiatric disorder. In multivariable models controlling for age, education, income, and sexual identity, participants reporting higher levels of self-esteem and greater levels of satisfaction with the social support they receive from family and friends were at lower risk of suicidality (self-esteem AOR?=?0.85, 95% CI: 0.78-0.93; social support AOR?=?0.76, 95% CI: 0.62-0.93) and major depression (self-esteem AOR?=?0.79, 95% CI: 0.71-0.89; social support AOR?=?0.68, 95% CI: 0.54-0.85). Those who reported greater social support satisfaction were also at lower risk of a clinical diagnosis of an anxiety disorder (AOR?=?0.80; 95% CI: 0.65-0.99). MSM in Mumbai have high rates of suicidal ideation, depression, and anxiety. Programs to improve self-esteem and perceived social support may improve these mental health outcomes. Because they are also a high-risk group for HIV, MSM HIV prevention and treatment services may benefit from incorporating mental health services and referrals into their programs.     

Stigma Towards Homosexuality and AIDS Among Students of a Large Hispanic-Serving University

Homosexuality and AIDS-related stigma lead to failures in testing, disclosure of HIV status, and treatment for HIV. This study explored stigma towards AIDS and homosexuality among students of a large Hispanic-serving university in the southeastern United States (US). An online anonymous survey was emailed to 8000 randomly selected students. Two multiple choice questions about attitudes towards a professor with AIDS and a gay classmate were analyzed using Chi-square tests, simple and multivariable logistic regression to examine the association of stigma with other factors. Most (60%) of the 632 respondents were women. Only 7.8% of study participants reported stigmatizing attitudes of wanting to drop a class, sitting further away from, or feeling less comfortable in a class with a professor diagnosed with AIDS. Similarly, 7.8% of respondents would stigmatize a gay classmate by trying to avoid social contact or feeling uncomfortable talking with him. Males (adjusted odds ratio [AOR] 3.71, 95% confidence interval [CI] 1.95, 7.04) and non-Hispanic students (AOR 2.03, 95% CI 1.08, 3.81) had a higher—and those born in the US had a lower (AOR 0.43, 95% CI 0.23, 0.81)—odds of stigmatizing a gay classmate. No variables were significantly associated with stigmatizing attitudes towards a professor with AIDS. Stigmatizing attitudes towards a faculty member with AIDS or a gay classmate do not appear to be a major problem among students at this Hispanic-serving university. Interventions designed to further reduce gay-related stigma might focus on non-Hispanic young men who are born outside of the United States.     

Relationship Between Social Relations and Mortality of Older Japanese People Living Alone

The association of social relations with mortality was studied over a 54-month period in 535 older Japanese people living alone. Sex-specific proportional hazard analyses indicated that finding it difficult to establish and maintain relationships with other people was significantly related to mortality, regardless of age, general health status, history of health management, psychological conditions, or economic status. The adjusted hazard ratio for finding relations with other people difficult was 4.61 [95% confidence interval (CI): 1.39–15.30] for men and 4.56 (95% CI: 2.19–9.48) for women. The adjusted hazard ratio for nonparticipation in social activities was 1.45 (95% CI: 0.42–4.97) for men and 1.72 (95% CI: 0.70–4.22) for women and did not reach statistical significance. On the other hand, there was a gender difference in the direction of the association between a low-level contact with children, siblings, or other relatives and mortality, for which the adjusted hazard ratio was 3.16 (95% CI: 0.94–10.62) for men and 0.51 (95% CI: 0.27–0.97) for women. These results suggest the need to create a different model for the relationship between social relations and mortality for men and for women living alone.     

The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

The Children’s Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5.5 ? 12.9 years) to the randomized controlled trial. Over 22 weeks, children randomized to the CATTS service delivery model received six sessions of telepsychiatry and six sessions of caregiver behavior management training provided in person by community therapists who were trained and supervised remotely. Children randomized to the comparison Augmented Primary Care (APC) service model received management in primary care augmented by a single telepsychiatry consultation. Caregiver outcomes included changes in distress, as measured by the Patient Health Questionnaire (PHQ-9), Parenting Stress Index (PSI), Caregiver Strain Questionnaire (CSQ) and Family Empowerment Scale (FES). Caregivers completed five assessments. Multilevel mixed effects regression modeling tested for differences between the two service delivery models in caregiver outcomes from baseline to 25 weeks. Compared to caregivers of children in the APC model, caregivers of children in the CATTS service model showed statistically significantly greater improvements on the PHQ-9 (β?=?-1.41, 95 % CI?=?[?2.74, ?0.08], p?<?.05), PSI (β?=??4.59, 95 % CI?=?[?7.87, ? 1.31], p?<?.001), CSQ (β?=??5.41, 95 % CI?=?[? 8.58, ?2.24], p?<?.001) and FES (β?=?6.69, 95 % CI?=?[2.32, 11.06], p?<?.01). Improvement in child ADHD symptoms mediated improved caregiver scores on the PSI and CSQ. Improvement in child ODD behaviors mediated caregiver CSQ scores. The CATTS trial supports the effectiveness of a hybrid telehealth service delivery model for reducing distress in caregivers of children with ADHD and suggests a mechanism through which the service model affected caregiver distress.     

Integrated Treatment Programmes for Mothers with Substance Use Problems: A Systematic Review and Meta-analysis of Interventions to Prevent Out-of-home Child Placements

Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.

