Language and oral-motor development and disorders in infants and young toddlers with human immunodeficiency virus

The Value of a Motor Intervention for 3 to 6-Year-Old Children Infected with and Affected by HIV

Human immunodeficiency virus (HIV)/Aquired Immune Deficiency Syndrome (AIDS) is a large threat to human health and is challenging to address. This study aims to determine if motor intervention is a possibility for promoting the life expectancy and quality of life of children with HIV. The group consisted of 22 participants: 11 HIV-infected (51.73 months, SD 10.15) and 11 HIV-affected children (44.45 months, SD 10.76). A two-group (intervention and control group) pre-test−post-test research design was followed. The HIV-infected and affected children were randomly matched and grouped into an intervention and control group. The intervention group participated in a 12-week motor intervention of 60 min per session, twice per week. The effect of the program was analyzed with regard to motor skills, as established by the PDMS-2 and two strength capabilities. An ANCOVA adjusted for pre-test differences (p < 0.05) indicated statistically significant improvement (p < 0.05) with large practical significance (d > 0.8) in locomotor, fine motor and overall motor skills. The infected children also showed better improvement compared to the affected children. Motor intervention is recommended in the health care path of children affected and infected with HIV, although modifications for improvement of the program are suggested, based on the results attained.

Incidence and description of dysphagia in infants and toddlers with tracheostomies: a retrospective review

OBJECTIVE

An increasing number of infants and toddlers with tracheostomies were identified at a large paediatric referral hospital in South Africa. They are at risk for swallowing and feeding difficulties, however, there is limited literature reporting the incidence and describing the dysphagia in this population, and no literature specific to a developing country. The purpose of this study was therefore to report the incidence and describe the dysphagia in infants and toddlers with tracheostomies at a large paediatric referral hospital in South Africa.

METHOD

A retrospective, descriptive review of the medical records of 80 infants and toddlers (0-3 years) with tracheostomies between 2002 and 2004 was conducted.

RESULTS

Eighty percent (64/80) of the participants presented with dysphagic symptoms. Oral phase dysphagia was reported in 81.25% (52/64), pharyngeal phase dysphagia in 60.9% (39/64) and oesophageal phase dysphagia in 79.7% of the dysphagic participants.

CONCLUSIONS

Infants and toddlers with tracheostomies are at increased risk for dysphagia. Multiple risk factors for dysphagia associated with tracheostomies, underlying medical conditions and the context of a developing country were identified in the study population.

Swallowing Difficulties Reported by Adults Infected with HIV/AIDS Attending a Hospital Outpatient Clinic in Gauteng, South Africa

OBJECTIVE

Swallowing difficulties can exert a profound effect on quality of life, may result in reduced nutritional intake and place individuals at risk of aspiration. However, there is little data available on the swallowing difficulties occurring within the HIV/AIDS population in South Africa. A descriptive study was therefore conducted to document the presence of reported swallowing difficulties in a sample of adults with HIV.

PATIENTS AND METHODS

One-to-one semi-structured interview schedules were administered to 120 adults with HIV attending a clinic in Gauteng, and medical records were evaluated to document the presence of reported swallowing difficulties.

RESULTS

Participants described a range of swallowing difficulties and the number of swallowing difficulties reported by participants was negatively correlated with CD4 count. Swallowing difficulties were significantly associated with various opportunistic diseases and related medical pathologies. Prescribed medications were associated with reported swallowing difficulties. Treatment of swallowing difficulties was mainly medical in nature. Swallowing difficulties had affected quality of life.

CONCLUSIONS

From the results it was concluded that speech therapists have a role to play in the assessment and treatment of swallowing difficulties in individuals with HIV/AIDS.

HIV and communication

The human immunodeficiency virus (HIV) continues to plague many countries across the globe, including the United States, Africa, China and India. Children and adults have been infected with HIV, and both populations can present with communication disorders that coexist with the presence of the virus. The purpose of this paper is to present an overview of HIV and a discussion of the types of conditions that impact communication in both pediatric and adult populations. Persons living with HIV may present with disorders in the areas of language, phonology, voice and swallowing. Given the advances in pharmacological management of HIV, speech-language pathologists need to be knowledgeable of how medications can impact communication and swallowing. Also, since HIV crosses the blood-brain barrier and impacts all aspects of an infected person's life, speech-language and hearing professionals need to be members of the interdisciplinary teams that assess and manage patients living with HIV. Specific information regarding communication disorders in the pediatric population and research issues that warrant continued investigation will be addressed.

LEARNING OUTCOMES

The reader will become aware of the ways in which a speech-language pathologist or audiologist may become involved with a patient infected with HIV or AIDS. The reader will learn the specific manners in which HIV and AIDS may affect the speech, language, hearing, and swallowing of pediatric and adult patients, as well as the appropriate intervention philosophies.