| Summary: | Research indicates that children with Human Immunodeficiency Virus (HIV) / Acquired Immune
Deficiency Syndrome (AIDS) display a variety of neuro-developmental, cognitive, motor and
nutritional deficiencies (Epstein el al., 1986:678; Davis-McFarland, 2000:20; Blanchette et al.,
2001:50). Research also substantiates a need for additional intervention strategies such as
improved nutrition and exercise programmes to improve the quality of life for HIV-infected
children (Brady, 1994: 18; Stein et al., 1995:3 1 ; Parks & Danoff, 1999:527). The maintenance of
motor skills in above-mentioned children is an important objective for intervention programmes,
especially gross motor skills (Parks & Danoff, 1999:525). Literature indicates that growth
retardation, exhaustion of fat storage and neuro-developmental deficiencies are related to
HIV/AIDS (Aylward et al., 1992:218; Miller & Garg, 1998:368; Davis-McFarland, 2000:20;
Miller et al., 200 1 : 1287). The monitoring of growth status is of outmost importance as children
with serious stunting and wasting run the risk of early death. Growth retardation can also be an
indication of infection or fast disease progression (Bobat et al, 200! :209).
The aim of this study was firstly to determine the state of the motor development of 2, to 6-year
old children infected with HIV and to compare it with that of affected (in that they are not
infected with HIV, but have lost one or both parents to AIDS-related diseases) and non-affected
children. Secondly the study aimed to determine the effect of a motor intervention programme
for 2 to 6-year old children infected with and affected by HIV. A third aim was to determine the
growth status of 2 to 6-year old children infected with HIV and to compare it with that of affected
and non-affected children; and the last aim was to monitor the developmental tendencies of body
composition and growth of 2 to 6-year old children infected with HIV in the course of nine
months and to compare it with that of affected and non-affected children.
The Peabody Developmental Motor Scales-:! (PDMS-2) (Folio & Fewell, 2000), which consist of
six subtests, was used to determine the motor development of the children. Regarding the growth
status the children were subjected to a series of anthropometric measurements of height, weight,
circumference (upper arm - both tonic and relaxed), as well as skin folds (triceps, sub-scapular,
calf), in accordance with standard procedures as prescribed by the International Society of
Advanced Kinanthropometry (ISAK).
The data was analysed using Statistica for Windows (Statsoft-, Inc S.A., 2001) and SAS (2000-
2003). Descriptive statistics were used to determine means (M), standard deviations (SD) and
maximum and minimum values. One-way variance of analysis, forward stepwise discriminant
analysis, independent T-testing, dependant T-testing and an ANCOVA, repeated measures
ANOVA, and Bonferroni post hoc analysis were used to analyse the data in accordance with the
above-mentioned aims. The level of statistic significance was set at p<0,05. Practical
significance of differences (ES) between the testing sessions was calculated by dividing the mean
difference (M) between the two testing sessions by the largest standard deviation (SD), as
recommended by Cohen (1988) and Steyn (1999). Cohen (1988) set the following guidelines for
interpreting practical significance, namely ES = 0,2 (small effect); ES = 0,5 (medium effect) and
ES = 0,8 (large effect). Due to the small number of subjects it was considered practically
significant if this effect size indicated a medium and larger effect.
From the results of the study it seemed that the HIV-infected children performed the poorest of
the groups regarding gross motor, fine motor and total motor skills. This group's gross motor
skills showed larger deficits than their fine motor skills, while loco-motor skills contributed the
most to the discrimination between the groups. The motor intervention programme led to a
statistically significant improvement in loco-motor, fine motor, as well as total motor skills. The
infected children showed better improvement compared to the affected children. The infected
group displayed the poorest growth status of the three groups compared to the Centre for Disease
Control (CDC) growth profiles, although they did not differ significantly from the affected
children. The infected children differed significantly regarding height percentile, fat percentage
and height-for-age 2-score (HAZ) from non-affected children. The infected group also displayed
the least significant effects in the form of growth increases over the nine months monitoring
period.
It can be concluded from the results that motor deficiencies and growth impediments are part OF
the life of HIV infected children. To address these problems, intervention strategies, such as
motor intervention and nutrition programmes are needed. === Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.
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