     

Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b?=?0.034, SE?=?0.01, p?<?0.001), child ODD (b?=?0.053, SE?=?0.02, p?<?0.01), and caregiver depression (b?=?0.049, SE?=?0.02, p?<?0.01). Family rules significantly related to caregiver depression (b?=?0.228, SE?=?0.11, p?<?0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.

     

Hazardous Alcohol Use among Persons Living with Human Immunodeficiency Virus Infection in the Eastern Cape,South Africa

The study assessed the prevalence of hazardous alcohol use among people living with HIV (PLHIV) and its correlates with socio-economic characteristics, disease variables and ART adherence in South Africa. The sample included 607 PLHIV (males =475, females =132; age range =18–61), sampled by all districts in the Eastern Cape. Participants were recruited through a health facility in the community through key informants or a support group. Results indicate that male PLHIV were more often than female PLHIV “past month” (18.9% vs. 6.1%) and hazardous alcohol drinkers (6.1% vs. 2.7%); using a cut-off score of 8 and more on the Alcohol Use Disorders Identification Test (AUDIT). Not having a disability grant for HIV/AIDS and the disability grant terminated were both related to past month alcohol use, while having the “disability grant stopped” was also related with hazardous or harmful drinking. Not having an AIDS diagnosis and not being on ART were both associated with past month alcohol use and hazardous or harmful drinking. CD4 counts and non-adherence to ART were both not significantly related with alcohol use status. Brief health provider initiated alcohol interventions for PLHIV should be promoted, with emphasis on targeting men.     

College Students With Military Experience Report Greater Alcohol-Related Consequences

This study examined associations among military experience, alcohol use, and alcohol-related consequences among a large national sample of 27,249 students pursuing postsecondary education. Because of the uniqueness of the developmental period of emerging adulthood, we stratified all analyses by age groups of 18–24 and 25 and older. There were no differences between students with and without military service history in terms of 3 indicators of alcohol use: alcohol consumption in the last 30 days, binge drinking in the last 2 weeks, and drinking and driving in the last 30 days. There were, however, several differences in self-reported consequences of drinking. Among individuals ages 18–24, students with military service history had nearly twofold increased odds of police encounters as a consequence of drinking (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] [1.02, 3.57]) and increased odds greater than twofold of experiencing nonconsensual sex (aOR = 2.68, 95% CI [1.17, 6.19]). Among both age groups, students with military service history reported greater odds of having unprotected sex as a consequence of drinking when compared to students without military service history. Research is needed to identify the reasons why alcohol use results in these particular negative consequences for students with military service history, which can inform prevention and intervention efforts.     

Nonmaternal care in infancy and emotional/behavioral difficulties at 4 years old: moderation by family risk characteristics

The authors examined the role of familial risk and child characteristics in the association between the type of child care in infancy (maternal care [MC]) versus nonmaternal care [NMC]) and emotional/behavioral difficulties at 4 years old. Canadian families (N=1,358) with children between 1 and 12 months old were followed over 4 years. Family risks were found to moderate the association between type of child care and physical aggression. MC in infancy was associated with lower levels of physical aggression among children from a low-risk family background but not among those from a high-risk family background. The effect size was small (d=-0.16; confidence interval [CI]=-0.3, -0.01). Family risk and the sex of the child moderated the association between child care and emotional problems. MC in infancy was associated with a lower level of emotional difficulties among girls from low-risk families but not among boys or among children from high-risk families. The effect size was moderate (d=-0.44; CI=-0.65, -0.23). The study indicates that the effect of child care type in infancy varies by family and child characteristics.     

Effects of Deviant Child Behavior on Parental Distress and Alcohol Consumption in Laboratory Interactions

Levels of adult distress and ad lib alcohol consumption following interactions with child confederates were investigated in parents of children with no diagnosable psychiatric disorders. Sixty parents (20 married couples and 20 single mothers) interacted with boys trained to enact behaviors characteristic of either normal children or deviant children with externalizing behavior disorders — attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD). Relative to the normal child role, interactions with deviant confederates were rated as significantly more unpleasant, resulted in feelings of role inadequacy, and produced significantly more anxiety, depression, and hostility. After the interactions, parents were given the opportunity to drink as much of their preferred alcoholic beverage as they desired while anticipating a second interaction with the same child. The participants consumed more alcohol following exposure to deviant as opposed to normal confederates.     

Neurodevelopmental delay among HIV-infected preschool children receiving antiretroviral therapy and healthy preschool children in Soweto, South Africa

Neurodevelopmental delay has been documented in up to 97.5% of HIV-infected children in Soweto who were not yet on antiretroviral treatment (ART). With growing numbers of children in South Africa being successfully treated with ART, the effects of ART on neurocognitive functioning in children require investigation. The objective of this study was to determine the extent of neurodevelopmental delay in stable HIV-infected preschool children (aged five to six years) receiving ART and compare it to an apparently healthy (unconfirmed HIV-status) group of preschool children. Thirty HIV-infected preschool children (virologically and immunologically stable on ART for more than one year) were conveniently sampled from 350 eligible children on ART at the Harriet Shezi Children's Clinic in Soweto, Johannesburg. The comparison group comprised 30 well-nourished preschool children attending the Lilian Ngoyi Primary Health Care Clinic in Soweto for routine immunizations. Each child was assessed using the Griffiths Mental Development Scales-Extended Revised Version (GMDS-ER), at a single point in time. The overall developmental z-scores on GMDS-ER were <-2 (indicating severe delay) in 27 (90%) children in the HIV-infected group compared to 23 (76%) in the comparison group (p?=?0.166). Mental handicap (overall GQ?相似文献